18F-FDG和18F-FLT PET/CT不同诊断方法在肺部单发结节中的临床价值分析

Differential diagnosis protocols of 18F-FDG and 18F-FLT PET/CT for solitary pulmonary nodules

  • 摘要: 目的探讨18F-FDG和18F-胸腺嘧啶核苷(FLT)PET/CT不同的诊断方法对肺部单发结节的诊断价值。方法对40例发现肺部单发结节的患者行18F-FDG和18F-FLT PET/CT显像,所有病例均经病理或密切随访确诊,应用受试者工作特征(ROC)曲线比较18F-FDG SUVmax18F-FLT SUVmax18F-FLT SUVmax/同层面椎体SUVmax对肺部恶性肿瘤的诊断价值;18F-FDG和18F-FLT PET/CT两种显像结果均行视觉分析和半定量分析,比较不同诊断方法的诊断效能。结果18F-FDG SUVmax18F-FLT SUVmax18F-FLT SUVmax/同层面椎体SUVmaxROC曲线下面积分别为0.687、0.821和0.817。以18F-FDG SUVmax > 2.5、18F-FLT SUVmax > 2.0为恶性诊断标准、18F-FDG PET/CT视觉分析评分法、18F-FLT PET/CT视觉分析评分法4种方法诊断肺癌的灵敏度、特异度和准确率分别为88.2%、73.9%和80.0%;58.8%、82.6%和72.5%;94.1%、91.3%和92.5%;88.2%、65.2%和75.0%。结论18F-FLT SUVmax18F-FLT SUVmax/同层面椎体SUVmax单独诊断肺部恶性肿瘤的价值较18F-FDG SUVmax高,且前两者可替换使用。18F-FDG PET/CT视觉评分法在肺部单发结节良恶性的诊断中效能最佳。

     

    Abstract: Objective To investigate the diagnostic values of 18F-FDG and 3′-deoxy-3′-18F-fluorothymidine(18F-FLT) PET/CT for solitary pulmonary nodules. Methods 18F-FDG and 18F-FLT PET/CT imaging were performed in 40 patients with solitary pulmonary nodules. All cases were confirmed by pathology or follow-up. The diagnostic values of 18F-FDG SUVmax, 18F-FLT SUVmax, and 18F-FLT/the same level of vertebral SUVmax for pulmonary malignant tumor were compared using the receiver operating characteristic(ROC) curves. 18F-FDG and 18F-FLT imaging results were analyzed by visual observation and semi-quantitative analysis. The diagnostic efficiencies of the different diagnostic methods were compared. Results Areas under the ROC curves of 18F-FDG SUVmax, 18F-FLT SUVmax, and 18F-FLT/ same level of vertebral SUVmax were 0.687, 0.821, and 0.817, respectively. The diagnostic sensitivities, specificities, and accuracies of tested diagnostic tools were as follows:18F-FDG SUVmax > 2.5 as the malignant diagnostic criteria, 88.2%, 73.9% and 80.0%; 18F-FLT SUVmax > 2.0 as the malignant diagnostic criteria, 58.8%, 82.6% and 72.5%; 18F-FDG PET/CT visual analysis of scoring method, 94.1%, 91.3% and 92.5%; and 18F-FLT PET/CT for visual analysis of scoring method 88.2%, 65.2% and 75.0%. Conclusions 18F-FLT SUVmax and 18F-FLT/vertebral SUVmax showed higher accuracies in diagnosing solitary pulmonary modules compared with 18F-FDG SUVmax. 18F-FDG PET/CT visual scoring method was the most effective in diagnosing solitary pulmonary nodules.

     

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