双期18F-FDG PET/CT在诊断胰腺小肿瘤中的应用价值
Usefulness of dual-phase 18F-FDG PET/CT for diagnosing small pancreatic tumors.
作者信息
Kawada Natsuko, Uehara Hiroyuki, Hosoki Takuya, Takami Motohisa, Shiroeda Hisakazu, Arisawa Tomiyasu, Tomita Yasuhiko
机构信息
From the *Department of Pathology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka; †Department of Gastroenterology, Kanazawa Medical University, Ishikawa; ‡Department of Gastroenterology, Osaka Medical Center for Cancer and Cardiovascular Diseases; and §Morinomiya Clinic PET Center, Osaka, Japan.
出版信息
Pancreas. 2015 May;44(4):655-9. doi: 10.1097/MPA.0000000000000313.
OBJECTIVES
The usefulness of dual-phase F-fluorodeoxyglucose (F-FDG) positron emission tomography/computed tomography (PET/CT) for pancreatic tumors was investigated including numerous small tumors.
METHODS
Consecutive 116 patients with solid pancreatic tumors were subjected. Maximum standard uptake values (SUVmax) at 1 and 2 hours after FDG injection were defined as early and delayed SUVmax, respectively. Receiver operating characteristic curve was used to determine the optimal cutoff value of early SUVmax. Diagnostic accuracy of dual-phase FDG PET/CT was compared with that of single phase.
RESULTS
The mean ± SD tumor size was 25 ±12 mm in diameter. The level of early SUVmax and proportion of elevated SUVmax in delayed phase were significantly higher in malignancy than those in benignancy for less than 25 mm tumors (4.1 ± 2.6 vs 1.9 ± 0.5, P < 0.001; 89% vs 17%, P < 0.0001) although they did not reach statistical significance for greater than or equal to 25 mm tumors. When diagnostic criteria of dual-phase FDG PET/CT for less than 25 mm tumors were determined as (1) early SUVmax greater than or equal to 2.1 and/or (2) delayed SUVmax greater than early SUVmax, sensitivity, specificity, and over all accuracy of dual-phase FDG PET/CT were better than that of single phase for less than 25 mm tumor (93%, 83%, and 91% vs 79%, 83%, and 80%, respectively).
CONCLUSIONS
Dual-phase FDG PET/CT might be useful for diagnosing small pancreatic tumors.
目的
研究双期氟代脱氧葡萄糖（F-FDG）正电子发射断层扫描/计算机断层扫描（PET/CT）对胰腺肿瘤（包括众多小肿瘤）的诊断价值。
方法
纳入116例连续性实性胰腺肿瘤患者。将FDG注射后1小时和2小时的最大标准摄取值（SUVmax）分别定义为早期和延迟SUVmax。采用受试者操作特征曲线确定早期SUVmax的最佳截断值。比较双期FDG PET/CT与单期的诊断准确性。
结果
肿瘤平均直径±标准差为25±12mm。对于直径小于25mm的肿瘤，恶性肿瘤的早期SUVmax水平和延迟期SUVmax升高的比例显著高于良性肿瘤（4.1±2.6对1.9±0.5，P<0.001；89%对17%，P<0.0001），而对于直径大于或等于25mm的肿瘤，差异无统计学意义。当将双期FDG PET/CT对直径小于25mm肿瘤的诊断标准确定为（1）早期SUVmax大于或等于2.1和/或（2）延迟SUVmax大于早期SUVmax时，对于直径小于25mm的肿瘤，双期FDG PET/CT的敏感性、特异性和总体准确性均优于单期（分别为93%、83%和91%对79%、83%和80%）。
结论
双期FDG PET/CT可能有助于诊断小胰腺肿瘤。
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