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双时相(18)F-氟脱氧葡萄糖一体化正电子发射断层显像与计算机断层扫描在胃肠道恶性与良性疾病鉴别中的价值

[Value of dual-time-point (18)F-fluorodeoxyglucose integrated positron emission and computed tomography in differentiation of malignant from benign gastrointestinal diseases].

作者信息

Xu Xiu-xia, Cheng Juan, Xu Wen-gui, Dai Dong, Song Xiu-yu, Ma Wen-chao, Zhu Lei, Zhu Xiang

机构信息

Department of Molecule Imaging and Nuclear Medicine, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.

出版信息

Zhonghua Zhong Liu Za Zhi. 2012 May;34(5):364-8. doi: 10. 3760/cma.j.issn.0253-3766.2012.05.010.

Abstract

OBJECTIVE

To explore the value of dual-time-point (18)F-fluorodeoxyglucose integrated positron emission and computed tomography ((18)F-FDG PET-CT) in differentiation of malignant from benign gastrointestinal diseases.

METHODS

Sixty five patients with suspected gastrointestinal lesions underwent dual-time-point (18)F-FDG PET-CT imaging. Standardized uptake value (SUV) was calculated for semi-quantitative assessment. The SUV of the two acquisitions were signed SUV(early) and SUV(delayed), respectively. Then the change of SUVmax (ΔSUVmax) was calculated. The ROC curves of the SUV(early), SUV(delayed) and ΔSUV were drawn to find the best cut-off point value for differential diagnosis, and then the sensitivity, specificity, positive predictive value, negative predictive value and accuracy were calculated, respectively.

RESULTS

Of the malignant lesions, the SUVmax in delayed imaging were significantly higher than those in early imaging, while there were no significant differences of SUVmax between the two images of the benign lesions. The ΔSUVmax of the malignant lesions were significantly higher than that of the benign ones. Taking the SUVmax higher than 9.2 in early imaging as positive diagnostic criteria, the sensitivity was 72.7%, the specificity was 85.7%, the positive predictive value was 91.4%, the negative predictive value was 60.0%, and the accuracy was 76.9%. Taking the SUVmax higher than 10.9 in delayed imaging as positive diagnostic criteria, the sensitivity was 75.0%, the specificity was 90.5%, the positive predictive value was 94.3%, the negative predictive value was 63.3%, and the accuracy was 80.0%. Taking the ΔSUVmax higher than 5.1% as positive diagnostic criteria, the sensitivity was 95.5%, the specificity was 85.7%, the positive predictive value was 93.3%, the negative predictive value was 90.0%, and the accuracy was 92.3%. The accuracy of dual-time-point (18)F-FDG PET-CT imaging was significantly higher than that of single-time point (18)F-FDG PET-CT imaging.

CONCLUSION

Dual-time-point (18)F-FDG PET-CT imaging is a useful method for differentiating malignant from benign gastrointestinal diseases, and it is superior to the single-time point (18)F-FDG PET-CT imaging.

摘要

目的

探讨双时相18F-氟脱氧葡萄糖正电子发射断层显像与计算机断层扫描(18F-FDG PET-CT)在鉴别胃肠道良恶性疾病中的价值。

方法

65例疑似胃肠道病变患者接受双时相18F-FDG PET-CT成像。计算标准化摄取值(SUV)用于半定量评估。两次采集的SUV分别标记为SUV(早期)和SUV(延迟)。然后计算SUVmax的变化(ΔSUVmax)。绘制SUV(早期)、SUV(延迟)和ΔSUV的ROC曲线以找到鉴别诊断的最佳截断点值,然后分别计算敏感性、特异性、阳性预测值、阴性预测值和准确性。

结果

恶性病变中,延迟显像的SUVmax显著高于早期显像,而良性病变的两次图像间SUVmax无显著差异。恶性病变的ΔSUVmax显著高于良性病变。以早期显像SUVmax高于9.2为阳性诊断标准,敏感性为72.7%,特异性为85.7%,阳性预测值为91.4%,阴性预测值为60.0%,准确性为76.9%。以延迟显像SUVmax高于10.9为阳性诊断标准,敏感性为75.0%,特异性为90.5%,阳性预测值为94.3%,阴性预测值为63.3%,准确性为80.0%。以ΔSUVmax高于5.1%为阳性诊断标准,敏感性为95.5%,特异性为85.7%,阳性预测值为93.3%,阴性预测值为90.0%,准确性为92.3%。双时相18F-FDG PET-CT成像的准确性显著高于单时相18F-FDG PET-CT成像。

结论

双时相18F-FDG PET-CT成像是鉴别胃肠道良恶性疾病的有用方法,且优于单时相18F-FDG PET-CT成像。

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