Multimodal virtual bronchoscopy using PET/CT images
Multimodal virtual bronchoscopy using PET/CT images
复制标题
DOI：
10.3109/10929080801954164
复制
发表时间：
2008-03-01
影响因子：
--
通讯作者：
Seemann, Marcus D.
中科院分区：
文献类型：
--
作者：
Englmeier, Karl-Hans;Seemann, Marcus D.
目的：利用正电子发射断层扫描 (PET) 和计算机断层扫描 (CT) 的数据集证明虚拟支气管镜检查的可能性、优点和局限性。材料和方法：连续 8 名非小细胞肺癌 (NSCLC) 患者接受了 PET/CT。使用最先进的全环 Pico-3D PET 扫描仪，使用葡萄糖类似物 2-[氟-18]-氟-2-脱氧-D-葡萄糖 (F-18-FDG) 进行 PET 扫描。使用 16 排 CT 扫描仪以静脉为主的对比增强相进行 CT 检查。使用 CT 数据集和交互式阈值间隔体积增长分割算法对气管支气管系统进行分割。使用 CT 数据集对原发肿瘤和淋巴结转移进行虚拟 CT 支气管镜检查，并使用 PET/CT 数据集进行虚拟混合支气管镜检查。感兴趣的结构通过颜色编码阴影表面渲染方法可视化。结果：CT 和虚拟 CT 支气管镜的使用主要有助于气管支气管系统解剖细节的可视化以及疾病引起的解剖/形态结构变化的检测。 PET/CT 和虚拟混合支气管镜检查或虚拟 PET/CT 支气管镜检查的结果优于虚拟 CT 支气管镜检查，因为混合支气管镜检查同时使用 CT 信息和从 PET 获得的有关疾病的分子/代谢信息。结论：PET/CT 成像已被证明是一种非常有价值的肿瘤诊断方式。虚拟混合支气管镜检查可以使用低剂量 CT 扫描或诊断 CT 进行。然而，它有望提高恶性肿瘤识别和表征、感染验证、活肿瘤组织与肺不张和疤痕组织的区分、肿瘤分期和治疗反应评估、以及使用虚拟 CT 支气管镜检查无法检测或容易误判的早期复发检测的诊断准确性。它也可用作疑似支气管内恶性肿瘤患者的筛查检查方法。具有透明颜色编码阴影表面渲染模型的虚拟混合支气管镜检查提供了纤维支气管镜检查的有用替代方案，对于纤维支气管镜检查不可行、禁忌或拒绝的患者特别有希望。
Objective: To demonstrate the possibilities, advantages and limitations of virtual bronchoscopy using data sets from positron emission tomography (PET) and computed tomography (CT).Materials and Methods: Eight consecutive patients with non-small cell lung cancer (NSCLC) underwent PET/CT. PET was performed with a glucose analog, 2-[fluorine-18]-fluoro-2-deoxy-D-glucose (F-18-FDG), using a state-of-the-art full-ring Pico-3D PET scanner. CT was performed with a venous-dominant contrast-enhanced phase using a 16-slice CT scanner. The tracheobronchial system was segmented using the CT data set with an interactive threshold interval volume-growing segmentation algorithm. The primary tumors and lymph node metastases were segmented for virtual CT-bronchoscopy using the CT data set and for virtual hybrid bronchoscopy using the PET/CT data set. The structures of interest were visualized with a color-coded shaded-surface rendering method.Results: The use of CT and virtual CT-bronchoscopy primarily facilitates visualization of the anatomical details of the tracheobronchial system and detection of anatomical/morphologic structural changes caused by disease. PET/CT and virtual hybrid bronchoscopy, or virtual PET/CT-bronchoscopy, give superior results to virtual CT-bronchoscopy because the hybrid bronchoscopy uses both the CT information and the molecular/metabolic information about the disease obtained from PET.Conclusions: PET/CT imaging has proven to be a highly valuable oncological diagnostic modality. Virtual hybrid bronchoscopy can be performed using a low-dose CT scan or diagnostic CT. However, it is expected to improve diagnostic accuracy in identification and characterization of malignancies, verification of infections, and differentiation of viable tumor tissue from atelectases and scar tissue, as well as assessment of tumor staging and therapeutic response, and detection of early stage recurrences that are not detectable or are liable to be misjudged using virtual CT-bronchoscopy. It could also be useful as a screening examination method for patients with suspected endobronchial malignancy. Virtual hybrid bronchoscopy with a transparent color-coded shaded-surface rendering model offers a useful alternative to fiberoptic bronchoscopy, and is particularly promising for patients for whom fiberoptic bronchoscopy is not feasible, contraindicated or refused.