Imaging of lung cancer with fluorine-18 fluorodeoxyglucose: comparison of a dual-head gamma camera in coincidence mode with a full-ring positron emission tomography system
Imaging of lung cancer with fluorine-18 fluorodeoxyglucose: comparison of a dual-head gamma camera in coincidence mode with a full-ring positron emission tomography system
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使用氟 18 氟脱氧葡萄糖对肺癌进行成像：符合模式双头伽玛相机与全环正电子发射断层扫描系统的比较
DOI：
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发表时间：
1999
期刊：
影响因子：
--
通讯作者：
M. Schwaiger
中科院分区：
文献类型：
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作者：
W. Weber;J. Neverve;J. Sklarek;S. Ziegler;P. Bartenstein;B. King;T. Treumann;A. Enterrottacher;M. Krapf;K. Häussinger;H. Lichte;H. Präuer;O. Thetter;M. Schwaiger
抽象的。以符合模式操作的双头伽玛相机是使用氟 18 氟脱氧葡萄糖 (FDG) 进行肿瘤成像的一种新方法。本研究的目的是评估这种摄像系统与全环正电子发射断层扫描 (PET) 系统对肺癌患者的诊断准确性。同一天，使用全环 PET 扫描仪 (Siemens ECAT EXACT) 和符合伽马相机系统 (ADAC Vertex MCD) 对 27 名肺癌或不确定性肺结节患者（1 名女性，26 名男性，年龄 62±9 岁）进行了研究。注射 185–370 MBq FDG 60 分钟后，使用全环系统进行胸部扫描。大约 2 小时后，进行了重合相机研究。由两名盲人观察者独立分析符合伽玛相机 (CGC) 以及带衰减校正 (PETac) 和不带衰减校正 (PETnac) 的 PET 图像。此外，相对于正常对侧肺（T/L 比），对原发肿瘤和受累淋巴结中的 FDG 摄取进行了定量。所有原发性肿瘤均经过组织学证实。对 23 名患者的淋巴结状态进行了组织学测定。在四名患者中，由于疾病广泛或并发疾病，没有进行淋巴结取样。 27例患者中，组织学诊断出25例原发性肺癌和2例转移性肺癌。 CGC 的每厘米轴向视野的重合数为 3.33±0.93×105，专用 PET 系统的重合数为 1.09±0.36×106。所有原发性肿瘤（大小：4.6±2.6 cm）均在 CGC 和专用 PET 研究中得到正确识别。 CGC 的 T/L 比率为 4.7±2.5，PETnac 的 T/L 比率为 6.9±2.8（P <0.001）。组织病理学评估显示 88 个采样淋巴结站中有 11 个存在淋巴结转移（大小：2.3±1.0 cm）。 PETac 研究中发现了所有淋巴结转移，而 PETnac 检测到了 10/11，CGC 检测到了 8/11。对于 CGC 和 PETnac 研究中可见的阳性淋巴结，CGC 的 T/L 比为 3.7±2.3，PETnac 的 T/L 比为 6.6±3.1（P=0.02）。 CGC 研究中假阴性淋巴结的直径分别为 0.75、1.5 和 2 厘米。在所有三种成像方法中，两名患者均发现淋巴结中 FDG 摄取呈假阳性。对于所有病变组合，CGC 相对于 PETnac 研究的 T/L 比值随着病变大小的减小而显着下降（r=0.62；P<0.001）。总之，与全环 PET 系统相比，CGC 成像检测肺癌的灵敏度受到图像对比度较低的限制，而图像对比度随着病灶尺寸的减小而恶化。尽管如此，CGC 成像检测直径至少 2 厘米的肺部病变的能力似乎与全环系统类似。两个系统都为评估淋巴结受累提供了相似的特异性。
Abstract. Dual-head gamma cameras operated in coincidence mode are a new approach for tumour imaging using fluorine-18 fluorodeoxyglucose (FDG). The aim of this study was to assess the diagnostic accuracy of such a camera system in comparison with a full-ring positron emission tomography (PET) system in patients with lung cancer. Twenty-seven patients (1 female, 26 males, age 62±9 years) with lung cancer or indeterminate pulmonary nodules were studied on the same day with a full-ring PET scanner (Siemens ECAT EXACT) and a coincidence gamma camera system (ADAC Vertex MCD). Sixty minutes after injection of 185–370 MBq FDG, a scan of the chest was performed with the full-ring system. Approximately 2 h p.i., the coincidence camera study was performed. Coincidence gamma camera (CGC) and PET images with (PETac) and without attenuation correction (PETnac) were analysed independently by two blinded observers. In addition, FDG uptake in primary tumours and involved lymph nodes was quantified relative to normal contralateral lung (T/L ratios). All primary tumours were histologically proven. The lymph node status was histologically determined in 23 patients. In four patients, no lymph node sampling was performed because of extensive disease or concurrent illnesses. In the 27 patients, 25 primary lung cancers and two metastatic lesions were histologically diagnosed. The number of coincidences per centimetre axial field of view was 3.33±0.93×105 for the CGC and 1.09±0.36×106 for the dedicated PET system. All primary tumours (size: 4.6±2.6 cm) were correctly identified in the CGC and dedicated PET studies. T/L ratios were 4.7±2.5 for CGC and 6.9±2.8 for PETnac (P <0.001). Histopathological evaluation revealed lymph node metastases in 11 of 88 sampled lymph node stations (size: 2.3±1.0 cm). All lymph node metastases were identified in the PETac studies, while PETnac detected 10/11 and CGC 8/11. For positive lymph nodes that were visible in CGC and PETnac studies, T/L ratios were 3.7±2.3 for CGC and 6.6±3.1 for PETnac (P=0.02). The diameters of false-negative lymph nodes in the CGC studies were 0.75, 1.5 and 2 cm. False-positive FDG uptake in lymph nodes was found in two patients with all three imaging methods. For all lesions combined, T/L ratios in CGC relative to PETnac studies decreased significantly with decreasing lesion size (r=0.62; P<0.001). In conclusion, compared with a full-ring PET system the sensitivity of CGC imaging for detection of lung cancer is limited by a lower image contrast which deteriorates with decreasing lesion size. Nevertheless, the ability of CGC imaging to detect pulmonary lesions with a diameter of at least 2 cm appears to be similar to that of a full-ring system. Both systems provide a similar specificity for the evaluation of lymph node involvement.
影响因子：
19.7
作者：
WAHL, RL;QUINT, LE;ORRINGER, MB
通讯作者：
ORRINGER, MB
DOI：
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发表时间：
1991-04
期刊：
Journal of nuclear medicine : official publication, Society of Nuclear Medicine
影响因子：
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作者：
L. Strauss;P. Conti
通讯作者：
L. Strauss;P. Conti
临床接受者操作特征研究的结果，比较 FDG PET 研究中的滤波反投影和最大似然估计图像。
DOI：
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发表时间：
1993
期刊：
Journal of nuclear medicine : official publication, Society of Nuclear Medicine
影响因子：
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作者：
Llacer,J;Veklerov,E;Baxter,LR;Grafton,ST;Griffeth,LK;Hawkins,RA;Hoh,CK;Mazziotta,JC;Hoffman,EJ;Metz,CE
通讯作者：
Metz,CE