1 Department of Radiology, Nanjing Hospital, Nanjing Medical University , Nanjing, Jiangsu, China .
Cancer Biother Radiopharm. 2013 Dec;28(10):731-6. doi: 10.1089/cbr.2013.1482. Epub 2013 Oct 5.
The objective of this study was to evaluate the clinical value of combination of diagnostic computed tomography (CT) and somatostatin receptor imaging with (99m)Tc-octreotide acetate SPECT/CT in differentiation of benign pulmonary nodules from cancers.
This was a retrospective study, 29 patients with suspected pulmonary neoplasm underwent diagnostic CT and (99m)Tc-octreotide SPECT/CT scans, and the tumor-to-normal tissue tracer value (T/N) for (99m)Tc-octreotide was measured. Diagnosis was confirmed by histological analysis.
Eighteen of the 29 patients included in this study had lung cancer: 2 with small cell lung cancer and 16 with nonsmall cell lung cancer. The other 11 patients had benign lung lesions: 5 with tuberculosis, 4 with nontuberculosis infection, 1 with hematoma, and 1 with fibroma. (99m)Tc-octreotide uptake (expressed as mean T/N±SD) was significantly higher in lung cancers (2.58±0.91) than benign lesions (1.38±0.79) (p=0.002). Specificity for pulmonary malignant nodule diagnosis was 63.6% for diagnostic CT, 72.7% for somatostatin receptor SPECT/CT imaging, and 81.8% for the combined use of diagnostic CT and somatostatin receptor SPECT/CT imaging.
Somatostatin receptor imaging with (99m)Tc-octreotide SPECT/CT is useful for the differentiation of benign pulmonary nodules from lung cancers, the combination of diagnostic CT and (99m)Tc-octreotide SPECT/CT further increases the specificity of malignant pulmonary nodule detection.
本研究旨在评估诊断 CT 与生长抑素受体成像联合应用(99m)Tc-奥曲肽 SPECT/CT 对良、恶性肺结节的鉴别诊断价值。
回顾性分析 29 例疑似肺部肿瘤患者,均行诊断 CT 及(99m)Tc-奥曲肽 SPECT/CT 扫描,测量(99m)Tc-奥曲肽肿瘤与正常组织摄取比值(T/N)。以组织病理学结果为金标准。
29 例患者中,肺癌 18 例,其中小细胞肺癌 2 例,非小细胞肺癌 16 例;良性病变 11 例,其中肺结核 5 例,非结核性肺部感染 4 例,血肿 1 例,纤维瘤 1 例。肺癌(2.58±0.91)摄取值显著高于良性病变(1.38±0.79)(p=0.002)。诊断 CT 对肺恶性结节的诊断特异性为 63.6%,生长抑素受体 SPECT/CT 为 72.7%,联合诊断 CT 和生长抑素受体 SPECT/CT 为 81.8%。
(99m)Tc-奥曲肽 SPECT/CT 生长抑素受体显像有助于良、恶性肺结节的鉴别诊断,诊断 CT 与(99m)Tc-奥曲肽 SPECT/CT 联合应用可进一步提高恶性肺结节的检出率。