Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 166 Gumiro, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707, Republic of Korea.
AJR Am J Roentgenol. 2012 Jan;198(1):83-8. doi: 10.2214/AJR.11.6862.
The purposes of our study were to evaluate 18F-FDG PET findings of ground-glass opacity (GGO) nodules and to determine the value of FDG PET for the preoperative staging of lung cancer manifesting predominantly as GGO.
Eighty-nine patients (46 men and 43 women; mean [±SD] age, 62.4±7.2 years [range, 33-81 years] and 61.7±6.7 years [range, 34-75 years], respectively) with 134 GGO nodules (56 single and 78 multiple) who underwent CT and FDG PET before surgery were included. CT and PET findings were assessed in terms of lesion size, GGO percentage, multiplicity, and maximum standardized uptake value (SUVmax). SUVmax was correlated with lesion size and GGO percentage using linear regression. The SUVmax and hypermetabolism rates of solitary and multiple GGO nodules were compared using the Student t test or Fisher exact test. Lymph node and distant organ metastasis staging by FDG PET were correlated with histopathologic findings.
SUVmax was positively correlated with lesion size (mean, 14.5 mm; range, 5-37 mm) (r=0.6705; p<0.0001) and was negatively correlated with GGO percentage (mean, 77%; range, 50-100%) (r=-0.7465; p<0.0001). Solitary nodules showed higher hypermetabolism rates (73% [41/56]) than did multiple nodules (27% [21/78]) (p=0.0001), but SUVmax was not significantly different between solitary and multiple nodules. There was no true-positive interpretation of nodal or distant metastasis from GGO nodules by FDG PET.
FDG PET showed no clear advantage for the staging of lung cancer with predominant GGO because of the low incidences of nodal and distant metastasis.
我们研究的目的是评估 18F-FDG PET 对磨玻璃密度（GGO）结节的发现，并确定 FDG PET 对主要表现为 GGO 的肺癌术前分期的价值。
共纳入 89 例（46 名男性和 43 名女性；平均年龄[±标准差]分别为 62.4±7.2 岁[范围 33-81 岁]和 61.7±6.7 岁[范围 34-75 岁]）患者，共 134 个 GGO 结节（56 个单发和 78 个多发）在术前均进行了 CT 和 FDG PET 检查。根据病变大小、GGO 百分比、多发性和最大标准化摄取值（SUVmax）评估 CT 和 PET 结果。使用线性回归分析 SUVmax 与病变大小和 GGO 百分比的相关性。使用学生 t 检验或 Fisher 确切检验比较单发和多发 GGO 结节的 SUVmax 和高代谢率。FDG PET 对淋巴结和远处器官转移的分期与组织病理学结果相关。
SUVmax 与病变大小（平均，14.5mm；范围，5-37mm）呈正相关（r=0.6705；p<0.0001），与 GGO 百分比（平均，77%；范围，50-100%）呈负相关（r=-0.7465；p<0.0001）。单发结节的高代谢率（73%[41/56]）高于多发结节（27%[21/78]）（p=0.0001），但单发和多发结节的 SUVmax 无显著差异。FDG PET 对 GGO 结节的淋巴结或远处转移无阳性结果。
由于淋巴结和远处转移的发生率较低，FDG PET 对主要表现为 GGO 的肺癌分期没有明显优势。
