非离子型静脉造影剂不会在肺癌患者的18F-FDG PET/CT检查中造成具有临床意义的伪影。
Nonionic intravenous contrast agent does not cause clinically significant artifacts to 18F-FDG PET/CT in patients with lung cancer.
作者信息
An Young-Sil, Sheen Seung S, Oh Y J, Hwang Sung C, Yoon Joon-Kee
机构信息
Department of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, San 5, Wonchun-dong, Youngtong-gu, Suwon, Kyunggi-do 443-721, Korea.
出版信息
Ann Nucl Med. 2007 Dec;21(10):585-92. doi: 10.1007/s12149-007-0066-3. Epub 2007 Dec 25.
OBJECTIVE
This study was performed to evaluate the effects of intravenous (i.v.) contrast agent on semi-quantitative values and lymph node (LN) staging of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) in patients with lung cancer.
METHODS
Thirty-five patients with lung cancer were prospectively included. Whole-body PET and nonenhanced CT images were acquired 60 min following the i.v. injection of 370 MBq 18F-FDG and subsequently, enhanced-CT images were acquired with the i.v. administration of 400 mg iodinated contrast agent without positional change. PET images were reconstructed with both nonenhanced and enhanced CTs, and the maximum and average standardized uptake values (SUVmax and SUVave) calculated from lung masses, LNs, metastatic lesions, and normal structures were compared. To evaluate the effects of the i.v. contrast agent on LN staging, we compared the LN status on the basis of SUVs (cut-offs; SUVmax=3.5, SUVave=3.0).
RESULTS
The mean differences of SUVmax in normal structures between enhanced and nonenhanced PET/CT were 15.23%+/-13.19% for contralateral lung, 8.53%+/-6.11% for aorta, 5.85%+/-4.99% for liver, 5.47%+/-6.81% for muscle, and 2.81%+/-3.05% for bone marrow, and those of SUVave were 10.17%+/-9.00%, 10.51%+/-7.89%, 4.95%+/-3.89%, 5.66%+/-9.12%, and 2.49%+/-2.50%, respectively. The mean differences of SUVmax between enhanced and nonenhanced PET/CT were 5.89%+/-3.92% for lung lesions (n=41), 6.27%+/-3.79% for LNs (n=76), and 3.55%+/-3.38% for metastatic lesions (n=35), and those of SUVave were 3.22%+/-3.01%, 2.86%+/-1.71%, and 2.33%+/-3.95%, respectively. Although one LN status changed from benign to malignant because of contrast-related artifact, there was no up- or down-staging in any of the patients after contrast enhancement.
CONCLUSIONS
An i.v. contrast agent may be used in PET/CT without producing any clinically significant artifact.
目的
本研究旨在评估静脉注射造影剂对肺癌患者18F-氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（18F-FDG PET/CT）半定量值及淋巴结（LN）分期的影响。
方法
前瞻性纳入35例肺癌患者。静脉注射370 MBq 18F-FDG后60分钟采集全身PET和非增强CT图像，随后在不改变体位的情况下静脉注射400 mg碘化造影剂后采集增强CT图像。PET图像分别用非增强和增强CT重建，并比较从肺肿块、淋巴结、转移灶和正常结构计算得出的最大和平均标准化摄取值（SUVmax和SUVave）。为评估静脉注射造影剂对LN分期的影响，我们根据SUV值（临界值；SUVmax = 3.5，SUVave = 3.0）比较淋巴结状态。
结果
增强和非增强PET/CT之间正常结构的SUVmax平均差异，对侧肺为15.23%±13.19%，主动脉为8.53%±6.11%，肝脏为5.85%±4.99%，肌肉为5.47%±6.81%，骨髓为2.81%±3.05%；SUVave的平均差异分别为10.17%±9.00%、10.51%±7.89%、4.95%±3.89%、5.66%±9.12%和2.49%±2.50%。增强和非增强PET/CT之间肺病灶（n = 41）的SUVmax平均差异为5.89%±3.92%，淋巴结（n = 76）为6.27%±3.79%，转移灶（n = 35）为3.55%±3.38%；SUVave的平均差异分别为3.22%±3.01%、2.86%±1.71%和2.33%±3.95%。尽管有一个淋巴结状态因造影剂相关伪影从良性变为恶性，但造影剂增强后所有患者均未出现分期上调或下调。
结论
静脉注射造影剂可用于PET/CT，且不会产生任何具有临床意义的伪影。
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