CZT-SPECT/CT肾动态显像中核医学断层显像测量肾脏体积的可行性探究

Investigation of the feasibility of measuring renal volume by nuclear medicine tomography in CZT-SPECT/CT renal dynamic imaging

    摘要
  • 摘要:
    目的  以CT测量体积为参考标准，评估核医学断层显像最大临界值自动勾画法在99Tcm-二亚乙基三胺五乙酸（DTPA）肾动态显像中自动测量肾脏体积的准确性。
    方法 收集2024年3月至7月于天津医科大学总医院核医学科行碲锌镉（CZT）-SPECT/CT肾动态显像的29例患者，其中男性20例、女性9例，年龄（43.9±2.2）岁。采用3D打印技术构建形态与体积参数符合成人肾脏解剖特征的中空肾脏模型，灌注 ^99\rmT\rmc^\rmm\rmO_4^ - 溶液后行CZT-SPECT/CT核医学断层扫描，通过20%最大标准摄取值（SUVmax）、30%SUVmax、40%SUVmax、50%SUVmax梯度临界值进行自动勾画，确定最佳临界值。临床验证阶段对比分析核医学断层法测量肾脏体积与CT测量肾脏体积差值的差异。采用配对t检验进行组间比较，采用Pearson相关性和Bland-Altman法评估核医学断层法与CT测量得出肾脏深度的一致性，采用组内相关系数（ICC）评价可重复性。
    结果 体模实验中，临界值为30%SUVmax测得的肾脏模型体积与实际肾脏体积差值（3.07±5.89 cm3）明显低于20%SUVmax（28.83±5.49 cm3）、40%SUVmax（21.70±2.35 cm3）、50%SUVmax（31.43±5.75 cm3），差异有统计学意义（t=3.961、2.937、3.444，均P<0.05）。临床验证实验中，临界值为30%SUVmax时，29例患者行核医学断层显像与CT显像测得的双侧肾脏体积差异无统计学意义（左肾：（166.88±9.41） cm3 vs. （163.24±7.59） cm3，t=1.377；右肾：（166.85±8.28） cm3 vs. （162.37±6.21 cm3），t=0.822，均P>0.05）。核医学断层显像与CT显像测量肾脏体积的左肾ICC为 0.866，右肾ICC为0.809，均P<0.001。核医学断层显像与CT显像所测得的肾脏体积的相关系数较高（左肾：r=0.79；右肾：r=0.88, 均P<0.001），相关性较好。Bland-Altman分析提示95%一致性界限处于临床可接受范围。
    结论 当核医学断层显像自动勾画临界值为30%SUVmax时，能够较为准确地获得肾脏体积。

     

    Abstract:
    Objective  To investigate the feasibility of measuring kidney volume by nuclear medicine tomography in 99mTc-DTPA renal dynamic imaging using the kidney volume measured by CT outlining.
    Methods A hollow kidney model matching the shape and volume of adult kidney was 3D printed, injected with Na99mTcO4 solution, and then subjected to nuclear medicine tomography in CZT-SPECT/CT, with the thresholds of 0.2, 0.3, 0.4, and 0.5 for outlining to investigate the optimal automatic outlining thresholds for the measurement of renal volume. Twenty-nine patients who underwent renal dynamic imaging at the Department of Nuclear Medicine, General Hospital of Tianjin Medical University were included, and the renal volume of the patients was measured by nuclear medicine tomographic images and the standardized value of the renal volume was derived from the CT scans of the patients that had been performed in recent March. The kidney volumes obtained in both modalities were correlated and the agreement between the two measurements was assessed.
    Results When the outlining threshold was selected as 0.3, the kidney volume measured by nuclear medicine tomography in the kidney model was closest to the actual volume of the model (P<0.05). There was no statistically significant difference between the bilateral kidney volumes measured by nuclear medicine tomography and CT in 29 patients (left kidney: 166.88±9.41 ml vs. 163.24±7.59 ml; right kidney: 166.85±8.28 ml vs. 162.37±6.21 ml). The intragroup correlation coefficients between nuclear medicine tomography and CT-measured volumes were 0.866 for the left kidney and 0.809 for the right kidney, with both P-values <0.001. The correlation coefficients between nuclear medicine tomography and CT-measured kidney volumes were high (left kidney: R=0.79, P<0.001; right kidney: R=0.88, P<0.001), and correlation was good. Bland-Altman plots were drawn to assess the agreement between nuclear medicine tomography and CT measurements of kidney volume.
    Conclusion  When the threshold of nuclear medicine tomography image outlining was 0.3, the automatic outlining method of nuclear medicine tomography was able to obtain kidney volume more accurately.

     

    • HTML全文
    • 参考文献(24)
    • 相关文章
    • 施引文献
  • 资源附件(0)

/

返回文章
返回