Differentiation of Malignant and Benign Pulmonary Nodules with Quantitative First-Pass 320-Detector Row Perfusion CT versus FDG PET/CT
Differentiation of Malignant and Benign Pulmonary Nodules with Quantitative First-Pass 320-Detector Row Perfusion CT versus FDG PET/CT
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DOI：
10.1148/radiol.10100245
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发表时间：
2011-02-01
期刊：
影响因子：
19.7
通讯作者：
Sugimura, Kazuro
中科院分区：
文献类型：
--
作者：
Ohno, Yoshiharu;Koyama, Hisanobu;Sugimura, Kazuro
目的：前瞻性比较定量首过灌注 320 排计算机断层扫描 (CT)（即区域探测器 CT）与正电子发射断层扫描和 CT 联合 (PET/CT) 区分恶性和良性肺结节的能力。 材料和方法：这项前瞻性研究得到了机构审查委员会的批准，并获得了 50 名患者的书面知情同意书。 连续76个肺结节患者。所有患者均接受动态区域探测器 CT、PET/CT 以及微生物和/或组织病理学检查。所有肺结节分为三组：恶性结节（n = 43）、低生物活性良性结节（n = 6）和高生物活性良性结节（n = 27）。对于每个动态区域探测器 CT 数据集，计算使用最大斜率模型导出的灌注 (PF(MS))、使用 Patlak 图模型导出的提取分数 (EF(PP)) 以及使用 Patlak 图模型导出的血容量 (BV(PP))。对三个结节组之间的这些参数进行统计比较。采用受试者工作特征（ROC）分析来比较CT和PET/CT指标的诊断能力。最后采用McNemar检验比较各指标的敏感度、特异度和准确度。结果：恶性结节组各项指标与低生物活性良性结节组相比均有显着性差异（P < .05）。 PF(MS) 和 EF(PP) 的 ROC 曲线下面积显着大于 BV(PP) (P < .05) 和最大标准摄取值 (SUV(max)) (P < .05)。 PF(MS)和EF(PP)的特异性和准确性显着高于BV(PP)和SUV(max)(P < .05)。结论：动态首过区域探测器灌注CT在鉴别良恶性肺结节方面比PET/CT具有更高的特异性和准确性。 (c) 北美放射学会，2011 年
Purpose: To prospectively compare the capability of quantitative first-pass perfusion 320-detector row computed tomography (CT) (ie, area-detector CT) with that of combined positron emission tomography and CT (PET/CT) for differentiation between malignant and benign pulmonary nodules.Materials and Methods: This prospective study was approved by the institutional review board, and written informed consent was obtained from 50 consecutive patients with 76 pulmonary nodules. All patients underwent dynamic area-detector CT, PET/CT, and microbacterial and/or histopathologic examinations. All pulmonary nodules were divided into three groups: malignant nodules (n = 43), benign nodules with low biologic activity (n = 6), and benign nodules with high biologic activity (n = 27). For each dynamic area-detector CT data set, the perfusion derived by using the maximum slope model (PF(MS)), extraction fraction derived by using the Patlak plot model (EF(PP)), and blood volume derived by using the Patlak plot model (BV(PP)) were calculated. These parameters were statistically compared among the three nodule groups. Receiver operating characteristic (ROC) analyses were used to compare the diagnostic capability of the CT and PET/CT indexes. Finally, the sensitivity, specificity, and accuracy of each index were compared by using the McNemar test.Results: All indexes in the malignant nodule group were significantly different from those in the low-biologic-activity benign nodule group (P < .05). Areas under the ROC curve for PF(MS) and EF(PP) were significantly larger than those for BV(PP) (P < .05) and maximal standard uptake value (SUV(max)) (P < .05). The specificity and accuracy of PF(MS) and EF(PP) were significantly higher than those of BV(PP) and SUV(max) (P < .05).Conclusion: Dynamic first-pass area-detector perfusion CT has the potential to be more specific and accurate than PET/CT for differentiating malignant from benign pulmonary nodules. (c) RSNA, 2011