Hickeson Marc, Yun Mijin, Matthies Alexander, Zhuang Hongming, Adam Lars-Eric, Lacorte Lester, Alavi Abass
Division of Nuclear Medicine, Department of Radiology, 110 Donner Building, Hospital of the University of Pennsylvania, 3400 Spruce St., Philadelphia, PA 19104, USA.
Eur J Nucl Med Mol Imaging. 2002 Dec;29(12):1639-47. doi: 10.1007/s00259-002-0924-0. Epub 2002 Oct 2.
The purpose of this study was to determine the actual standardized uptake value (SUV) by using the lesion size from computer tomography (CT) scan to correct for resolution and partial volume effects in positron emission tomography (PET) imaging. This retrospective study included 47 patients with lung lesions seen on CT scan whose diagnoses were confirmed by biopsy or by follow up CT scan when the PET result was considered negative for malignancy. Each lesion's FDG uptake was quantified by the SUV using two methods: by measuring the maximum voxel SUV (maxSUV) and by using the lesion's size on CT to calculate the actual SUV (corSUV). Among small lesions (2.0 cm or smaller on CT scan), ten were benign and 17 were malignant. The average maxSUV was 1.43+/-0.77 and 3.02+/-1.74 for benign and malignant lesions respectively. When using an SUV of 2.0 as the cutoff to differentiate benignity and malignancy, the sensitivity, specificity, and accuracy were 65%, 70%, and 67% respectively. When an SUV of 2.5 was used for cutoff, the sensitivity, specificity, and accuracy were 47%, 80%, and 59% respectively. The average corSUV was 1.65+/-1.09 and 5.28+/-2.71 for benign and malignant lesions respectively. Whether an SUV of either 2.0 or 2.5 was used for cutoff, the sensitivity, specificity, and accuracy remained 94%, 70%, and 85% respectively. The only malignant lesion that was falsely considered benign with both methods was a bronchioalveolar carcinoma which did not reveal any elevated uptake of fluorine-18 fluorodeoxyglucose (FDG). Of the large lesions (more than 2.0 cm and less than 6.0 cm), one was benign and 19 were malignant and the corSUV technique did not significantly change the accuracy. It is concluded that measuring the SUV by using the CT size to correct for resolution and partial volume effects offers potential value in differentiating malignant from benign lesions in this population. This approach appears to improve the accuracy of FDG-PET for optimal characterization of small lung nodules.
本研究的目的是通过使用计算机断层扫描（CT）的病变大小来校正正电子发射断层扫描（PET）成像中的分辨率和部分容积效应，从而确定实际标准化摄取值（SUV）。这项回顾性研究纳入了47例CT扫描发现肺部病变的患者，其诊断通过活检或PET结果被认为恶性阴性时的随访CT扫描得以证实。使用两种方法通过SUV对每个病变的氟代脱氧葡萄糖（FDG）摄取进行定量：测量最大体素SUV（maxSUV）以及使用CT上病变的大小来计算实际SUV（corSUV）。在小病变（CT扫描上2.0 cm或更小）中，10个为良性，17个为恶性。良性和恶性病变的平均maxSUV分别为1.43±0.77和3.02±1.74。当使用SUV 2.0作为区分良性和恶性的临界值时，敏感性、特异性和准确性分别为65%、70%和67%。当使用SUV 2.5作为临界值时，敏感性、特异性和准确性分别为47%、80%和59%。良性和恶性病变的平均corSUV分别为1.65±1.09和5.28±2.71。无论使用SUV 2.0还是2.5作为临界值，敏感性、特异性和准确性分别保持在94%、70%和85%。两种方法均被错误地认为是良性的唯一恶性病变是一例未显示任何18F-氟代脱氧葡萄糖（FDG）摄取升高的细支气管肺泡癌。在大病变（大于2.0 cm且小于6.0 cm）中，1个为良性，19个为恶性，corSUV技术并未显著改变准确性。结论是，通过使用CT大小校正分辨率和部分容积效应来测量SUV在区分该人群中的恶性和良性病变方面具有潜在价值。这种方法似乎提高了FDG-PET对小肺结节进行最佳特征描述的准确性。
