Accuracy of whole-body FDG-PET/CT for detecting brain metastases from non-central nervous system tumors
Accuracy of whole-body FDG-PET/CT for detecting brain metastases from non-central nervous system tumors
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DOI：
10.1007/s12149-008-0145-0
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发表时间：
2008-08-01
影响因子：
2.6
通讯作者：
Sugimura, Kazuro
中科院分区：
文献类型：
--
作者：
Kitajima, Kazuhiro;Nakamoto, Yuji;Sugimura, Kazuro
目的正电子发射断层扫描（PET）对脑转移瘤的检出存在局限性，而PET/CT联合应用的可行性尚不清楚。我们评估的准确性FDG-PET/CT的身体成像协议检测脑转移瘤时，比较PET单独和CT单独。方法50例患者进行全身FDG-PET/CT扫描，包括大脑和对比剂增强脑MR（磁共振）扫描。仅PET、仅CT和融合图像进行解释，并使用五点分级量表记录脑转移存在的置信度。计算受试者工作特征（ROC）曲线下面积（Az）。三种模式之间的差异进行了测试与Cochran-Q检验，然后使用McNemar检验与Bonferroni adjustment.Results多重比较磁共振成像显示70例脑转移灶20例。基于患者的分析显示，单独PET判读的灵敏度、特异度、准确度和Az分别为45%、80%、66%和0.6025，单独CT判读的灵敏度、特异度、准确度和Az分别为50%、97%、78%和0.7158，融合图像判读的灵敏度、特异度、准确度和Az分别为50%、93%、76%和0.7242，分别ROC分析显示三种解释方法之间（P = 0.0238）以及PET和PET/CT之间（P = 0.0129）存在显著差异。PET、CT和融合图像判读检测70个病灶的灵敏度分别为13%、20%和20%.Conclusions即使使用一体化PET/CT扫描仪的身体成像协议，脑转移瘤的灵敏度仍然不令人满意。为了评估颅内病变，仍应考虑MR扫描。
Objective Positron emission tomography (PET) using F-18-fluoro-2-deoxy- D-glucose (FDG) has a limitation in detecting cerebral metastases; however, the feasibility of detection by inline PET/computed tomography (CT) system remains unknown. We evaluated the accuracy of FDG-PET/CT of body imaging protocol for the detection of cerebral metastases when compared with PET alone and CT alone.Methods Fifty patients underwent whole-body FDG-PET/CT scanning including the brain and contrast-enhanced brain MR (magnetic resonance) scan. PET-only, CT-only, and the fused images were interpreted, and the confidence of presence of cerebral metastases was recorded using a five-point grading scale. Area under the receiver-operating characteristic (ROC) curve (Az) was calculated. Differences among the three modalities were tested with the Cochran-Q test, followed by multiple comparisons using the McNemar test with Bonferroni adjustment.Results Magnetic resonance imaging revealed 70 cerebral metastatic lesions in 20 patients. Patient-based analysis showed that the sensitivity, specificity, accuracy, and Az of PET-alone interpretation were 45%, 80%, 66%, and 0.6025, respectively, those of CT-alone interpretation were 50%, 97%, 78%, and 0.7158, respectively, and those of fused-image interpretation were 50%, 93%, 76%, and 0.7242, respectively. ROC analysis revealed significant differences among the three interpretation methods (P = 0.0238) and between PET and PET/CT (P = 0.0129). The sensitivity of PET, CT, and fused-image interpretation for detecting 70 lesions was 13%, 20%, and 20%, respectively.Conclusions Even with an integrated PET/CT scanner of body imaging protocol, the sensitivity of cerebral metastases remained unsatisfactory. To assess intracranial lesions, MR scanning should still be considered.