Department of Nuclear Medicine, University Hospital Bonn, Bonn, Germany.
Clin Nucl Med. 2011 Jun;36(6):423-8. doi: 10.1097/RLU.0b013e3182173823.
The aim of this study was to assess the utility of dual-time-point F-18 fluorodeoxyglucose positron emission tomography (F-18 FDG PET) in differentiating benign from malignant pleural disease, in patients with non-small-cell lung cancer.
A total of 61 patients with non-small-cell lung cancer and pleural effusion were included in this retrospective study. All patients had whole-body FDG PET/CT imaging at 60 ± 10 minutes post-FDG injection, whereas 31 patients had second-time delayed imaging repeated at 90 ± 10 minutes for the chest. Maximum standardized uptake values (SUV(max)) and the average percent change in SUV(max) (%SUV) between time point 1 and time point 2 were calculated. Malignancy was defined using the following criteria: (1) visual assessment using 3-points grading scale; (2) SUV(max) ≥2.4; (3) %SUV ≥ +9; and (4) SUV(max) ≥2.4 and/or %SUV ≥ +9. Analysis of variance test and receiver operating characteristic analysis were used in statistical analysis. P < 0.05 was considered significant.
Follow-up revealed 29 patient with malignant pleural disease and 31 patients with benign pleural effusion. The average SUV(max) in malignant effusions was 6.5 ± 4 versus 2.2 ± 0.9 in benign effusions (P < 0.0001). The average %SUV in malignant effusions was +13 ± 10 versus -8 ± 11 in benign effusions (P < 0.0004). Sensitivity, specificity, and accuracy for the 5 criteria were as follows: (1) 86%, 72%, and 79%; (2) 93%, 72%, and 82%; (3) 67%, 94%, and 81%; (4) 100%, 94%, and 97%.
Dual-time-point F-18 FDG PET can improve the diagnostic accuracy in differentiating benign from malignant pleural disease, with high sensitivity and good specificity.
本研究旨在评估双时相 F-18 氟代脱氧葡萄糖正电子发射断层扫描（F-18 FDG PET）在区分非小细胞肺癌患者的良性和恶性胸膜疾病中的效用。
本回顾性研究纳入了 61 例患有非小细胞肺癌和胸腔积液的患者。所有患者均在 FDG 注射后 60±10 分钟进行全身 FDG PET/CT 成像，其中 31 例患者在胸部进行 90±10 分钟的第二次延迟成像。计算时间点 1 和时间点 2 之间的最大标准化摄取值（SUV(max))和 SUV(max)的平均百分比变化（%SUV)。采用以下标准定义恶性肿瘤：（1）使用 3 分制评分量表进行视觉评估；（2）SUV(max)≥2.4；（3）%SUV≥+9；（4）SUV(max)≥2.4 和/或%SUV≥+9。方差分析检验和受试者工作特征分析用于统计分析。P<0.05 被认为具有统计学意义。
随访发现 29 例患者为恶性胸膜疾病，31 例患者为良性胸腔积液。恶性积液的平均 SUV(max)为 6.5±4，良性积液为 2.2±0.9（P<0.0001）。恶性积液的平均%SUV 为+13±10，良性积液为-8±11（P<0.0004）。5 项标准的灵敏度、特异性和准确性分别为：（1）86%、72%和 79%；（2）93%、72%和 82%；（3）67%、94%和 81%；（4）100%、94%和 97%。
双时相 F-18 FDG PET 可提高区分良性和恶性胸膜疾病的诊断准确性，具有较高的灵敏度和良好的特异性。
