Use of a corrected standardized uptake value based on the lesion size on CT permits accurate characterization of lung nodules on FDG-PET
Use of a corrected standardized uptake value based on the lesion size on CT permits accurate characterization of lung nodules on FDG-PET
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DOI：
10.1007/s00259-002-0924-0
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发表时间：
2002-12-01
影响因子：
9.1
通讯作者：
Alavi, A
中科院分区：
文献类型：
--
作者：
Hickeson, M;Yun, MJ;Alavi, A
本研究的目的是通过使用计算机断层扫描（CT）的病灶大小来校正正电子发射断层扫描（PET）成像中的分辨率和部分容积效应，从而确定实际标准化摄取值（SUV）。这项回顾性研究纳入了47例CT扫描发现肺部病变的患者，这些患者的诊断通过活检或随访CT扫描（当PET结果被认为是恶性肿瘤阴性时）得到证实。每个病灶的FDG摄取通过SUV使用两种方法进行量化：通过测量最大体素SUV（maxSUV）和通过使用CT上病灶的大小来计算实际SUV（cor-SUV）。CT扫描2.0cm或更小的病灶中，良性10例，恶性17例。良性和恶性病变的平均maxSUV分别为1.43 ± 0.77和3.02 ± 1.74。以SUV = 2.0作为良恶性鉴别诊断的临界值，其敏感性、特异性和准确性分别为65%、70%和67%。当SUV为2.5时，敏感性、特异性和准确性分别为47%、80%和59%。良性和恶性病变的平均corSUV分别为1.65 ± 1.09和5.28 ± 2.71。无论SUV为2.0还是2.5作为临界值，敏感性、特异性和准确性分别为94%、70%和85%。唯一的恶性病变，被错误地认为是良性的两种方法是细支气管肺泡癌，没有发现任何升高的氟-18氟脱氧葡萄糖（FDG）的摄取。在较大病变（大于2.0 cm和小于6.0 cm）中，1例为良性，19例为恶性，corSUV技术未显著改变准确性。可以得出结论，测量SUV使用CT大小，以纠正分辨率和部分容积效应提供了潜在的价值，在区分良性病变的恶性在这个人群中。这种方法似乎可以提高FDG-PET的准确性，以最佳表征肺小结节。
The purpose of this study was to determine the actual standardized uptake value (SUV) by using the lesion size from computer tomography (CT) scan to correct for resolution and partial volume effects in positron emission tomography (PET) imaging. This retrospective study included 47 patients with lung lesions seen on CT scan whose diagnoses were confirmed by biopsy or by follow up CT scan when the PET result was considered negative for malignancy. Each lesion's FDG uptake was quantified by the SUV using two methods: by measuring the maximum voxel SUV (maxSUV) and by using the lesion's size on CT to calculate the actual SUV (cor-SUV). Among small lesions (2.0 cm or smaller on CT scan), ten were benign and 17 were malignant. The average maxSUV was 1.43 +/- 0.77 and 3.02 +/- 1.74 for benign and malignant lesions respectively. When using an SUV of 2.0 as the cutoff to differentiate benignity and malignancy, the sensitivity, specificity, and accuracy were 65%, 70%, and 67% respectively. When an SUV of 2.5 was used for cutoff, the sensitivity, specificity, and accuracy were 47%, 80%, and 59% respectively. The average corSUV was 1.65 +/- 1.09 and 5.28 +/- 2.71 for benign and malignant lesions respectively. Whether an SUV of either 2.0 or 2.5 was used for cutoff, the sensitivity, specificity, and accuracy remained 94%, 70%, and 85% respectively. The only malignant lesion that was falsely considered benign with both methods was a bronchioal-veolar carcinoma which did not reveal any elevated uptake of fluorine-18 fluorodeoxyglucose (FDG). Of the large lesions (more than 2.0 cm and less than 6.0 cm), one was benign and 19 were malignant and the corSUV technique did not significantly change the accuracy. It is concluded that measuring the SUV by using the CT size to correct for resolution and partial volume effects offers potential value in differentiating malignant from benign lesions in this population. This approach appears to improve the accuracy of FDG-PET for optimal characterization of small lung nodules.