新型示踪剂68Ga-柠檬酸盐在结节病患者中的诊断效能。

Diagnostic yield of a novel tracer 68Ga-citrate in sarcoidosis patients.

作者信息

Tetikkurt Cuneyt, Kubat Bahar, Sayman Haluk Burcak, Yanardag Halil, Bilir Muammer

机构信息

Istanbul-Cerrahpasa University, Cerrahpasa Medical Faculty, Pulmonary Diseases Department.

Pulmonary Diseases Department, Cerrahpaşa Medical Faculty, Istanbul University-Cerrahpaşa.

出版信息

Sarcoidosis Vasc Diffuse Lung Dis. 2024 Dec 10;41(4):e2024064. doi: 10.36141/svdld.v41i4.15207.

DOI:10.36141/svdld.v41i4.15207

PMID:39655595

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11708952/

Abstract

BACKGROUND

Sarcoidosis is a granulomatous disease of unknown origin. Conventional laboratory and imaging modalities may lead to equivocal conclusions for sarcoidosis diagnosis. 68Ga-citrate PET/CT has been utilized in the diagnosis of inflammatory and infectious diseases due to its beter performance. Aims: This study was designed to determine the clinical trenchancy of 68Ga-citrate in sarcoidosis patients as an alternative tracer that binds to the somtastotin receptors of the inflammatory cells in sarcoid granulomas because current laboratory modalities may occasionally lack accuracy for sarcoidosis diagnosis. Conventional criteria including clinical, laboratory, radiologic modalities, and 18F-FDG PET/CT were compared with the 68Ga-citrate PET/CT to evaluate the diagnostic yield in sarcoidosis.

METHODS

Forty-four sarcoidosis patients were include in the study. Conventional laboratory and imaging modalities were done in 44 while 68Ga-citrate PET/CT and 18F-FDG-PET/CT were performed in 22 patients. The three modalities were compared with in regard to granulomatous activity evaluation, extrapulmonary organ involvement, and identification of coexistent malignant disease.

RESULTS

68Ga-citrate PET/CT revealed a significantly higher diagnostic yield for sarcoidosis compared to conventional laboratory and 18F-FDG-PET/CT imaging modalties. 68Ga-citrate PET/CT revealed 72.7% sensitivity and 68.4% specificity for the detection of granulomatous inflammation in sarcoidosis.

CONCLUSIONS

68Ga-citrate PET/CT was conclusive for activity assessment in sarcoidosis for diagnosis, activity assessment, and identification of extrapulmonary organ involvement. As an innovative novel tracer, 68Ga-citrate identified disease activity, extrapulmonary organ involvement, biopsy sites, and coexistent malignancy due to its chemical properties with a higher statistical diagnostic yield compared to conventional laboratory findings and the PET/CT imaging manifestations in sarcoidosis.

摘要

背景

结节病是一种病因不明的肉芽肿性疾病。传统的实验室检查和影像学检查对于结节病的诊断可能会得出模棱两可的结论。由于其更好的性能，68Ga-柠檬酸盐PET/CT已被用于炎症和感染性疾病的诊断。目的：本研究旨在确定68Ga-柠檬酸盐在结节病患者中的临床诊断价值，作为一种与结节病肉芽肿中炎症细胞的生长抑素受体结合的替代示踪剂，因为目前的实验室检查方法偶尔可能缺乏对结节病诊断的准确性。将包括临床、实验室、放射学检查方法以及18F-FDG PET/CT在内的传统标准与68Ga-柠檬酸盐PET/CT进行比较，以评估结节病的诊断率。

方法

44例结节病患者纳入本研究。44例患者进行了传统的实验室和影像学检查，22例患者进行了68Ga-柠檬酸盐PET/CT和18F-FDG-PET/CT检查。对这三种检查方法在肉芽肿活性评估、肺外器官受累情况以及并存恶性疾病的识别方面进行了比较。

结果

与传统实验室检查和18F-FDG-PET/CT影像学检查方法相比，68Ga-柠檬酸盐PET/CT对结节病的诊断率显著更高。68Ga-柠檬酸盐PET/CT对结节病肉芽肿性炎症检测的灵敏度为72.7%，特异度为68.4%。

结论

68Ga-柠檬酸盐PET/CT对结节病的诊断、活性评估以及肺外器官受累情况的识别具有决定性作用。作为一种创新的新型示踪剂，68Ga-柠檬酸盐因其化学性质，在识别疾病活性、肺外器官受累情况、活检部位以及并存恶性肿瘤方面，与传统实验室检查结果和结节病的PET/CT影像学表现相比，具有更高的统计学诊断率。