~(18)F-FDG PET/CT双时相显像定性诊断肺占位性病变
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摘要
目的探讨~(18)F-FDG PET/CT双时相显像定性诊断肺占位性病变的价值。方法回顾性分析235例接受~(18)F-FDG PET/CT双时相显像的肺内占位性病变患者的临床和影像学资料,按照病理结果分为良性病变组(n=80)和恶性病变组(n=155)。比较2组早期和延迟显像中肺部病灶的最大标准摄取值(SUV_(max)),计算SUV_(max)变化率[以储留指数(RI)表示];以ROC曲线分析早期及延迟期肺部病灶SUV_(max)、RI对肺部恶性病变的诊断效能。结果恶性病变组早期及延迟期SUV_(max)均大于良性病变组(P均<0.001),且2组延迟期SUV_(max)均大于早期(P均<0.001)。恶性病变组RI大于良性病变组(P<0.001)。ROC曲线分析结果显示,早期SUV_(max)、延迟期SUV_(max)、RI及三者联合诊断肺部恶性病变的AUC分别为0.645、0.697、0.722及0.727(P均<0.05)。结论 ~(18)F-FDG PET/CT双时相显像可用于定性诊断肺占位性病变。
Objective To explore the value of ~(18)F-FDG PET/CT dual-phase imaging in qualitative diagnosis of pulmonary occupying lesions. Methods Clinical and imaging data of 235 patients with pulmonary occupying lesions underwent ~(18)F-FDG PET/CT dual-phase imaging were retrospectively analyzed. According to pathology results, the patients were divided into benign lesion group(n=80) and malignant lesion group(n=155). Maximal standardized uptake value(SUV_(max)) of pulmonary lesions in early and delayed imaging were compared between the two groups, and the change rate of SUV_(max) expressed as retention index(RI) were calculated. ROC curve was used to analyze the diagnostic efficacy of SUV_(max) in early and delayed imaging and RI for malignant pulmonary lesions. Results The early and delayed SUV_(max) in malignant lesion group were both higher than those in benign lesion group, and the delayed SUV_(max) in both groups were higher than the early SUV_(max)(all P<0.001). RI in malignant lesion group was higher than that in benign lesion group(P<0.001). ROC curve analysis showed that AUC of early SUV_(max), delayed SUV_(max), RI and combined of them for diagnosis of pulmonary malignant lesions were 0.645, 0.697, 0.722 and 0.727, respectively(all P<0.05). Conclusion ~(18)F-FDG PET/CT dual-phase imaging can be used to qualitative diagnose pulmonary occupying lesions.
Objective To explore the value of ~(18)F-FDG PET/CT dual-phase imaging in qualitative diagnosis of pulmonary occupying lesions. Methods Clinical and imaging data of 235 patients with pulmonary occupying lesions underwent ~(18)F-FDG PET/CT dual-phase imaging were retrospectively analyzed. According to pathology results, the patients were divided into benign lesion group(n=80) and malignant lesion group(n=155). Maximal standardized uptake value(SUV_(max)) of pulmonary lesions in early and delayed imaging were compared between the two groups, and the change rate of SUV_(max) expressed as retention index(RI) were calculated. ROC curve was used to analyze the diagnostic efficacy of SUV_(max) in early and delayed imaging and RI for malignant pulmonary lesions. Results The early and delayed SUV_(max) in malignant lesion group were both higher than those in benign lesion group, and the delayed SUV_(max) in both groups were higher than the early SUV_(max)(all P<0.001). RI in malignant lesion group was higher than that in benign lesion group(P<0.001). ROC curve analysis showed that AUC of early SUV_(max), delayed SUV_(max), RI and combined of them for diagnosis of pulmonary malignant lesions were 0.645, 0.697, 0.722 and 0.727, respectively(all P<0.05). Conclusion ~(18)F-FDG PET/CT dual-phase imaging can be used to qualitative diagnose pulmonary occupying lesions.
引文
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[11] Chen CJ,Lee BF,Yao WJ,et al.Dual-phase 18F-FDG PET in the diagnosis of pulmonary nodules with an initial standard uptake value less than 2.5.AJR Am J Roentgenol,2008,191(2):475-479.
[12] 李文婵,姚稚明,屈婉莹,等.SUV小于2.5的孤立性肺结节18F-FDG PET/CT诊断价值初探.医学研究杂志,2011,40(9):47-51.
[13] Macdonald K,Searle J,Lyburn I.The role of dual time point FDG PET imaging in the evaluation of solitary pulmonary nodules with an initial standard uptake value less than 2.5.Clin Radiol,2011,66(3):244-250.
[2] 苏富勇,孙爱君,刘健,等.双时相PET显像诊断胃癌术后复发与转移.中国医学影像技术,2011,27(1):108-111.
[3] 王寅中,张沥,雷军强.双时相与单时相18F-FDG PET/CT对乳腺癌诊断价值的Meta分析.中国医学影像技术,2013,29(3):415-419.
[4] 杨鹏,龚静山,陈立光,等.双时相18F-FDG PET鉴别诊断肺内良恶性病变的价值.中国医学影像技术,2011,27(10):2017-2020.
[5] 李国雄,刘志军,张海捷,等.肺硬化性肺泡细胞瘤的18F-FDG PET/CT显像特征.中国医学影像技术,2017,33(6):889-892.
[6] 王欣欣,孙江宏,耿佳时,等.肺内高代谢类肿瘤样炎性病变18氟-脱氧核糖分布特点的研究.临床外科杂志,2017,25(1):42-45.
[7] Xiu Y,Bhutani C,Dhurairaj T,et al.Dual-time point FDG PET imaging in the evaluation of pulmonary nodules with minimally increased metabolic activity.Clin Nucl Med,2007,32(2):101-105.
[8] 郑建国,屈婉莹,姚稚明,等.18F-FDG PET/CT对不同大小孤立性肺结节的诊断价值.中华核医学与分子影像杂志,2008,28(3):170-173.
[9] 王跃涛,刘德峰,钱作宾,等.18F-FDG PET/CT双时相显像对肺部病灶的定性诊断价值.中华核医学与分子影像杂志,2009,29(5):293-296.
[10] 韩招娣,尤徐阳,郁春景,等.18F-FDG PET/CT显像在孤立性肺结节中的应用研究.影像诊断与介入放射学,2013,22(1):61-64.
[11] Chen CJ,Lee BF,Yao WJ,et al.Dual-phase 18F-FDG PET in the diagnosis of pulmonary nodules with an initial standard uptake value less than 2.5.AJR Am J Roentgenol,2008,191(2):475-479.
[12] 李文婵,姚稚明,屈婉莹,等.SUV小于2.5的孤立性肺结节18F-FDG PET/CT诊断价值初探.医学研究杂志,2011,40(9):47-51.
[13] Macdonald K,Searle J,Lyburn I.The role of dual time point FDG PET imaging in the evaluation of solitary pulmonary nodules with an initial standard uptake value less than 2.5.Clin Radiol,2011,66(3):244-250.