应用肾上腺最大标准化摄取值对 I-6β-碘甲基-19-去甲胆固醇 SPECT/CT 进行单侧功能性肾上腺皮质肿块的特征描述。

Application of adrenal maximum standardized uptake value to I-6β-iodomethyl-19-norcholesterol SPECT/CT for characterizing unilateral hyperfunctioning adrenocortical masses.

机构信息

Department of Radiology, Kagoshima University, Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan.

出版信息

Eur J Radiol. 2020 Dec;133:109397. doi: 10.1016/j.ejrad.2020.109397. Epub 2020 Nov 4.

DOI:10.1016/j.ejrad.2020.109397

PMID:33190101

Abstract

PURPOSE

To evaluate the maximum standardized uptake value (SUVmax) by I-6β-iodomethyl-19-norcholesterol (NP-59) single-photon emission computed tomography (SPECT)/computed tomography (CT) for characterizing unilateral hyperfunctioning adrenocortical masses.

METHODS

Ten patients underwent NP-59 SPECT/CT to evaluate the following unilateral adrenocortical hyperfuncting masses: three with Cushing's syndrome (CS), three with subclinical CS, and four with primary aldosteronism (PA). Visual and quantitative or semiquantitative analyses (noncontrast CT HU [Hounsfield units], lesion SUVmax, contralateral SUVmax, and SUVmax ratio [lesion SUVmax/contralateral adrenal SUVmax]) were performed. The Mann-Whitney U test or Chi-squared test was used appropriately to assess differences between quantitative variables or compare categorical data. Diagnostic performance was evaluated by receiver operating characteristic (ROC) curve analysis.

RESULTS

All adrenal tumors were diagnosed as cortical adenomas. On visual analysis, unilateral uptake was noted in three patients with CS and one patient with subclinical CS, whereas bilateral uptake was noted in four patients with PA and two patients with subclinical CS (p = 0.046). No significant difference was observed in CT HU (p = 0.055). The lesion SUVmax and SUVmax ratio were significantly higher and the contralateral SUVmax was significantly lower in six patients with CS than in four patients with PA (each, p < 0.05). The area under the ROC curve and accuracy for differentiating between CS and PA were, respectively, 0.92 and 90.0 % for the lesion SUVmax, 1.00 and 100 % for the contralateral SUVmax, and 0.92 and 90.0 % for the SUVmax ratio.

CONCLUSIONS

Quantitative or semiquantitative analysis using the adrenal SUVmax in adrenocortical NP-59 SPECT/CT has potential for characterizing unilateral hyperfunctioning adrenocortical masses.

摘要

目的

评估 I-6β-碘甲基-19-去甲胆固醇（NP-59）单光子发射计算机断层扫描（SPECT）/计算机断层扫描（CT）的最大标准化摄取值（SUVmax），以对单侧功能性肾上腺皮质肿块进行特征分析。

方法

10 名患者接受 NP-59 SPECT/CT 检查，以评估以下单侧肾上腺皮质功能亢进性肿块：3 例库欣综合征（CS），3 例亚临床 CS，4 例原发性醛固酮增多症（PA）。进行视觉和定量或半定量分析（非对比 CT HU [亨氏单位]、病变 SUVmax、对侧 SUVmax 和 SUVmax 比值[病变 SUVmax/对侧肾上腺 SUVmax]）。适当使用曼-惠特尼 U 检验或卡方检验评估定量变量之间的差异或比较分类数据。通过接收者操作特征（ROC）曲线分析评估诊断性能。

结果

所有肾上腺肿瘤均被诊断为皮质腺瘤。在视觉分析中，3 例 CS 患者和 1 例亚临床 CS 患者出现单侧摄取，而 4 例 PA 患者和 2 例亚临床 CS 患者出现双侧摄取（p=0.046）。CT HU 无显著差异（p=0.055）。CS 组 6 例患者的病变 SUVmax 和 SUVmax 比值显著升高，对侧 SUVmax 显著降低，而 PA 组 4 例患者无显著差异（各，p<0.05）。ROC 曲线下面积和区分 CS 和 PA 的准确性分别为病变 SUVmax 的 0.92 和 90.0%，对侧 SUVmax 的 1.00 和 100%，SUVmax 比值的 0.92 和 90.0%。