Halley Arnaud, Hugentobler Alexis, Icard Philippe, Porret Emilie, Sobrio Franck, Lerochais Jean-Philippe, Bouvard Gerard, Zalcman Gerard, Agostini Denis
Department of Nuclear Medicine, University Hospital, Avenue de la cote de Nacre, 14033 Caen, France.
Eur J Nucl Med Mol Imaging. 2005 Sep;32(9):1026-32. doi: 10.1007/s00259-005-1812-1. Epub 2005 May 5.
The purpose of the study was to compare ( 18)F-fluorodeoxyglucose (FDG) positron emission tomography (PET) and ( 99m)Tc-depreotide single-photon emission computed tomography (SPECT) in the diagnosis of malignancy of solitary pulmonary nodules (SPNs).
Twenty-eight patients without any history of cancer and presenting an SPN (0.8-3 cm in size) underwent FDG PET and depreotide SPECT. Depreotide SPECT and FDG PET were performed on a double-head gamma camera and a dedicated PET scanner respectively. Twenty-five out of 28 lesions were removed by thoracotomy or assessed by biopsy (n=1) and histologically examined. A strategy of serial CT scanning was adopted in the three remaining patients.
Histological findings revealed 18 malignant nodules and seven benign lesions. Stability over a 2-year period indicated a benign process in the remaining three cases. Both techniques yielded true positive results in 15 of the 18 cancers. FDG PET identified two additional adenocarcinomas not detected by depreotide SPECT. A carcinoid tumour not visualised on FDG PET was identified by depreotide SPECT. Seven of the ten benign lesions did not reveal tracer uptake on either depreotide SPECT or FDG PET. Both techniques showed false positive results for the same two lesions. One more false positive was seen on FDG PET. FDG PET and depreotide SPECT had a sensitivity of 94.4% and 88.9% respectively; this difference was not significant. In our experience, depreotide SPECT and FDG PET are equally sensitive (92.3%) for large (>1.5 cm) and equally specific (85.7%) for small (up to 1.5 cm) SPNs suspicious for malignancy.
This study showed( 18)F-FDG PET to be more sensitive than ( 99m)Tc-depreotide SPECT in the diagnosis of malignancy of SPNs. However, the combination of both techniques may provide additional accuracy.
本研究旨在比较¹⁸F-氟脱氧葡萄糖（FDG）正电子发射断层扫描（PET）和⁹⁹ᵐTc-德普列肽单光子发射计算机断层扫描（SPECT）在孤立性肺结节（SPN）恶性肿瘤诊断中的应用。
28例无癌症病史且存在SPN（大小为0.8 - 3 cm）的患者接受了FDG PET和德普列肽SPECT检查。德普列肽SPECT和FDG PET分别在双头γ相机和专用PET扫描仪上进行。28个病灶中的25个通过开胸手术切除或活检评估（n = 1）并进行组织学检查。其余3例患者采用了系列CT扫描策略。
组织学检查发现18个恶性结节和7个良性病变。在2年期间保持稳定表明其余3例为良性病变。两种技术在18例癌症中的15例均得出真阳性结果。FDG PET识别出另外2例德普列肽SPECT未检测到的腺癌。德普列肽SPECT识别出1例FDG PET未显示的类癌肿瘤。10个良性病变中的7个在德普列肽SPECT或FDG PET上均未显示示踪剂摄取。两种技术对相同的2个病变均显示假阳性结果。FDG PET上还出现了1例假阳性。FDG PET和德普列肽SPECT的敏感性分别为94.4%和88.9%；这种差异不显著。根据我们的经验，德普列肽SPECT和FDG PET对可疑恶性的大（>1.5 cm）SPN敏感性相同（92.3%），对小（≤1.5 cm）SPN特异性相同（85.7%）。
本研究表明¹⁸F-FDG PET在SPN恶性肿瘤诊断中比⁹⁹ᵐTc-德普列肽SPECT更敏感。然而，两种技术联合使用可能会提高诊断准确性。
