胰腺病变~(18)F-FDG PET/CT与MRI的对照研究
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摘要
目的探讨行氟~(18)标记的脱氧葡萄糖(~(18)F-FDG)PET/CT与MRI在病理诊断明确的胰腺病变中的应用价值。资料与方法回顾性分析152例经病理明确诊断的胰腺病变患者的PET/CT及MRI结果,与病理结果对照,计算PET/CT及MRI诊断的敏感度、特异度、阳性预测值、阴性预测值及准确度。采用受试者工作特征(ROC)曲线计算PET/CT最大标准化摄取值(SUVmax)鉴别诊断良、恶性病变的阈值。比较PET/CT、MRI测量病变长径与病理诊断测量的差异及相关性。结果 152例胰腺病变患者中,106例恶性,46例良性,PET/CT的诊断敏感度、特异度、阳性预测值、阴性预测值及准确度分别为92.5%、63.0%、85.1%、76.3%及82.9%,MRI分别为85.8%、73.9%、88.3%、69.4%及82.2%。ROC曲线显示SUVmax区分良、恶性病变的阈值为3.25。PET/CT测量所得病灶长径与病理结果、MRI结果与病理结果差异均无统计学意义(P>0.05)。PET/CT测量所得病灶长径与病理结果(r=0.898,P=0.001)、MRI结果与病理结果(r=0.948,P=0.023)均呈正相关。结论 ~(18)F-FDG PET/CT与MRI相比在鉴别诊断胰腺良、恶性病变中具有较好的敏感度、阴性预测值及准确度,SUVmax及测量大小具有一定的参考价值。
Purpose To explore the application value of ~(18) F-fluorodeoxyglucose(~(18) F-FDG) PET/CT imaging in pancreatic lesions which are specifically diagnosed by pathology. Materials and Methods PET/CT and MRI results of 152 patients with pancreatic lesions which were specifically diagnosed by pathology were retrospectively analyzed. The results were compared with pathological results to calculate sensitivity, specificity, positive predictive value, negative predictive value and accuracy of PET/CT and MRI diagnosis. ROC curve was taken to calculate the maximum standard uptake value(SUVmax) of PET/CT to identify threshold value of benign and malignant lesions. The difference of lesion diameter measured by PET/CT and MRI and pathology was compared, and their correlations were also analyzed. Results Among the 152 patients with pancreatic lesions, 106 were malignant and 46 were benign. The sensitivity,specificity, positive predictive value, negative predictive value and accuracy diagnosed with PET/CT were 92.5%, 63.0%, 85.1%, 76.3%and 82.9%, respectively; and that of MRI were 85.8%, 73.9%, 88.3%, 69.4% and 82.2%, respectively. ROC curve indicated that threshold value in judging malignancy and benign was 3.25. There was no statistical significance regarding lesion diameter measured with PET/CT and pathological results and MRI results and pathological results(P>0.05). There was correlation between lesion diameter measured with PET/CT and pathological results(r=0.898, P=0.001) and MRI results and pathological results(r=0.948, P=0.023). Conclusion Compared with MRI, PET/CT is of better sensitivity, negative predictive value and accuracy in identifying and diagnosing benign and malignant pancreatic lesions and SUVmax and measured size are of certain reference value.
Purpose To explore the application value of ~(18) F-fluorodeoxyglucose(~(18) F-FDG) PET/CT imaging in pancreatic lesions which are specifically diagnosed by pathology. Materials and Methods PET/CT and MRI results of 152 patients with pancreatic lesions which were specifically diagnosed by pathology were retrospectively analyzed. The results were compared with pathological results to calculate sensitivity, specificity, positive predictive value, negative predictive value and accuracy of PET/CT and MRI diagnosis. ROC curve was taken to calculate the maximum standard uptake value(SUVmax) of PET/CT to identify threshold value of benign and malignant lesions. The difference of lesion diameter measured by PET/CT and MRI and pathology was compared, and their correlations were also analyzed. Results Among the 152 patients with pancreatic lesions, 106 were malignant and 46 were benign. The sensitivity,specificity, positive predictive value, negative predictive value and accuracy diagnosed with PET/CT were 92.5%, 63.0%, 85.1%, 76.3%and 82.9%, respectively; and that of MRI were 85.8%, 73.9%, 88.3%, 69.4% and 82.2%, respectively. ROC curve indicated that threshold value in judging malignancy and benign was 3.25. There was no statistical significance regarding lesion diameter measured with PET/CT and pathological results and MRI results and pathological results(P>0.05). There was correlation between lesion diameter measured with PET/CT and pathological results(r=0.898, P=0.001) and MRI results and pathological results(r=0.948, P=0.023). Conclusion Compared with MRI, PET/CT is of better sensitivity, negative predictive value and accuracy in identifying and diagnosing benign and malignant pancreatic lesions and SUVmax and measured size are of certain reference value.
引文
[1]Yeh R,Dercle L,Garg I,et al.The role of 18F-FDG PET/CT and PET/MRI in pancreatic ductal adenocarcinoma.Abdom Radiol(NY),2018,43(2):415-434.
[2]Pery C,Meurette G,Ansquer C,et al.Role and limitations of F-18-FDG positron emission tomography(PET)in the management of patients with pancreatic lesions.Gastroenterol Clin Biol,2010,34(8/9):465-474.
[3]Parikh U,Marcus C,Sarangi R,et al.FDG PET/CT in pancreatic and hepatobiliary carcinomas value to patient management and patient outcomes.PET Clin,2015,10(3):327-343.
[4]Jha P,Bijan B.PET/CT for pancreatic malignancy:potential and pitfalls.J Nucl Med Technol,2015,43(2):92-97.
[5]Santhosh S,Mittal BR,Rana SS,et al.Metabolic signatures of malignant and non-malignant mass-forming lesions in the periampulla and pancreas in FDG PET/CT scan:an Atlas with pathologic correlation.Abdom Imaging,2015,40(5):1285-1315.
[6]Chu LC,Goggins MG,Fishman EK.Diagnosis and detection of pancreatic cancer.Cancer J,2017,23(6):333-342.
[7]Pinho DF,Subramaniam RM.PET-Computed tomography and precision nedicine in pancreatic adenocarcinoma and pancreatic neuroendocrine tumors.PET Clin,2017,12(4):407-421.
[8]Joo I,Lee JM,Lee DH,et al.Preoperative assessment of pancreatic cancer with FDG PET/MR imaging versus FDGPET/CT plus contrast-enhanced multidetector CT:a prospective preliminary study.Radiology,2017,282(1):149-159.
[9]Bosman T,Carneiro F,Hruban R,et al.WHO classification of tumours of the digestive system.4th ed.Lyon:Iarc Press,2010:13-14.
[10]Ergul N,Gundogan C,Tozlu M,et al.Role of F-18-Fluorodeoxyglucose positron emission tomography/computed tomography in diagnosis and management of pancreatic cancer;comparison with multidetector row computed tomography,magnetic resonance imaging and endoscopic ultrasonography.Rev Esp Med Nucl Imagen Mol,2014,33(3):159-164.
[11]Rijkers AP,Valkema R,Duivenvoorden HJ,et al.Usefulness of F-18-fluorodeoxyglucose positron emission tomography to confirm suspected pancreatic cancer:a meta-analysis.EJSO,2014,40(7):794-804.
[12]Kauhanen S,Rinta-Kiikka I,Kemppainen JA,et al.Accuracy of F-18-FDG PET/CT,multidetector CT,and MR imaging in the diagnosis of pancreatic cysts:a prospective single-center study.J Nucl Med,2015,56(8):1163-1168.
[13]李文婵,陈敏,姚稚明,等.肺单发结核瘤18F-FDG PET/CT误诊分析.中国医学影像学杂志,2016,24(10):737-740.
[14]Ahn SJ,Park MS,Lee JD,et al.Correlation between F-18-fluorodeoxyglucose positron emission tomography and pathologic differentiation in pancreatic cancer.Ann Nucl Med,2014,28(5):430-435.
[15]Santhosh S,Mittal BR,Bhasin DA,et al.Role of 18F-fluorodeoxyglucose positron emission tomography/computed tomography in the characterization of pancreatic masses:experience from tropics.J Gastroenterol Hepatol,2013,28(2):255-261.
[16]田艳涛,王成锋,赵心明,等.不同影像学检查对胰腺癌肿瘤大小及周围组织浸润的前瞻性评估.中华肿瘤杂志,2008,30(4):270-273.
[17]Wang XY,Yang F,Jin C,et al.Utility of PET/CT in diagnosis,staging,assessment of respectability and metabolic response of pancreatic cancer.World JGastroenterol,2014,20(42):15580-15589.
[2]Pery C,Meurette G,Ansquer C,et al.Role and limitations of F-18-FDG positron emission tomography(PET)in the management of patients with pancreatic lesions.Gastroenterol Clin Biol,2010,34(8/9):465-474.
[3]Parikh U,Marcus C,Sarangi R,et al.FDG PET/CT in pancreatic and hepatobiliary carcinomas value to patient management and patient outcomes.PET Clin,2015,10(3):327-343.
[4]Jha P,Bijan B.PET/CT for pancreatic malignancy:potential and pitfalls.J Nucl Med Technol,2015,43(2):92-97.
[5]Santhosh S,Mittal BR,Rana SS,et al.Metabolic signatures of malignant and non-malignant mass-forming lesions in the periampulla and pancreas in FDG PET/CT scan:an Atlas with pathologic correlation.Abdom Imaging,2015,40(5):1285-1315.
[6]Chu LC,Goggins MG,Fishman EK.Diagnosis and detection of pancreatic cancer.Cancer J,2017,23(6):333-342.
[7]Pinho DF,Subramaniam RM.PET-Computed tomography and precision nedicine in pancreatic adenocarcinoma and pancreatic neuroendocrine tumors.PET Clin,2017,12(4):407-421.
[8]Joo I,Lee JM,Lee DH,et al.Preoperative assessment of pancreatic cancer with FDG PET/MR imaging versus FDGPET/CT plus contrast-enhanced multidetector CT:a prospective preliminary study.Radiology,2017,282(1):149-159.
[9]Bosman T,Carneiro F,Hruban R,et al.WHO classification of tumours of the digestive system.4th ed.Lyon:Iarc Press,2010:13-14.
[10]Ergul N,Gundogan C,Tozlu M,et al.Role of F-18-Fluorodeoxyglucose positron emission tomography/computed tomography in diagnosis and management of pancreatic cancer;comparison with multidetector row computed tomography,magnetic resonance imaging and endoscopic ultrasonography.Rev Esp Med Nucl Imagen Mol,2014,33(3):159-164.
[11]Rijkers AP,Valkema R,Duivenvoorden HJ,et al.Usefulness of F-18-fluorodeoxyglucose positron emission tomography to confirm suspected pancreatic cancer:a meta-analysis.EJSO,2014,40(7):794-804.
[12]Kauhanen S,Rinta-Kiikka I,Kemppainen JA,et al.Accuracy of F-18-FDG PET/CT,multidetector CT,and MR imaging in the diagnosis of pancreatic cysts:a prospective single-center study.J Nucl Med,2015,56(8):1163-1168.
[13]李文婵,陈敏,姚稚明,等.肺单发结核瘤18F-FDG PET/CT误诊分析.中国医学影像学杂志,2016,24(10):737-740.
[14]Ahn SJ,Park MS,Lee JD,et al.Correlation between F-18-fluorodeoxyglucose positron emission tomography and pathologic differentiation in pancreatic cancer.Ann Nucl Med,2014,28(5):430-435.
[15]Santhosh S,Mittal BR,Bhasin DA,et al.Role of 18F-fluorodeoxyglucose positron emission tomography/computed tomography in the characterization of pancreatic masses:experience from tropics.J Gastroenterol Hepatol,2013,28(2):255-261.
[16]田艳涛,王成锋,赵心明,等.不同影像学检查对胰腺癌肿瘤大小及周围组织浸润的前瞻性评估.中华肿瘤杂志,2008,30(4):270-273.
[17]Wang XY,Yang F,Jin C,et al.Utility of PET/CT in diagnosis,staging,assessment of respectability and metabolic response of pancreatic cancer.World JGastroenterol,2014,20(42):15580-15589.