Zhou Nina, Zhang Annan, Su Hua, Zhao Wei, Li Nan, Yang Zhi
Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Nuclear Medicine, Peking University Cancer Hospital and Institute, Beijing, China.
NMPA Key Laboratory for Research and Evaluation of Radiopharmaceuticals (National Medical Products Administration), Department of Nuclear Medicine, Peking University Cancer Hospital and Institute, Beijing, China.
Front Oncol. 2022 Oct 6;12:983833. doi: 10.3389/fonc.2022.983833. eCollection 2022.
The main purpose is to explore the use of visual assessment of the heterogeneous distribution of F-FDG in single pulmonary solid lesions to differentiate the benign from the malignant.
The 200 cases of pulmonary nodules or masses examined by F-FDG PET/CT were retrospectively analyzed. The heterogeneity of F-FDG distribution of the lesion was visually and quantitatively evaluated and the higher part of metabolism was observed and measured at the proximal or distal part to determine the lesion nature. The sensitivity, specificity, PPV, NPV, and accuracy of this method were calculated.
Total 171 pulmonary lesions showed heterogeneity of F-FDG uptake, including the 111 malignant and 60 benign. 54/60 (90.00%) benign lesions showed higher F-FDG uptake visually at distal part, while 104/111 (93.69%) malignant lesions showed higher F-FDG uptake visually at the proximal part. This visual method has good repeatability with a high kappa value (0.821, p<0.001). 52/60 (86.67%) benign lesions showed higher F-FDG uptake quantitatively at distal part, while 107/111 (96.40%) malignant lesions showed higher F-FDG uptake quantitatively at the proximal part. The sensitivity, specificity, PPV, NPV and accuracy of visual and quantitative methods were 93.69%; 96.40%, 90.0%; 86.67%, 94.55%; 93.04%, 88.52%; 92.86%, 92.40%; 92.98%, respectively (p<0.001). When combining the metabolic value and morphological characteristics of PET/CT with visual F-FDG heterogeneous features, the accuracy reached to 98.25%. The other 29 lesions (14.5%) with no heterogeneity were smaller (2.17 ± 1.06 vs 3.58 ± 1.48, P<0.001).
Benign and malignant lung lesions showed different heterogeneity of F-FDG uptake. Lung cancer can be effectively distinguished from infectious or inflammatory lesions by this simple and convenient method.
主要目的是探讨利用视觉评估单发性肺实性病变中F-FDG的异质性分布来鉴别良恶性。
回顾性分析200例经F-FDG PET/CT检查的肺结节或肿块。对病变的F-FDG分布异质性进行视觉和定量评估，观察并测量病变近端或远端代谢较高的部分以确定病变性质。计算该方法的敏感性、特异性、阳性预测值、阴性预测值和准确性。
共171例肺病变显示F-FDG摄取异质性，其中111例为恶性，60例为良性。60例良性病变中54例（90.00%）在视觉上显示远端F-FDG摄取较高，而111例恶性病变中104例（93.69%）在视觉上显示近端F-FDG摄取较高。这种视觉方法具有良好的重复性，kappa值较高（0.821，p<0.001）。60例良性病变中52例（86.67%）在定量上显示远端F-FDG摄取较高，而111例恶性病变中107例（96.40%）在定量上显示近端F-FDG摄取较高。视觉和定量方法的敏感性、特异性、阳性预测值、阴性预测值和准确性分别为93.69%；96.40%，99%；86.67%，94.55%；93.04%，88.52%；92.86%，92.40%；92.98%（p<0.001）。当将PET/CT的代谢值和形态特征与视觉F-FDG异质性特征相结合时，准确性达到98.25%。另外29例（14.5%）无异质性的病变较小（2.17±1.06对3.58±1.48，P<0.001）。
良性和恶性肺病变显示出不同的F-FDG摄取异质性。通过这种简单便捷的方法可有效区分肺癌与感染性或炎性病变。
