Orino K, Kawamura M, Hatazawa J, Suzuki I, Sazawa Y
Department of Thoracic Surgery, Nakadohri General Hospital, Akita, Japan.
Jpn J Thorac Cardiovasc Surg. 1998 Dec;46(12):1267-74. doi: 10.1007/BF03217914.
To evaluate the value of F-18 fluorodeoxyglucose positron emission tomography (FDG-PET) scans, we performed FDG-PET scans in 23 patients with indeterminate pulmonary nodules less than 3 cm in size and analyzed these scans qualitatively and semiquantitatively. Histologic specimens were obtained by thoracoscopic excisional biopsy in 16 patients, CT-guided needle aspiration cytology in three, and bronchoscopic brushing cytology in four. Pathological diagnoses were lung cancer in 16 patients, benign inflammation in six, and malignant lymphoma in one. Sensitivity, specificity and accuracy of the FDG-PET scans were 88% (15/17), 67% (4/6) and 83% (19/23), respectively. There were two false-positive cases (organizing pneumonia and cryptococcosis) and two false-negative ones (slow-growing adenocarcinoma and malignant lymphoma). Although a few false-positive cases of granulomatous disease were yielded, the FDG-PET scans were highly sensitive in the detection of lung cancer. We conclude that the FDG-PET scanning in a useful diagnostic imaging modailty in the management of indeterminate pulmonary nodules.
为评估F-18氟脱氧葡萄糖正电子发射断层扫描(FDG-PET)的价值,我们对23例直径小于3 cm的肺结节性质不明的患者进行了FDG-PET扫描,并对这些扫描进行了定性和半定量分析。16例患者通过胸腔镜切除活检获取组织学标本,3例通过CT引导下针吸细胞学检查获取标本,4例通过支气管镜刷检细胞学检查获取标本。病理诊断为肺癌16例,良性炎症6例,恶性淋巴瘤1例。FDG-PET扫描的敏感性、特异性和准确性分别为88%(15/17)、67%(4/6)和83%(19/23)。有2例假阳性病例(机化性肺炎和隐球菌病)和2例假阴性病例(生长缓慢的腺癌和恶性淋巴瘤)。尽管产生了一些肉芽肿性疾病的假阳性病例,但FDG-PET扫描在肺癌检测中具有高度敏感性。我们得出结论,FDG-PET扫描是管理肺结节性质不明患者的一种有用的诊断成像方法。