Department of Radiology, Toyohashi Municipal Hospital, 50 Hakken-nishi, Aotake, Toyohashi, Aichi, 441-8570, Japan.
Department of Quantum Medical Technology, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan.
Ann Nucl Med. 2023 Oct;37(10):561-571. doi: 10.1007/s12149-023-01857-6. Epub 2023 Jul 31.
To investigate whether the center-of-mass shift distance (CMSD) analysis on whole-body dynamic positron emission tomography (WBD-PET) with continuous bed motion is an objective index for discriminating pathological and physiological uptake in the lower abdominal colon.
We retrospectively analyzed the CMSD in 39 patients who underwent delayed imaging to detect incidental focal uptake that was difficult to determine as pathological and physiological on a conventional early-PET (early) image reconstructed by 5-phase WBD-PET images. The CMSD between each phase of WBD-PET images and between conventional early and delayed (two-phase) PET images were classified into pathological and physiological uptake groups based on endoscopic histology or other imaging diagnostics. The diagnostic performance of CMSD analysis on WBD-PET images was evaluated by receiver operator characteristic (ROC) analysis and compared to that of two-phase PET images.
A total of 66 incidental focal uptake detected early image were classified into 19 and 47 pathological and physiological uptake groups, respectively. The CMSD on WBD-PET and two-phase PET images in the pathological uptake group was significantly lower than that in the physiological uptake group (p < 0.01), respectively. The sensitivity, specificity, and accuracy in CMSD analysis on WBD-PET images at the optimal cutoff of 5.2 mm estimated by the Youden index were 94.7%, 89.4%, and 89.4%, respectively, which were not significantly different (p = 0.74) from those of two-phase PET images.
The CMSD analysis on WBD-PET was useful in discriminating pathological and physiological colorectal uptake in the lower abdominal region, and its diagnostic performance was comparable to that of two-phase PET images. We suggested that CMSD analysis on WBD-PET images would be a novel objective method to omit unnecessary additional delayed imaging.
研究全身动态正电子发射断层扫描（WBD-PET）中质心移动距离（CMSD）分析是否是区分下腹部结直肠病理性和生理性摄取的客观指标。
我们回顾性分析了 39 例患者的 CMSD，这些患者进行了延迟成像以检测在常规早期 PET（早期）图像上难以确定为病理性和生理性的偶然局灶性摄取，该早期图像由 5 期 WBD-PET 图像重建。根据内镜组织学或其他影像学诊断，将 WBD-PET 图像各期之间以及常规早期和延迟（两期）PET 图像之间的 CMSD 分为病理性和生理性摄取组。通过接受者操作特征（ROC）分析评估 CMSD 分析在 WBD-PET 图像上的诊断性能，并与两期 PET 图像进行比较。
在早期图像中总共检测到 66 个偶然局灶性摄取，分别分为 19 个和 47 个病理性和生理性摄取组。病理性摄取组 WBD-PET 和两期 PET 图像上的 CMSD 明显低于生理性摄取组（p<0.01）。通过 Youden 指数估算的最佳截断值 5.2mm 时，WBD-PET 图像上 CMSD 分析的灵敏度、特异性和准确度分别为 94.7%、89.4%和 89.4%，与两期 PET 图像无显著差异（p=0.74）。
WBD-PET 上的 CMSD 分析有助于区分下腹部结直肠的病理性和生理性摄取，其诊断性能与两期 PET 图像相当。我们建议，WBD-PET 图像上的 CMSD 分析将是一种新的客观方法，可以避免不必要的额外延迟成像。
