Dynamic whole-body 18F-FDG PET for differentiating abnormal lesions from physiological uptake
Dynamic whole-body 18F-FDG PET for differentiating abnormal lesions from physiological uptake
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DOI：
10.1007/s00259-020-04726-w
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发表时间：
2020-03-18
影响因子：
9.1
通讯作者：
Yamada, Kei
中科院分区：
文献类型：
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作者：
Nishimura, Motoki;Tamaki, Nagara;Yamada, Kei
目的对F-18-FDG全身摄取的视觉变化进行一系列评估，以区分尿路和胃肠道的病理性摄取和生理性摄取。方法对88例疑似癌症患者，从注射F-18-FDG后60min开始，连续4次进行3min动态全身PET显像。在动态图像评估中，两名核医学医生对高F-18-FDG摄取进行了评估，并根据摄取形状随时间的变化将其分类为“改变的”或“未改变的”。评估基于这些标准的病理性摄取的可检测性，并与传统的图像评估进行比较。结果动态全身正电子发射计算机断层扫描提供了符合视觉评价要求的图像。在118/154个生理性高摄取F-18-FDG的区域(77%)中，动态影像评价“改变”了：9/19个胃(47%)，32/39个小肠(82%)，17/33个结肠(52%)，60/63个尿路(95%)。在86个良恶性病变中，84个病变(98%)“不变”。F-18-FDG高摄取区在这些标准下显示不随时间变化的高摄取区很可能代表病理性摄取，敏感度为97%，特异度为76%，PPV为70%，NPV为98%，准确性为84%。结论动态全身F-18-FDG PET显像可根据摄取形态的视觉变化，区分尿路和胃肠道的病理性摄取和生理性摄取。
Purpose Serial assessment of visual change in F-18-FDG uptake on whole-body F-18-FDG PET imaging was performed to differentiate pathological uptake from physiological uptake in the urinary and gastrointestinal tracts. Methods In 88 suspected cancer patients, serial 3-min dynamic whole-body PET imaging was performed four times, from 60 min after F-18-FDG administration. In dynamic image evaluation, high F-18-FDG uptake was evaluated by two nuclear medicine physicians and classified as "changed" or "unchanged" based on change in uptake shape over time. Detectability of pathological uptake based on these criteria was assessed and compared with conventional image evaluation. Results Dynamic whole-body PET imaging provided images of adequate quality for visual assessment. Dynamic image evaluation was "changed" in 118/154 regions of high physiological F-18-FDG uptake (77%): in 9/19 areas in the stomach (47%), in 32/39 in the small intestine (82%), in 17/33 in the colon (52%), and in 60/63 in the urinary tract (95%). In the 86 benign or malignant lesions, 84 lesions (98%) were "unchanged." A high F-18-FDG uptake area that shows no change over time using these criteria is highly likely to represent pathological uptake, with sensitivity of 97%, specificity of 76%, PPV of 70%, NPV of 98%, and accuracy of 84%. Conclusion Dynamic whole-body F-18-FDG PET imaging enabled differentiation of pathological uptake from physiological uptake in the urinary and gastrointestinal tracts, based on visual change of uptake shape.