a predictive tool for an effective use of 18f-fdg pet in assessing activity of sarcoidosis预测工具的有效使用18 f-fdg宠物在评估活动的结节病.pdfVIP

Mostard et al. BMC Pulmonary Medicine 2012, 12:57 /1471-2466/12/57 RESEARCH ARTICLE Open Access A predictive tool for an effective use of 18F-FDG PET in assessing activity of sarcoidosis 1 2 3 4 Rémy LM Mostard , Sander MJ Van Kuijk , Johny A Verschakelen , Marinus JPG van Kroonenburgh , 2 5 6,7* Patty J Nelemans , Petal AHM Wijnen and Marjolein Drent Abstract Background: 18F-FDG PET/CT (PET) is useful in assessing inflammatory activity in sarcoidosis. However, no appropriate indications are available. The aim of this study was to develop a prediction rule that can be used to identify symptomatic sarcoidosis patients who have a high probability of PET-positivity. Methods: We retrospectively analyzed a cohort of sarcoidosis patients with non organ specific persistent disabling symptoms (n = 95). Results of soluble interleukin-2 receptor (sIL-2R) assessment and high-resolution computed tomography (HRCT) were included in the predefined model. HRCT scans were classified using a semi-quantitative scoring system and PET findings as positive or negative, respectively. A prediction model was derived based on logistic regression analysis. We quantified the model’s performance using measures of discrimination and calibration. Finally, we constructed a prediction rule that should be easily applicable in clinical practice. Results: The prediction rule showed good calibration and good overall performance (goodness-of-fit test, p = 0.78, Brier score 20.1%) and discriminated between patients with positive and negative PET findings (area under the receiver-operating characteristic curve, 0.83). If a positive predictive value fo