实时超声图像与 FDG-PET/CT 融合在颈部淋巴结中进行融合图像引导细针抽吸：可行性和诊断价值。
Real-Time Ultrasound Image Fusion with FDG-PET/CT to Perform Fused Image-Guided Fine-Needle Aspiration in Neck Nodes: Feasibility and Diagnostic Value.
机构信息
From the Departments of Radiology (P.K.d.K.-D., M.M., J.C., R.B.-T.)
From the Departments of Radiology (P.K.d.K.-D., M.M., J.C., R.B.-T.).
出版信息
AJNR Am J Neuroradiol. 2021 Mar;42(3):566-572. doi: 10.3174/ajnr.A6938. Epub 2021 Jan 28.
BACKGROUND AND PURPOSE
New imaging techniques such as hybrid imaging of ultrasound and FDG-PET/CT are available but not yet investigated for node staging. The aim of the study was to evaluate the feasibility and added diagnostic value of real-time image-fused ultrasound-guided fine-needle aspiration with FDG-PET/CT data for node staging.
MATERIALS AND METHODS
Ninety-six patients who were referred for cervical lymph node staging with FDG-PET/CT before ultrasound were prospectively included. After routine ultrasound-guided fine-needle aspiration, all FDG-PET-positive nodes were marked on FDG-PET/CT, and real-time image fusing of ultrasound and FDG-PET/CT was performed using the electromagnetic navigation system PercuNav. Already-punctured nodes were confirmed to be PET-positive, and additional fused-ultrasound-guided fine-needle aspiration was performed in previously missed PET-positive nodes.
RESULTS
Of 96 patients, 87 (91%) patients had suspicious nodes requiring fine-needle aspiration cytology. Ultrasound-guided fine-needle aspiration was performed in 175 nodes. Cytology was inconclusive in 9/175 (5%) nodes, and 85/166 (51%) nodes were malignant. Target planning was performed in 201 PET-positive nodes; 195/201 (97%) of those nodes were fused successfully. Twenty of 175 ultrasound-guided fine-needle aspiration nodes turned out to be FDG-PET-negative, and 149/175 (85%) of the fused ultrasound-guided fine-needle aspiration nodes were confirmed to be FDG-PET-positive. Of 201 PET-positive nodes, 46 (23%) were additionally identified, and fused ultrasound-guided fine-needle aspiration was performed. Cytology was inconclusive in 4/46 nodes (9%), and 13/42 (31%) nodes were malignant.
CONCLUSIONS
Real-time ultrasound image fusion with FDG-PET-positive nodes is feasible in cervical lymph nodes, and fused ultrasound-guided fine-needle aspiration increases the number of malignant nodes detected.
背景与目的
新的成像技术，如超声与 FDG-PET/CT 的融合成像已经出现，但尚未应用于淋巴结分期。本研究旨在评估实时融合超声引导下细针抽吸与 FDG-PET/CT 数据用于淋巴结分期的可行性和附加诊断价值。
材料与方法
96 例患者因 FDG-PET/CT 检查前被转诊行颈部淋巴结分期而前瞻性纳入研究。在常规超声引导下细针抽吸后，所有 FDG-PET 阳性的淋巴结均在 FDG-PET/CT 上标记，使用电磁导航系统 PercuNav 进行实时超声与 FDG-PET/CT 图像融合。已经穿刺的淋巴结被确认为 PET 阳性，对先前遗漏的 PET 阳性淋巴结进行额外的融合超声引导下细针抽吸。
结果
96 例患者中，87 例（91%）患者有可疑淋巴结需要细针抽吸细胞学检查。对 175 个淋巴结进行了超声引导下细针抽吸。9/175（5%）个淋巴结的细胞学检查结果不确定，85/166（51%）个淋巴结为恶性。在 201 个 FDG-PET 阳性的淋巴结中进行了靶区规划；201 个中的 195 个（97%）成功融合。在 175 个超声引导下细针抽吸的淋巴结中，有 20 个结果为 FDG-PET 阴性，而 149/175（85%）个融合的超声引导下细针抽吸的淋巴结确认为 FDG-PET 阳性。在 201 个 FDG-PET 阳性的淋巴结中，另外发现了 46 个（23%），并进行了融合超声引导下细针抽吸。4/46（9%）个淋巴结的细胞学检查结果不确定，而 13/42（31%）个淋巴结为恶性。
结论
实时融合超声与 FDG-PET 阳性淋巴结是可行的，融合超声引导下细针抽吸可增加检出的恶性淋巴结数量。
Zotero 插件