Nanni Cristina, Rossetti Virginia, Zompatori Maurizio, Ambrosini Valentina, Montesi Valeria, Mascherini Donatella, Pettinato Cinzia, Marzola Maria Cristina, Colletti Patrick M, Rubello Domenico, Fanti Stefano
Department of Nuclear Medicine, Policlinico Sant'Orsola-Malpighi, Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
Department of Radiology, Policlinico Sant'Orsola-Malpighi, Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
Biomed Pharmacother. 2014 Mar;68(2):219-23. doi: 10.1016/j.biopha.2013.11.002. Epub 2014 Jan 10.
The aim of this study was to assess the performance of FDG PET/ceCT simultaneously acquired, contemporary read and finally discussed by the radiologist and the nuclear medicine physician for staging and restaging lung cancer patients.
We analysed 17 consecutive patients (7F; 10M; mean age 68). Six patients were in staging, 8 patients were in restaging (1 during therapy, 2 after therapy and 5 during the follow-up) and 2 patients needed to characterise a suspect pulmonary mass. All the patients underwent combined FDG PET/CT and ceCT acquired simultaneously on the same tomograph. The images were read and reported together by the nuclear medicine physician and the radiologist.
None of the patients had adverse reactions nor complained about the procedure. Thirteen FDG PET/ceCT turned out positive, while 4 were completely negative. Among positive patients, a significant SUV max was detected in all the cases (range 1.8-17.5). In the end, 9 patients had a true positive result, 4 true negative, 3 false positive and 1 false negative. Sensitivity, specificity and accuracy of the combined procedure were 90%, 57% and 76% respectively. In 7/17 patients FDG PET/CT and ceCT were completely concordant. FDG PET/CT provided a significant impact on the final interpretation in 7/17 patients while ceCT had a major impact in 3/17 patients.
This preliminary study shows that FDG PET/ceCT is a feasible technique for lung cancer patients, providing an optimal sensitivity (90%). From our results it is advisable not to include patients without an histological diagnosis of cancer due to possible false positivity of the two methods, significantly reducing specificity. However, a proper patient selection is not easy and the future of this combined test relies essentially on the capacity to early identify only the subjects who would really benefit from both the procedures.
本研究旨在评估同时采集、由放射科医生和核医学医生进行当代解读并最终讨论的FDG PET/ceCT在肺癌患者分期及再分期中的表现。
我们分析了连续的17例患者（7例女性；10例男性；平均年龄68岁）。6例患者处于分期阶段，8例患者处于再分期阶段（1例在治疗期间，2例在治疗后，5例在随访期间），2例患者需要对可疑肺部肿块进行特征描述。所有患者均在同一台断层扫描仪上同时进行了FDG PET/CT和ceCT检查。图像由核医学医生和放射科医生共同解读并报告。
所有患者均未出现不良反应，也未对检查过程提出抱怨。13例FDG PET/ceCT结果呈阳性，4例完全阴性。在阳性患者中，所有病例均检测到显著的最大标准化摄取值（SUV max）（范围为1.8 - 17.5）。最终，9例患者为真阳性，4例为真阴性，3例为假阳性，1例为假阴性综合检查的敏感性、特异性和准确性分别为90%、57%和76%。在17例患者中的7例中，FDG PET/CT和ceCT完全一致。FDG PET/CT对17例患者中的7例最终解读产生了重大影响，而ceCT对17例患者中的3例产生了重大影响。
这项初步研究表明，FDG PET/ceCT对于肺癌患者是一种可行的技术，具有最佳的敏感性（90%）。根据我们的结果，由于这两种方法可能存在假阳性，不建议纳入没有癌症组织学诊断的患者，这会显著降低特异性。然而，进行合适的患者选择并不容易，这种联合检查的未来主要依赖于早期仅识别真正能从两种检查中获益的受试者的能力。
