Su Ming-gang, Fan Qiu-ping, Tian Ye, Li Fang-lan, Yang Xiao-chuan, Li Lin, Fan Cheng-zhong, Tian Rong
Department of Nuclear Medicine, West China Hospital, Sichuan University, Chengdu 610041, China.
Sichuan Da Xue Xue Bao Yi Xue Ban. 2009 May;40(3):517-20.
To evaluate the value of dual time point 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) in differentiating malignant and benign superficial lymph nodes.
Sixty-eight patients with ninety superficial lymph nodes were examined. Whole body 18F-FDG PET imaging was performed one hour (early) after FDG injection and repeated one hour (delayed) later but only for the interesting areas. The maximum standardized uptake value (SUVmax) was determined for each of the node on both early and delayed images (SUV early and SUV delayed, respectively). Retention index (RI) was then calculated. The cutoff values of SUV early, SUV delayed and RI were determined by receiver operating characteristic (ROC) analyses. The efficacy of each parameter was also analyzed by ROC analyses.
The histopathology examinations confirmed 51 malignant nodes and 39 benign nodes. The SUV early (x +/- s) for benign nodes and malignant nodes were 3.26 +/- 1.62 and 8.04 +/- 5.56, respectively (P=0.000). The SUV delayed for benign nodes and malignant nodes were 3.93 +/- 2.11 and 9.82 +/- 6.29, respectively (P=0.000). The RI for benign nodes and malignant nodes were 19.1 +/- 22.5 and 24.8 +/- 18.8, respectively (P=0.191). The cutoff values of SUV early, SUV delayed and RI were 4.3, 4.8 and 18, respectively. The cutoff values of SUV early, SUV delayed and RI produced a sensitivity of 71%, 78% and 63%, a specificity of 87%, 85% and 46%, and an accuracy of 78%, 80% and 57%, respectively. The ROC analyses illustrated that the diagnostic efficacy of SUV early, SUV delayed was higher than RI (P<0.001). However, there was no difference in diagnostic efficacy between SUV early, and SUV delayed (P=0.409).
Dual-time point 18F-FDG PET does differentiate benign and malignant superficial lymph nodes effectively.
评估双时相18F-氟脱氧葡萄糖正电子发射断层扫描（18F-FDG PET）在鉴别浅表淋巴结良恶性方面的价值。
对68例患者的90个浅表淋巴结进行检查。在注射FDG后1小时（早期）进行全身18F-FDG PET成像，并在1小时后（延迟期）仅对感兴趣区域重复成像。分别在早期和延迟期图像上测定每个淋巴结的最大标准化摄取值（SUVmax）（分别为SUV早期和SUV延迟期）。然后计算滞留指数（RI）。通过受试者操作特征（ROC）分析确定SUV早期、SUV延迟期和RI的截断值。还通过ROC分析分析每个参数的效能。
组织病理学检查证实51个恶性淋巴结和39个良性淋巴结。良性淋巴结和恶性淋巴结的SUV早期（x±s）分别为3.26±1.62和8.04±5.56（P = 0.000）。良性淋巴结和恶性淋巴结的SUV延迟期分别为3.93±2.11和9.82±6.29（P = 0.000）。良性淋巴结和恶性淋巴结的RI分别为19.1±22.5和24.8±18.8（P = 0.191）。SUV早期、SUV延迟期和RI的截断值分别为4.3、4.8和18。SUV早期、SUV延迟期和RI的截断值产生的敏感性分别为71%、78%和63%，特异性分别为87%、85%和46%，准确性分别为78%、80%和57%。ROC分析表明SUV早期、SUV延迟期的诊断效能高于RI（P<0.001）。然而，SUV早期和SUV延迟期之间的诊断效能没有差异（P = 0.409）。
双时相18F-FDG PET能有效鉴别浅表淋巴结的良恶性。
