Worsley D F, Celler A, Adam M J, Kwong J S, Müller N L, Coupland D B, Champion P, Finley R J, Evans K G, Lyster D M
Division of Nuclear Medicine, Vancouver Hospital and Health Sciences Centre, B.C., Canada.
AJR Am J Roentgenol. 1997 Mar;168(3):771-4. doi: 10.2214/ajr.168.3.9057532.
The objective of this study was to prospectively evaluate the feasibility and efficacy of single-photon emission computed tomography (SPECT) with 18F-fluorodeoxyglucose (FDG) for differentiating malignant from benign pulmonary nodules.
Twenty-six patients with 28 radiologically indeterminate focal pulmonary lesions were examined. Fasting patients were injected with 5 MBq/kg of FDG (maximum dose, 370 MBq). Imaging was performed with dual-head SPECT cameras equipped with 511-keV collimators.
Seventeen of 21 pathologically malignant nodules showed FDG uptake on SPECT imaging (sensitivity, 81%). None of the seven benign modules showed uptake (specificity, 100%). SPECT imaging with FDG was positive in all 16 malignant nodules that were larger than or equal to 2 cm in diameter. However, only one (20%) of five nodules smaller than 2 cm in diameter showed positive on SPECT imaging.
Using current technology, we found FDG SPECT imaging useful for distinguishing benign from malignant pulmonary nodules that were larger than or equal to 2 cm in diameter. However, because of the relatively low sensitivity of SPECT, smaller malignant nodules were not adequately revealed.
本研究的目的是前瞻性评估18F-氟脱氧葡萄糖（FDG）单光子发射计算机断层扫描（SPECT）鉴别肺内良恶性结节的可行性和有效性。
对26例有28个放射学表现不明确的局灶性肺病变的患者进行检查。空腹患者静脉注射5MBq/kg的FDG（最大剂量370MBq）。采用配备511keV准直器的双头SPECT相机进行成像。
21个病理诊断为恶性的结节中，17个在SPECT成像上表现为FDG摄取（敏感性81%）。7个良性结节均未显示摄取（特异性100%）。所有直径大于或等于2cm的16个恶性结节在FDG SPECT成像上均为阳性。然而，直径小于2cm的5个结节中只有1个（20%）在SPECT成像上呈阳性。
应用现有技术，我们发现FDG SPECT成像有助于鉴别直径大于或等于2cm的肺内良恶性结节。然而，由于SPECT的敏感性相对较低，较小的恶性结节未能得到充分显示。
