数字化[F]FDG PET/CT中的新半定量参数提高了疑似感染性心内膜炎的诊断准确性。
New semiquantitative parameters in digital [F]FDG PET/CT improve diagnostic accuracy in suspected infective endocarditis.
作者信息
Bregenzer Carola Maria, Knappe Luisa Maria, Weissensee Alexander, Gözlügöl Nasir, Afshar-Oromieh Ali, Mingels Clemens, Gräni Christoph, Rominger Axel, Caobelli Federico
机构信息
Department of Nuclear Medicine, Bern University Hospital, Inselspital, University of Bern, Freiburgstrasse 18, Bern, 3000, Switzerland.
Department of Cardiology, University Hospital Bern, Inselspital, University of Bern, Bern, Switzerland.
出版信息
EJNMMI Rep. 2025 Jun 23;9(1):21. doi: 10.1186/s41824-025-00256-6.
BACKGROUND
The purpose of this study was to identify semiquantitative parameters of [F]FDG PET/CT using a digital PET scanner, which may increase diagnostic accuracy and readers' confidence in the diagnosis of infective endocarditis (IE).
RESULTS
Images of 82 patients undergoing [F]FDG PET/CT for suspected IE were visually and semiquantitatively analyzed. Standardized uptake values (SUV) of suspected foci, also normalized to liver, mediastinum and surrounding activity were calculated. For each, best thresholds were identified to diagnose endocarditis. Final diagnosis was reached by consensus in a multidisciplinary board. Semiquantitative analysis (SUV/SUV mediastinum, SUV/SUV liver, SUV/SUV mediastinum, SUV/SUV liver, SUV/SUV liver, SUV/SUV mediastinum, SUV focus/SUV focus, SUV/SUV surrounding) added to visual interpretation increased sensitivity (57-86%), specificity (83-93%), PPV (64-86%), NPV (79-93%) and diagnostic accuracy (74-90%) when using best SUVs thresholds (all p < 0.05).
CONCLUSIONS
Combining visual and semiquantitative analysis allows for a more accurate diagnosis of IE, and might be implemented into clinical routine.
背景
本研究的目的是利用数字PET扫描仪确定[F]FDG PET/CT的半定量参数，这可能会提高感染性心内膜炎（IE）诊断的准确性和读者对其诊断的信心。
结果
对82例因疑似IE接受[F]FDG PET/CT检查的患者图像进行了视觉和半定量分析。计算了疑似病灶的标准化摄取值（SUV），并分别以肝脏、纵隔和周围组织活性进行标准化。针对每一项，确定了诊断心内膜炎的最佳阈值。最终诊断由多学科委员会达成共识得出。在视觉解读基础上增加半定量分析（SUV/纵隔SUV、SUV/肝脏SUV、SUV/纵隔SUV、SUV/肝脏SUV、SUV/肝脏SUV、SUV/纵隔SUV、病灶SUV/病灶SUV、SUV/周围组织SUV），使用最佳SUV阈值时，敏感性（57 - 86%）、特异性（83 - 93%）、阳性预测值（PPV，64 - 86%）、阴性预测值（NPV，79 - 93%）和诊断准确性（74 - 90%）均有所提高（所有p < 0.05）。
结论
结合视觉和半定量分析能够更准确地诊断IE，并且可能应用于临床常规诊断。
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