18F-FDG PET/CT显像诊断肺癌的价值
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江苏省科技厅社会发展计划面上项目(BS2007068)


Value of PET/CT with 18F-FDG in the diagnosis of lung cancer
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    摘要:

    目的:探讨18F-FDG PET/CT显像诊断肺癌的价值-方法:对2006年10月~2009年1月经病理证实的115例肺癌和53例肺良性病变的PET/CT显像进行回顾性分析-分别观察肺部病灶的CT形态及PET显像的FDG最大标准摄取值(SUVmax);结合临床-病理诊断及治疗资料,分析PET-CT-PET/CT对肺癌原发灶及转移灶诊断的灵敏度-特异性及准确性-结果:CT对168例肺部病变患者诊断的灵敏度-特异性和准确性分别为73.9%(85/115)-73.6%(39/53)-73.8%(124/168);PET分别为82.6%(95/115)-62.3%(33/53)-76.2%(128/168);PET/CT分别为90.4%(104/115)-81.1%(43/53)-87.5%(147/168)-55例行肺癌根治术患者中纵隔-肺门淋巴结转移31例,PET诊断肺癌纵隔-肺门淋巴结转移的灵敏度-特异性及准确性分别为70.9%- 95.8%-81.8%;CT分别为41.9%-87.5%-65.5%;PET/CT分别为90.3%-95.8%-92.7%-肺癌远处转移41例,PET/CT发现105处骨转移,单纯CT只发现25处-结论:PET/CT对肺癌原发灶及转移灶较单纯PET-单纯CT的诊断灵敏度-特异性及准确性高,在肺癌的诊断和分期中具有较高的应用价值-

    Abstract:

    Objective:To investigate the value of PET/CT with 18F-FDG in the diagnosis of lung cancer. Methods:A retrospective analysis was performed on 168 patients with pulmonary lesions (115 malignant,53 benign) by 18F-FDG PET/CT from October 2006 to January 2009. The shape was surveyed based on CT. The SUVmax in region of interest (ROI) of pulmonary lesion was calculated on PET. Imaging information was interpreted and compared with histopathology findings or other diagnostic procedures. Results:In 168 patients with pulmonary lesions,the sensitivity,specificity and accuracy of CT,PET and PET/CT in the diagnosis were as follows:73.9%(85/115),73.6%(39/53),73.8%(124/168) for CT alone; 82.6%(95/115),62.3%(33/53),76.2%(128/168)for PET alone;90.4%(104/115),81.1%(43/53),87.5%(147/168) for PET/CT scan. Among 55 patients with lung cancer undergone operation,there were 31 cases with and 24 without mediastinal and hilar nodal metastases. The sensitivity,specificity and accuracy of PET/CT in the diagnosis of mediastinal and hilar nodal metastases were 90.3%,95.8%,92.7%,respectively. Metastases were identified in 41 patients. 105 bone metastasis lesions were found by PET/CT,only 25 lesions showed lytic type on CT images. Conclusion:PET/CT is of greater value on the differential diagnosis of pulmonary than PET or CT alone. The sensitivity,specificity and accuracy of diagnosis are significantly improved by PET/CT scan,which may be useful in diagnosis and staging of lung cancer.

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丁重阳,黄庆娟,李天女,吴丽玲,丁其勇,陈建伟.18F-FDG PET/CT显像诊断肺癌的价值[J].南京医科大学学报(自然科学版),2010,(2):191-194

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