18F-FDG PET/CT在肾上腺肿块评估中的应用

18F-FDG PET/CT in the evaluation of adrenal masses.

作者信息

Metser Ur, Miller Elka, Lerman Hedva, Lievshitz Gennady, Avital Shmuel, Even-Sapir Einat

机构信息

Department of Nuclear Medicine, Tel-Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.

出版信息

J Nucl Med. 2006 Jan;47(1):32-7.

PMID:16391184

Abstract

UNLABELLED

Our purpose was to evaluate the performance of (18)F-FDG PET/CT, using data from both the PET and the unenhanced CT portions of the study, in characterizing adrenal masses in oncology patients.

METHODS

One hundred seventy-five adrenal masses in 150 patients referred for (18)F-FDG PET/CT were assessed. Final diagnosis was based on histology (n = 6), imaging follow-up (n = 118) of 6-29 mo (mean, 14 mo), or morphologic imaging criteria (n = 51). Each adrenal mass was characterized by its size; its attenuation on CT, expressed by Hounsfield units (HU); and the intensity of (18)F-FDG uptake, expressed as standardized uptake value (SUV). Receiver operating characteristic curves were drawn to determine the optimal cutoff values of HU and SUV that would best discriminate between benign and malignant masses.

RESULTS

When malignant lesions were compared with adenomas, PET data alone using an SUV cutoff of 3.1 yielded a sensitivity, specificity, positive predictive value, and negative predictive value of 98.5%, 92%, 89.3%, 98.9%, respectively. For combined PET/CT data, the sensitivity, specificity, positive predictive value, and negative predictive value were 100%, 98%, 97%, 100%, respectively. Specificity was significantly higher for PET/CT (P < 0.01). Fifty-one of the 175 masses were 1.5 cm or less in diameter. When a cutoff SUV of 3.1 was used for this group, (18)F-FDG PET/CT correctly classified all lesions.

CONCLUSION

(18)F-FDG PET/CT improves the performance of (18)F-FDG PET alone in discriminating benign from malignant adrenal lesions in oncology patients.

摘要

未标注

我们的目的是利用来自正电子发射断层显像（PET）和未增强计算机断层扫描（CT）部分的研究数据，评估18F-氟代脱氧葡萄糖（18F-FDG）PET/CT在肿瘤患者肾上腺肿块特征描述方面的表现。

方法

对150例接受18F-FDG PET/CT检查的患者中的175个肾上腺肿块进行了评估。最终诊断基于组织学检查（n = 6）、6至29个月（平均14个月）的影像学随访（n = 118）或形态学影像学标准（n = 51）。每个肾上腺肿块通过其大小、CT上的衰减（以亨氏单位（HU）表示）以及18F-FDG摄取强度（以标准化摄取值（SUV）表示）来进行特征描述。绘制了受试者操作特征曲线，以确定能最佳区分良性和恶性肿块的HU和SUV的最佳临界值。

结果

当将恶性病变与腺瘤进行比较时，仅使用SUV临界值3.1的PET数据得出的敏感性、特异性、阳性预测值和阴性预测值分别为98.5%、92%、89.3%和98.9%。对于PET/CT联合数据，敏感性、特异性、阳性预测值和阴性预测值分别为100%、98%、97%和100%。PET/CT的特异性显著更高（P < 0.01）。175个肿块中有51个直径为1.5厘米或更小。当对该组使用临界SUV值3.1时，18F-FDG PET/CT正确分类了所有病变。