Clinical value of manual fusion of PET and CT images in patients with suspected recurrent colorectal cancer
Clinical value of manual fusion of PET and CT images in patients with suspected recurrent colorectal cancer
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DOI：
10.2214/ajr.05.0708
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发表时间：
2007-01-01
影响因子：
5
通讯作者：
Togashi, Kaori
中科院分区：
文献类型：
--
作者：
Nakamoto, Yuji;Sakamoto, Setsu;Togashi, Kaori
客观的。本研究的目的是比较使用 F-18-FDG 和 CT 图像手动融合 PET 图像与单独 CT、单独 PET 以及常规 PET 图像和 CT 图像（以下简称“PET + CT”）对疑似复发结直肠癌患者的诊断性能。 材料和方法。获得了伦理委员会的批准和知情同意。 63 名疑似复发性结直肠癌患者接受了全身 F-18-FDG PET 检查，随后进行了诊断性 CT 检查。采集的 PET 和 CT 图像在工作站上逐像素合并。使用 5 点分级量表（0 = 绝对阴性，1 = 可能阴性，2 = 模棱两可，3 = 可能阳性，4 = 绝对阳性）分别评估 CT、PET、PET + CT 和融合图像是否存在复发、新转移或两者。确定为 3 级或 4 级的病变被认为是阳性，并使用卡方独立检验通过统计分析评估诊断的准确性和确定性。 结果。在 36 名患者的 119 个病理或临床确诊的病灶中，CT、PET、PET + CT 和融合图像的评估结果分别检测到 75 个（63%）、84 个（71%）、91 个（76%）和 111 个（93%）病灶（p < 0.01），检测到的 4 级病灶数量分别为 59 个（50%）、72 个（61%）、分别为 84 (71%) 和 108 (91%) (p < 0.01)。总体而言，根据患者情况，CT、PET、PET + CT 和融合图像的诊断准确性分别为 78%、79%、84% 和 92% (p = 0.13)。 结论。解读融合图像比解读 CT、PET 或 PET + CT 图像提供更准确的诊断。这种手动融合分别获得的 PET 和 CT 图像的方法提高了检测结直肠癌复发的诊断确定性，并减少了可疑病例的数量。
OBJECTIVE. The purpose of this study was to compare the diagnostic performance of manually fused PET images obtained using F-18-FDG and CT images with that of CT alone, PET alone, and conventional side-by-side review of PET images and CT images (hereafter referred to as "PET + CT") in patients with suspected recurrent colorectal cancer.MATERIALS AND METHODS. Ethics committee approval and informed consent were obtained. Sixty-three patients with suspected recurrent colorectal cancer underwent whole-body F-18-FDG PET followed by diagnostic CT. The acquired PET and CT images were merged on a workstation on a pixel-to-pixel basis. CT, PET, PET + CT, and fused images were evaluated separately in terms of the presence or absence of recurrence, new metastases, or both using a 5-point grading scale (0 = definitely negative, 1 = probably negative, 2 = equivocal, 3 = probably positive, and 4 = definitely positive). Lesions determined to be grade 3 or 4 were considered positive, and diagnostic accuracy and certainty were evaluated with statistical analysis using the chi-square test for independence.RESULTS. Of 119 pathologically or clinically confirmed lesions in 36 patients, evaluation of CT, PET, PET + CT, and fused images resulted in the detection of 75 (63%), 84 (71%), 91 (76%), and 111 (93%) lesions, respectively (p < 0.01) with the number of grade 4 lesions detected being 59 (50%), 72 (61%), 84 (71%), and 108 (91%), respectively (p < 0.01). Overall, the diagnostic accuracy of CT, PET, PET + CT, and fused images according to patient were 78%, 79%, 84%, and 92%, respectively (p = 0.13).CONCLUSION. Interpreting fused images provided more accurate diagnoses than interpreting CT, PET, or PET + CT images. This method of manually fusing separately obtained PET and CT images increased the diagnostic certainty for detecting colorectal cancer recurrence and decreased the number of equivocal cases.