¹⁸F-FDG与¹⁸F-P3BZA联合成像在黑色素瘤诊断中的临床价值
Clinical value of combined F-FDG and F-P3BZA imaging in the diagnosis of melanoma.
作者信息
An Rongchen, Xiang Tian, He Feng, Ma Xiaowei, Wang Yunhua
机构信息
Department of Nuclear Medicine, The Second Xiangya Hospital, Central South University, Changsha, China.
出版信息
Front Med (Lausanne). 2025 May 9;12:1571929. doi: 10.3389/fmed.2025.1571929. eCollection 2025.
OBJECTIVE
This study aims to explore the clinical value of the combination of F fluorodeoxyglucose (F-FDG) and N-[2-(dimethylamino) ethyl]-F-5-fluoropicolinamide (F-P3BZA) positron emission tomography/computed tomography (PET/CT) in melanoma patients.
METHODS
A retrospective study was conducted on 19 melanoma patients who underwent F-FDG and F-P3BZA PET/CT scans at the Nuclear Medicine Department/PET Imaging Center of the Second Xiangya Hospital, Central South University, from March 2022 to March 2024. The diagnostic efficacy of F-FDG, F-P3BZA, and the combination of both for melanoma was compared, and the value of combined imaging for TNM staging and clinical treatment decision-making in melanoma patients was discussed.
RESULTS
The sensitivity of F-P3BZA in diagnosing primary lesions of melanoma, all metastases, sentinel lymph node metastases (SLNM), distant lymph node metastases (DLNM), and bone metastases (BM) was 100% (12/12), 71.4% (40/56), 72.4% (21/29), 66.7% (14/21), and 83.3% (5/6), respectively. The corresponding values for F-FDG were 91.7% (11/12), 91.1% (51/56), 86.2% (25/29), 95.2% (20/21), and 100% (6/6), respectively. Combined imaging showed a higher sensitivity in diagnosing SLNM, DLNM, and all metastases than F-P3BZA ( = 7.105, = 0.004; = 3.860， = 0.045; = 15.604; < 0.001). In addition, the specificity of F-FDG in diagnosing all metastases, SLNM, DLNM, and BM, was 50.0, 69.2, 56.3, and 100%, respectively, and the corresponding values for F-P3BZA were 81.8, 100, 75.0, and 100%, respectively. Combined imaging improved N and M staging in 31.6% (6/19) of melanoma patients and changed clinical treatment decisions in 26.3% (5/19) of melanoma patients.
CONCLUSION
The specificity of F-FDG alone in diagnosing melanoma is low, but it can be combined effectively with F-P3BZA. The combination of F-FDG and F-P3BZA PET/CT can further improve the detection efficiency of lesions, TNM staging, and clinical treatment decisions.
目的
本研究旨在探讨¹⁸F-氟脱氧葡萄糖（¹⁸F-FDG）与N-[2-(二甲氨基)乙基]-¹⁸F-5-氟吡啶甲酰胺（¹⁸F-P3BZA）正电子发射断层扫描/计算机断层扫描（PET/CT）联合应用于黑色素瘤患者的临床价值。
方法
对2022年3月至2024年3月在中南大学湘雅二医院核医学科/PET影像中心接受¹⁸F-FDG和¹⁸F-P3BZA PET/CT扫描的19例黑色素瘤患者进行回顾性研究。比较¹⁸F-FDG、¹⁸F-P3BZA及其联合应用对黑色素瘤的诊断效能，并探讨联合成像在黑色素瘤患者TNM分期及临床治疗决策中的价值。
结果
¹⁸F-P3BZA诊断黑色素瘤原发灶、所有转移灶、前哨淋巴结转移（SLNM）、远处淋巴结转移（DLNM）和骨转移（BM）的敏感性分别为100%（12/12）、71.4%（40/56）、72.4%（21/29）、66.7%（14/21）和83.3%（5/6）。¹⁸F-FDG的相应值分别为91.7%（11/12）、91.1%（51/56）、86.2%（25/29）、95.2%（20/21）和100%（6/6）。联合成像在诊断SLNM、DLNM和所有转移灶方面比¹⁸F-P3BZA具有更高的敏感性（χ² = 7.105，P = 0.004；χ² = 3.860，P = 0.045；χ² = 15.604，P < 0.001）。此外，¹⁸F-FDG诊断所有转移灶、SLNM、DLNM和BM的特异性分别为50.0%、69.2%、56.3%和100%，¹⁸F-P3BZA的相应值分别为81.8%、100%、75.0%和100%。联合成像使31.6%（6/19）的黑色素瘤患者N和M分期得到改善，使26.3%（5/19）的黑色素瘤患者临床治疗决策发生改变。
结论
单独使用¹⁸F-FDG诊断黑色素瘤的特异性较低，但可与¹⁸F-P3BZA有效联合。¹⁸F-FDG与¹⁸F-P3BZA PET/CT联合应用可进一步提高病灶检测效率、TNM分期及临床治疗决策水平。
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