Prospective investigation of positron emission tomography in lung nodules
Prospective investigation of positron emission tomography in lung nodules
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DOI：
10.1200/jco.1998.16.3.1075
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发表时间：
1998-03-01
影响因子：
45.3
通讯作者：
Coleman, RE
中科院分区：
文献类型：
--
作者：
Lowe, VJ;Fletcher, JW;Coleman, RE
目的：孤立性肺结节(SPN)通常通过胸部X线片和计算机体层摄影(CT)确诊。经常进行活组织检查以进一步评估结节。一种准确的、非侵入性的诊断测试可以避免有创性组织采样的发病率和成本。在一项前瞻性的多中心试验中，我们评价了18F-脱氧葡萄糖正电子发射断层扫描(FDG-PET)鉴别肺部结节良恶性的能力。方法：对89例在胸部X线片和CT上新发现的不确定SPN患者进行FDG-PET检查。通过计算标准化摄取值(SUV)作为FDG累积的指标，并采用目视计分方法，对PET数据进行半定量分析。结果：恶性结节60个，良性结节29个。使用SUV数据，PET检测恶性结节的总体敏感性和特异性分别为92%和90%，视觉分析的敏感性略高，但没有统计学意义，敏感性为98%，特异性较低，为69%。对于小于或等于1.5 cm的SPN(34/89)，SUV和肉眼分析的灵敏度和特异度分别为80%和95%，100%和74%。PET成像提供了一种非侵入性方法来评估不确定的SPN，可以减少对侵入性组织活检的需要。(C)1998年由美国临床肿瘤学会主办。
Purpose: Solitary pulmonary nodules (SPNs) are commonly identified by chest radiographs and computed tomography (CT). Biopsies are often performed to evaluate the nodules further. An accurate, noninvasive diagnostic test could avoid the morbidity and costs of invasive tissue sampling. We evaluated the ability of fluorine-18 deoxyglucose positron emission tomography (FDG-PET) to discriminate between benign and malignant pulmonary nodules in a prospective, multicenter trial.Methods: Eighty-nine patients who had newly identified indeterminate SPNs on chest radiographs and CT were evaluated with FDG-PET. PET data were analyzed semiquantitatively by calculating standardized uptake values (SUVs) as an index of FDG accumulation and also by a visual scoring method. PET results were compared with pathology results.Results: Sixty SPNs were malignant and 29 were benign. Using SUV data, PET had an overall sensitivity and specificity for detection of malignant nodules of 92% and 90%, Visual analysis provided a slightly higher, but not statistically significant, sensitivity of 98% and lower specificity of 69%. For SPNs less than or equal to 1.5 cm (34 of 89), the sensitivity and specificity of SUV and visual analysis were 80% and 95% and 100% and 74%, respectively.Conclusion: FDG-PET can accurately, characterize indeterminate SPNs. PET imaging provides a noninvasive method to evaluate indeterminate SPNs, which can reduce the need for invasive tissue biopsy. (C) 1998 by American Society of Clinical Oncology.