Department of PET/CT, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang Province, China.
Nucl Med Commun. 2024 Dec 1;45(12):1013-1021. doi: 10.1097/MNM.0000000000001898. Epub 2024 Sep 18.
This study was conducted to explore the differential diagnostic value of PET/computed tomography (PET/CT) combined with high-resolution computed tomography (HRCT) in predicting the invasiveness of ground-glass nodules (GGNs).
This retrospective analysis included 67 patients (mean age 62.5 ± 8.4, including 45 females and 22 males) with GGNs who underwent preoperative 18 F-fluorodeoxyglucose ( 18 F-FDG) PET/CT and HRCT examinations between January 2018 and October 2022. Based on the postoperative pathological results of lung adenocarcinoma, the patients were classified into two groups: invasive adenocarcinoma (IAC) and non-IAC. Besides, the clinical and imaging information of these patients was collected. HRCT signs include the existence of air bronchial signals, vascular convergence, pleural indentation, lobulation, and spiculation. Moreover, the diameter of solid components (D Solid ), diameter of ground-glass nodules (D GGN ), and computed tomography values of ground-glass nodules (CT GGN ) were measured concurrently. Furthermore, the mean standardized uptake value, maximal standardized uptake value (SUVmax), metabolic tumor volume, and total lesion glycolysis were assessed during PET/CT. Associations between invasiveness and these factors were evaluated using univariate and multivariate analyses.
The results of logistic regression analysis demonstrated that D GGN , D Solid , consolidation tumor ratio (CTR), CT GGN , and SUVmax were independent predictors in the IAC group. The combined diagnosis based on these five predictors revealed that area under the curve was 0.825.
The D GGN , D Solid , CTR, CT GGN , and SUVmax in GGNs were independent predictors of IAC, and combining 18 F-FDG PET/CT metabolic parameters with HRCT may improve the predictive value of pathological classification in lung adenocarcinoma.
本研究旨在探讨正电子发射断层扫描/计算机断层扫描（PET/CT）联合高分辨率计算机断层扫描（HRCT）对预测磨玻璃结节（GGN）侵袭性的鉴别诊断价值。
本回顾性分析纳入了 2018 年 1 月至 2022 年 10 月间接受术前 18 F-氟脱氧葡萄糖（ 18 F-FDG）PET/CT 和 HRCT 检查的 67 例 GGN 患者（平均年龄 62.5±8.4 岁，包括 45 名女性和 22 名男性）。根据肺腺癌术后病理结果，患者分为侵袭性腺癌（IAC）组和非 IAC 组。同时收集患者的临床和影像学资料。HRCT 征象包括空气支气管征、血管聚集、胸膜凹陷、分叶和毛刺。此外，还测量了实性成分直径（D Solid ）、磨玻璃结节直径（D GGN ）和 CT 磨玻璃结节值（CT GGN ）。同时在 PET/CT 检查中评估了平均标准化摄取值、最大标准化摄取值（SUVmax）、代谢肿瘤体积和总肿瘤糖酵解。采用单因素和多因素分析评估侵袭性与这些因素的关系。
logistic 回归分析结果表明，D GGN 、D Solid 、实性肿瘤比例（CTR）、CT GGN 和 SUVmax 是 IAC 组的独立预测因子。基于这五个预测因子的联合诊断，曲线下面积为 0.825。
GGN 中的 D GGN 、D Solid 、CTR、CT GGN 和 SUVmax 是 IAC 的独立预测因子，将 18 F-FDG PET/CT 代谢参数与 HRCT 相结合可能提高肺腺癌病理分类的预测价值。
