Comparing the Diagnostic Potential of 68Ga-Alfatide II and 18F-FDG in Differentiating Between Non Small Cell Lung Cancer and Tuberculosis
Comparing the Diagnostic Potential of 68Ga-Alfatide II and 18F-FDG in Differentiating Between Non Small Cell Lung Cancer and Tuberculosis
复制标题
比较 68Ga-Alfatide II 和 18F-FDG 区分非小细胞肺癌和结核病的诊断潜力。
DOI：
10.2967/jnumed.115.167924
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发表时间：
2016-05-01
影响因子：
9.3
通讯作者：
Wang, Jing
中科院分区：
文献类型：
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作者：
Kang, Fei;Wang, Shengjun;Wang, Jing
本研究的目的是比较Ga-68-Alfatide II和F-18-FDG在鉴别非小细胞肺癌（NSCLC）和肺结核（TB）患者中的诊断潜力。方法：选取21例非小细胞肺癌患者和13例结核病患者。使用Ga-68-Alfatide II或F-18-FDG连续2天获得PET/CT图像。进行SUV定量比较、接受者-工作曲线分析、综合目视分析。应用免疫组织化学方法分析了血管生成标志物α (v) β(3)在NSCLC和TB原发病变中的表达。结果：Ga-68-Alfatide II SUVmax和SUVmean在NSCLC和TB中存在显著差异（P分别为0.0001和0.0007）。Ga-68-Alfatide II SUVmax的受者-工作曲线值下面积显著高于F-18-FDG （P = 0.038）。Ga-68-Alfatide II的视觉分化诊断特异性是F-18-FDG的1.57倍（84.62% vs. 53.85%）。在检测NSCLC淋巴结时，Ga-68-Alfatide II的特异性更高（100% vs. 66.7%），而F-18-FDG的敏感性更高（87.5% vs. 75%）。在TB淋巴结检测中，Ga-68-Alfatide II的假阳性率为F-18-FDG的1 / 3（15.4%/ 46.2%）。此外，Ga-68-Alfatide II检测到更多的脑转移，而较少的肝和骨转移。α (v) β(3)生物标志物在非小细胞肺癌病变的细胞和新生血管中特异性表达。结论：Ga-68-Alfatide II具有检测NSCLC原发病灶的能力，在区分NSCLC与结核原发病灶及提示淋巴结方面优于F-18-FDG。Ga-68-Alfatide II更有可能检测到脑转移，而F-18-FDG更有可能检测到肝脏和早期骨转移。
The objectives of this study were to compare the diagnostic potential of Ga-68-Alfatide II with F-18-FDG in differentiating between non-small cell lung cancer patients (NSCLC) and lung tuberculosis (TB) patients. Methods: Twenty-one NSCLC patients and 13 TB patients were recruited. PET/CT images using either Ga-68-Alfatide II or F-18-FDG were acquired in 2 consecutive days. SUV quantitative comparison, receiver-operating curve analysis, and comprehensive visual analysis were performed. The expression of the angiogenesis marker alpha(v)beta(3) in NSCLC and TB primary lesions was analyzed by immunohistochemistry. Results: The Ga-68-Alfatide II SUVmax and SUVmean were significantly different in NSCLC and TB (P = 0.0001 and 0.0007, respectively). The area under the receiver-operating curve value of Ga-68-Alfatide II SUVmax was significantly higher than that of F-18-FDG (P = 0.038). The visual differentiation diagnostic specificity of Ga-68-Alfatide II was 1.57-fold (84.62% vs. 53.85%) higher than that of F-18-FDG. In the detection of NSCLC lymph nodes, Ga-68-Alfatide II was superior in specificity (100% vs. 66.7%), whereas the sensitivity was greater with F-18-FDG (87.5% vs. 75%). In TB lymph node detection, the false-positive rate of Ga-68-Alfatide II was one-third (15.4%/ 46.2%) the value of F-18-FDG. Additionally, Ga-68-Alfatide II detected more metastases in the brain but less in the liver and the bone. The alpha(v)beta(3) biomarker was specifically expressed in the cells and the neovasculature of NSCLC lesions. Conclusion: Ga-68-Alfatide II is qualified for detecting NSCLC primary lesions and is superior to F-18-FDG in distinguishing NSCLC from TB in primary lesions and suggestive lymph nodes. Ga-68-Alfatide II is more likely to be capable of detecting brain metastasis, and F-18-FDG is more likely to be capable of detecting liver and early-stage bone metastases.