Shinya Takayoshi, Rai Kammei, Okumura Yoshihiro, Fujiwara Keiichi, Matsuo Kiyoshi, Yonei Toshiro, Sato Toshio, Watanabe Kazuhiko, Kawai Haruyuki, Sato Shuhei, Kanazawa Susumu
PET-RI center, Okayama Kyokuto Hospital, Okayama, Japan.
Clin Nucl Med. 2009 Apr;34(4):216-21. doi: 10.1097/RLU.0b013e31819a1f3d.
The aim of this study was to evaluate the diagnostic capacity of F-18 fluorodeoxyglucose dual-time-point (DTP) positron emission tomography (PET)/computed tomography (CT) for intrathoracic lymph node (LN) metastases in patients with nonsmall cell lung cancer (NSCLC).
Thirty-four patients had DTP PET/CT, with 60 minutes and 2-hour scans (n=19, NSCLC; n=15, benign pulmonary disease). LN diagnoses were confirmed by surgery or clinical follow-up (n=14, metastatic LNs; n=45, nonmetastatic LNs; n=39, inflammatory LNs).
The maximum standardized uptake value (SUVmax) in the metastatic group was significantly higher than those in the nonmetastatic and inflammatory groups on both early- and delayed-phase imaging (each P<0.0001). The retention index (RI) of SUVmax (RI-SUVmax) in the metastatic group was significantly higher than in the nonmetastatic (P=0.0008) and inflammatory groups (P=0.0074). No significant difference was found between SUVmax values of the nonmetastatic and inflammatory groups on early- (P=0.6461) or delayed-phase (P=0.6913), or between RI-SUVmax values of the nonmetastatic and inflammatory groups (P=0.5717). For early-phase SUVmax, the cut-off value for highest accuracy with metastatic LNs was 3.61, yielding a sensitivity of 86.67% and a specificity of 88.00%. For delayed-phase SUVmax, the cut-off value was 4.00, yielding a sensitivity of 91.6% and specificity of 92.9%. For RI-SUVmax, the cut-off value was 20.91%, yielding a sensitivity of 73.6% and specificity of 75.9%.
DTP PET/CT with a semiquantitative technique may improve diagnostic capacity for nodal staging of NSCLC.
本研究旨在评估F-18氟脱氧葡萄糖双时相（DTP）正电子发射断层扫描（PET）/计算机断层扫描（CT）对非小细胞肺癌（NSCLC）患者胸内淋巴结（LN）转移的诊断能力。
34例患者接受了DTP PET/CT检查，分别在60分钟和2小时进行扫描（n = 19，NSCLC；n = 15，良性肺部疾病）。LN诊断通过手术或临床随访得以证实（n = 14，转移性LN；n = 45，非转移性LN；n = 39，炎性LN）。
在早期和延迟期成像中，转移组的最大标准化摄取值（SUVmax）均显著高于非转移组和炎性组（各P < 0.0001）。转移组SUVmax的滞留指数（RI）（RI-SUVmax）显著高于非转移组（P = 0.0008）和炎性组（P = 0.0074）。非转移组和炎性组在早期（P = 0.6461）或延迟期（P = 0.6913）的SUVmax值之间，以及非转移组和炎性组的RI-SUVmax值之间均未发现显著差异。对于早期SUVmax，诊断转移性LN的最高准确性的临界值为3.61，灵敏度为86.67%，特异性为88.00%。对于延迟期SUVmax，临界值为4.00，灵敏度为91.6%，特异性为92.9%。对于RI-SUVmax，临界值为20.91%，灵敏度为73.6%，特异性为75.9%。
采用半定量技术的DTP PET/CT可能会提高NSCLC淋巴结分期的诊断能力。
