PET-CT在肺癌分期中的附加价值：与单纯CT、单纯PET以及PET与CT的视觉相关性比较
Additional value of PET-CT in the staging of lung cancer: comparison with CT alone, PET alone and visual correlation of PET and CT.
作者信息
De Wever W, Ceyssens S, Mortelmans L, Stroobants S, Marchal G, Bogaert J, Verschakelen J A
机构信息
Department of Radiology, University Hospitals Gasthuisberg, Herestraat 49, 3000 Leuven, Belgium.
出版信息
Eur Radiol. 2007 Jan;17(1):23-32. doi: 10.1007/s00330-006-0284-4. Epub 2006 May 9.
Integrated positron emission tomography (PET) and computed tomography (CT) is a new imaging modality offering anatomic and metabolic information. The purpose was to evaluate retrospectively the accuracy of integrated PET-CT in the staging of a suggestive lung lesion, comparing this with the accuracy of CT alone, PET alone and visually correlated PET-CT. Fifty patients undergoing integrated PET-CT for staging of a suggestive lung lesion were studied. Their tumor, node, metastasis (TNM) statuses were determined with CT, PET, visually correlated PET-CT and integrated PET-CT. These TNM stages were compared with the surgical TNM status. Integrated PET-CT was the most accurate imaging technique in the assessment of the TNM status. Integrated PET-CT predicted correctly the T status, N status, M status and TNM status in, respectively, 86%, 80%, 98%, 70% versus 68%, 66%,88%, 46% with CT, 46%, 70%, 96%, 30% with PET and 72%, 68%, 96%, 54% with visually correlated PET-CT. T status and N status were overstaged, respectively, in 8% and 16% with integrated PET-CT, in 20% and 28% with CT, in 16% and 20% with PET, in 12% and 20% with visually correlated PET-CT and understaged in 6% and 4% with integrated PET-CT, versus 12% and 6% with CT, 38% and 10% with PET and 12% with visually correlated PET-CT. Integrated PET-CT improves the staging of lung cancer through a better anatomic localization and characterization of lesions and is superior to CT alone and PET alone. If this technique is not available, visual correlation of PET and CT can be a valuable alternative.
正电子发射断层扫描（PET）与计算机断层扫描（CT）相结合是一种能提供解剖和代谢信息的新型成像方式。本研究旨在回顾性评估PET-CT融合成像在提示性肺部病变分期中的准确性，并将其与单纯CT、单纯PET以及视觉关联PET-CT的准确性进行比较。对50例因提示性肺部病变而接受PET-CT融合成像检查以进行分期的患者进行了研究。通过CT、PET、视觉关联PET-CT和PET-CT融合成像确定了他们的肿瘤、淋巴结、转移（TNM）状态。将这些TNM分期与手术TNM状态进行比较。PET-CT融合成像在评估TNM状态方面是最准确的成像技术。PET-CT融合成像分别正确预测T状态、N状态、M状态和TNM状态的比例为86%、80%、98%、70%，而单纯CT分别为68%、66%、88%、46%，单纯PET分别为46%、70%、96%、30%，视觉关联PET-CT分别为72%、68%、96%、54%。PET-CT融合成像中T状态和N状态分别有8%和16%被高估，CT分别为20%和28%，PET分别为16%和20%，视觉关联PET-CT分别为12%和20%；PET-CT融合成像中T状态和N状态分别有6%和4%被低估，CT分别为12%和6%，PET分别为38%和10%，视觉关联PET-CT为12%。PET-CT融合成像通过更好地对病变进行解剖定位和特征描述，改善了肺癌的分期，优于单纯CT和单纯PET。如果无法使用该技术，PET与CT的视觉关联可以是一种有价值的替代方法。
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