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18F-FDG PET/CT作为一种无创的影像检查方法,在多种肿瘤诊疗中被推荐应用[1]。研究结果显示, 18F-FDG摄取程度与肿瘤异质性之间存在相关性,可提供肿瘤的生理信息及代谢情况[2]。因此,18F-FDG PET/CT也逐渐被认为是肿瘤的诊断、疗效评价和预后评估的经典方法。PET/CT在提供病灶整体分子信息的同时对全身情况进行全面评估,并可在治疗过程中反复进行。PET/CT中18F-FDG摄取程度的主要评估方法包括半定量评估法及视觉评估法。本文对肺癌PET/CT中18F-FDG摄取评估方式的应用研究进行综述,并分析各种评估方法在PET/CT显像中的特点。
肺癌PET/CT中18F-FDG摄取程度评估方法的应用研究
Study on the application of 18F-FDG uptake assessment in PET/CT of lung cancer
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摘要: 18F-氟脱氧葡萄糖(FDG) PET/CT作为一种无创的影像检查,可以提供肿瘤异质性的相关信息,因此被认为是肺癌的早期诊断、准确分期、早期疗效评估及预后评价的经典方法。以往对PET/CT中肿瘤摄取18F-FDG的评估方法通常选用半定量评估法,其使用更加客观的参数来反映肿瘤代谢特征,当使用半定量评估法对18F-FDG PET/CT图像进行多中心研究分析时,很难做到对标准化摄取值的标准化,阻碍了半定量评估法在临床实践中的广泛应用。相比之下,视觉评估法更加简单易行,重复性高,不易受外界因素影响。笔者就肺癌PET/CT中18F-FDG摄取评估方法的应用及局限性进行综述。
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关键词:
- 肺肿瘤 /
- 氟脱氧葡萄糖F18 /
- 正电子发射断层扫描术 /
- 体层摄影术,X线计算机 /
- 最大标准化摄取值 /
- 半定量评估 /
- 视觉评估
Abstract: 18F-fluorodeoxyglucose (FDG) PET/CT is a non-invasive imaging modality that is widely used to assess lung cancer. This technique provides valuable insights into tumor heterogeneity and is thus a fundamental tool for the early diagnosis, accurate staging, early therapeutic response assessment, and prognostic evaluation of lung cancer. In PET/CT, semi-quantitative evaluation is commonly used to assess 18F-FDG uptake in tumors. The process utilizes objective parameters to depict tumor metabolic characteristics. However, in multi-center analyses of 18F-FDG PET/CT images, the standardization of uptake value proves challenging, thereby hindering the widespread implementation of semi-quantitative evaluation in clinical practice. Conversely, visual evaluation method is a simpler, more feasible, and highly repeatable alternative that is less susceptible to external factors. In this study, the author critically appraises the application and limitations of 18F-FDG uptake evaluation in PET/CT imaging of lung cancer. -
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