Tomographic imaging of the spleen: the role of morphological and metabolic features in differentiating benign from malignant diseases

To evaluate the tomographic features in differentiating benign from malignant splenic diseases, 54 patients with a cytohistological examination and a contrast-enhanced multidetector computed tomography (ce-MDCT) and/or positron emission tomography/computed tomography (PET/CT) were retrospectively selected. Significant associations were observed between ce-MDCT Pattern 3 (focal hyperdense lesion) and Pattern 4 (infarcts/cysts) as well as PET/CT Pattern 3 (focal photopenia/diffuse uptake<liver) and benign pathologies, and between ce-MDCT Pattern 1 (splenomegaly without focal lesions) and Pattern 2 (focal hypodense lesion) as well as PET/CT Pattern 1 (diffuse uptake>=liver) and Pattern 2 (focal increased uptake) and malignant diseases. No significant association between benign or malignant diseases and spleen volumes and maximum standardized uptake value (SUVmax) as well as lesion characteristics was observed. The metabolic data do not improve the performance of morphological patterns.