Significance of chronic marked hyperglycemia on FDG-PET: is it really problematic for clinical oncologic imaging?
Significance of chronic marked hyperglycemia on FDG-PET: is it really problematic for clinical oncologic imaging?
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FDG-PET 上慢性显着高血糖的意义：这对于临床肿瘤成像来说真的有问题吗？
DOI：
10.1007/s12149-009-0288-7
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发表时间：
2009
影响因子：
2.6
通讯作者：
Togashi,Kaori
中科院分区：
文献类型：
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作者：
Hara,Tadashi;Higashi,Tatsuya;Nakamoto,Yuji;Suga,Tsuyoshi;Saga,Tsuneo;Ishimori,Takayoshi;Ishizu,Koichi;Kawashima,Hidekazu;Kawase,Shigeto;Matsumoto,Keiichi;Togashi,Kaori
目的 本研究的目的是评估慢性显着高血糖对使用 18 F-氟脱氧葡萄糖 (FDG) 进行正电子发射断层扫描 (PET) 的临床诊断性能的不利影响。方法对 54 名患者进行 57 次扫描，这些患者接受 FDG-PET 诊断各种癌症，尽管在 FDG 给药时，这些患者的血浆葡萄糖水平仍高于 200 mg/dl。至少4小时禁食，进行回顾性分析。在临床随访中，这种高血糖被证实是由未控制的糖尿病（n = 32）和未经治疗的糖尿病（n = 25）引起的慢性高血糖。根据至少 6 个月的组织病理学或临床随访获得的恶性肿瘤的最终诊断，评估目视 PET 分析的诊断性能。结果排除 9 名患者的 9 次扫描而没有充分随访的情况，最终诊断是在 45 名患者的 48 次扫描中获得的。在36名患者的36次扫描中，最终确认了至少1处恶性病变，分别获得了30例和6例的真阳性和6例假阴性结果。 6例因FDG亲和度低的病理特征（肝细胞癌等）、化疗效果或肿瘤体积小而出现假阴性结果。总体而言，基于患者的敏感性、特异性、阳性预测值、阴性预测值和诊断准确性分别为 83%、83%、94%、63% 和 83%。在基于病灶的诊断中，75 个病灶中有 56 个 (74%) 被 PET 显示，而 19 个病灶 PET 呈阴性，这也是由于 FDG 亲和力低或尺寸小（小于 15 mm）。 结论 在慢性高血糖（而非急性高血糖）时，高血糖水平造成的不良影响最小。在大多数情况下，肿瘤的 FDG 摄取保持足够高的水平以进行视觉临床诊断，但 FDG 亲和力较低的肿瘤或小病灶（大小为 15 毫米）的情况除外。
ObjectivesThe purpose of this study was to evaluate the adverse effects of chronic marked hyperglycemia on clinical diagnostic performance of positron emission tomography (PET) using18F-fuorodeoxyglucose (FDG).MethodsFifty-seven scans of 54 patients, who received FDG-PET for the diagnosis of various cancer(s), and who showed high plasma glucose level of more than 200 mg/dl at the time of administration of FDG in spite of at least 4-h fasting, were retrospectively analyzed. In the clinical follow-up, this high plasma glucose was confirmed as chronic hyperglycemia derived from uncontrolled diabetes (n= 32) and untreated diabetes (n= 25). Based on the final diagnosis of malignancy obtained by histopathology or clinical follow-up for at least 6 months, the diagnostic performance of visual PET analysis was evaluated.ResultsExcluding nine scans of nine patients without sufficient follow-up, final diagnosis was obtained in 48 scans of 45 patients. In 36 scans of 36 patients, at least one malignant lesion was finally confirmed, and true-positive and false-negative results were obtained in 30 and six cases, respectively. Six cases showed false-negative results due to low FDG-avid pathological characteristics (hepatocellular carcinoma, etc.), chemotherapeutic effect or small tumor size. Overall, the patient-based sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy were 83, 83, 94, 63 and 83%, respectively. In lesion-based diagnosis, 56 of 75 lesions (74%) were depicted by PET, while 19 lesions were negative on PET, also due to low FDG-avid characteristics or small size (less than 15 mm).ConclusionsAt the time of chronic hyperglycemia (not acute hyperglycemia), the adverse effect caused by high plasma glucose level was minimum. The FDG uptake of the tumor maintained a sufficiently high level for visual clinical diagnosis in most cases, except in the cases of low FDG-avid tumors or small lesions (15 mm in size).
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DOI：
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发表时间：
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期刊：
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影响因子：
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影响因子：
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作者：
Yu;T. Yen;K. Ng;L. See;Chyong;T. Chang;C. Tsai;Ji;S. Hsueh;H. Chou
通讯作者：
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影响因子：
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