双时间点18F-FDG PET用于评估肺结节

Dual time point 18F-FDG PET for the evaluation of pulmonary nodules.

作者信息

Matthies Alexander, Hickeson Marc, Cuchiara Andrew, Alavi Abass

机构信息

Division of Nuclear Medicine, Hospital of the University of Pennsylvania, Philadelphia 19104, USA.

出版信息

J Nucl Med. 2002 Jul;43(7):871-5.

PMID:12097455

Abstract

UNLABELLED

18F-FDG PET has reached widespread application in the assessment of pulmonary nodules. This study compares the diagnostic accuracy of standard 18F-FDG PET scanning with those of dual time point 18F-FDG PET scanning.

METHODS

Thirty-six patients (21 women, 15 men; mean age, 67 y; range, 36-88 y) with 38 known or suspected malignant pulmonary nodules underwent PET of the thorax at 2 time points: scan 1 at 70 min (range, 56-110 min) and scan 2 at 123 min (range, 100-163 min) after the intravenous injection of 2.5 MBq 18F-FDG per kilogram of body weight. All scanning was performed on a dedicated C-PET scanner. The mean interval between the scans was 56 min (range, 49-64 min). Regions of interest were overlaid onto each fully corrected image in the areas of the radiographically known lung densities. The standardized uptake values (SUVs) were calculated for both time points.

RESULTS

Surgical pathology and follow-up revealed 19 patients with 20 malignant tumors, whereas 16 patients had benign lesions. The tumor SUVs (mean +/- SD) were 3.66 +/- 1.95 (scan 1) and 4.43 +/- 2.43 (scan 2) (20.5% +/- 8.1% increase; P < 0.01). Four of 20 malignant tumors had SUVs of <2.5 on scan 1 (range, 1.12-1.69). Benign lesions had SUVs of 1.14 +/- 0.64 (scan 1) and 1.11 +/- 0.70 (scan 2) (P = not significant). Standard PET scanning (single time point) with a threshold SUV of 2.5 (at time point 1) reached a sensitivity of 80% and a specificity of 94%; dual time point scanning with a threshold value of 10% increase between scan 1 and scan 2 reached a sensitivity of 100% with a specificity of 89%.

CONCLUSION

Dual time point 18F-FDG PET results in a very high sensitivity and specificity for detection of malignant lung tumors.

摘要

未标注

18F-FDG PET在肺结节评估中已得到广泛应用。本研究比较了标准18F-FDG PET扫描与双时相18F-FDG PET扫描的诊断准确性。

方法

36例（21例女性，15例男性；平均年龄67岁；范围36 - 88岁）有38个已知或疑似恶性肺结节的患者在两个时间点进行胸部PET检查：静脉注射每千克体重2.5 MBq 18F-FDG后70分钟（范围56 - 110分钟）进行扫描1，123分钟（范围100 - 163分钟）进行扫描2。所有扫描均在专用的C-PET扫描仪上进行。两次扫描之间的平均间隔为56分钟（范围49 - 64分钟）。在影像学已知的肺部密度区域，将感兴趣区覆盖到每个完全校正的图像上。计算两个时间点的标准化摄取值（SUV）。

结果

手术病理及随访显示19例患者有20个恶性肿瘤，16例患者有良性病变。肿瘤SUV（平均值±标准差）在扫描1时为3.66±1.95，在扫描2时为4.43±2.43（增加20.5%±8.1%；P<0.01）。20个恶性肿瘤中有4个在扫描1时SUV<2.5（范围1.12 - 1.69）。良性病变在扫描1时SUV为1.14±0.64，在扫描2时为1.11±0.70（P =无显著性差异）。标准PET扫描（单时间点），SUV阈值为2.5（在时间点1）时，敏感性为80%，特异性为94%；双时相扫描，扫描1和扫描2之间增加阈值为10%时，敏感性为100%，特异性为89%。