术前使用混合 SPECT/低剂量 CT 进行肺功能量化：一项初步研究。
Pre-operative quantification of pulmonary function using hybrid-SPECT/low-dose-CT: A pilot study.
机构信息
Department for Radiology and Nuclear Medicine, University Hospital Magdeburg, Magdeburg, Germany.
Department for Radiology and Nuclear Medicine, University Hospital Magdeburg, Magdeburg, Germany; Department of Nuclear Medicine, Charité University Hospital Berlin, Berlin, Germany.
出版信息
Lung Cancer. 2018 Apr;118:155-160. doi: 10.1016/j.lungcan.2018.02.010. Epub 2018 Feb 19.
RATIONALE
Pre-operative lobar function is estimated by scintigraphy in patients with pulmonary malignancies and compromised function. This study compared the lobar perfusion determined by scintigraphy (PS) with data from SPECT/low-dose-CT (SPECT/ldCT) analyzed manually and semi-automatic.
METHODS
Retrospective analysis on 39 patients (m/f = 25/14; age: 72.5 [22-89] years) with indication for pulmonary perfusion scintigraphy. Imaging was performed using SPECT/ldCT. Data was analyzed manually and by semi-automatic software. Readers' confidence in 3D-segmentation was scored by two independent readers. Interrater agreement was calculated. In addition, Spearman's rank correlation and Wilcoxon's test were used.
RESULTS
Results from PS differed significantly from SPECT/ldCT processed manually or semi-automatically in 4/5 lobes (total difference ≤21.6%; rho ≥0.44) and in 3/5 (total difference 21.6%; rho ≥0.37), respectively. Readers' confidence in 3D-segmentation showed a perfect interrater agreement (κ = 0.98).
CONCLUSION
Quantification of lobar perfusion by SPECT/ldCT differs significantly from planar scintigraphy (e.g., with potential influence on therapy). The semi-automatic software analysis provides an applicable methodology.
原理
在有肺部恶性肿瘤和功能受损的患者中，通过闪烁扫描术来估计术前的肺叶功能。本研究比较了闪烁扫描术（PS）确定的肺叶灌注与手动和半自动分析的 SPECT/低剂量 CT（SPECT/ldCT）数据。
方法
对 39 名有肺灌注闪烁扫描指征的患者（男/女=25/14；年龄：72.5[22-89]岁）进行回顾性分析。使用 SPECT/ldCT 进行成像。数据通过手动和半自动软件进行分析。两位独立的读者对 3D 分段的置信度进行评分，并计算组内相关系数。此外，还使用了 Spearman 秩相关和 Wilcoxon 检验。
结果
PS 的结果与手动或半自动处理的 SPECT/ldCT 在 4/5 个肺叶（总差异≤21.6%；rho≥0.44）和 3/5 个肺叶（总差异 21.6%；rho≥0.37）中存在显著差异。3D 分段的读者置信度显示出极好的组内相关系数（κ=0.98）。
结论
SPECT/ldCT 对肺叶灌注的定量与平面闪烁扫描术有显著差异（例如，可能对治疗有影响）。半自动软件分析提供了一种可行的方法。
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