Improvement of Hepatic Lesion Characterization by 18F-FDG PET/CT with the Use of the Lesion to Background Liver Activity Ratio
Improvement of Hepatic Lesion Characterization by 18F-FDG PET/CT with the Use of the Lesion to Background Liver Activity Ratio
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DOI：
10.1097/rlu.0000000000000221
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发表时间：
2013-11-01
影响因子：
10.6
通讯作者：
Wong, C. Y. Oliver
中科院分区：
文献类型：
--
作者：
Jolepalem, Prashant;Rydberg, John N.;Wong, C. Y. Oliver
目的：本研究的目的是开发一种可重复的方法，以提高F-18-FDG PET/CT的诊断准确性时，表征hepatic insulines.Methods：这是一项回顾性研究的76例不同类型的癌症谁有134肝病变的诊断CT，MRI，或F-18-FDG PET/CT。所有134个病灶均通过PET/CT成像。为了比较，所有134个病灶也通过MRI（58个病灶）或诊断CT（107个病灶）成像，其中一些同时成像。最初的读者的解释被用来确定每一个模态的诊断有效性。然后使用肝脏病变的SUVmax与肝脏背景的SUVavg的比值（SUVTLR）对F-18-FDG PET/CT结果进行重新分层。参考标准是组织病理学和/或成像随访。134个病灶中有89个病灶转移呈阳性。双尾P值计算使用卡方test.Results：SUVTLR大于2.0与转移密切相关，而小于2.0与良性活动密切相关。基于原始解释者的视觉分析（PETVA），F-18-FDG PET/CT的准确性为74.6%，灵敏度高（95.5%），但特异性有限（33.3%）。使用SUVTLR截止值2.0对这些病例进行客观重新分层，准确性提高到97.8%，敏感性提高到100%，特异性提高到93.3%。通过卡方分析，这些值具有统计学显著性，PETVA和SUVTLR的P = 0.0001。58个MRI病变和107个诊断CT病变进行审查的准确性为70.7%（P = 0.008）和73.8%（P = 0.0001），分别。结论：使用SUVTLR的截止值为2.0，以客观地评估潜在的肝转移F-18-FDG PET结果在一个显着提高诊断准确性的主观视觉分析。在这项有限的研究中，使用SUVTLR比原始CT或MRI解释更准确地表征肝脏病变。
Objective: This study aimed to develop a reproducible method to improve F-18-FDG PET/CT's diagnostic accuracy when characterizing hepatic lesions.Methods: This was a retrospective study of 76 patients with various types of cancer who had 134 liver lesions described on diagnostic CT, MRI, or F-18-FDG PET/CT. All 134 lesions were imaged by PET/CT. For comparison, all 134 lesions were also imaged either by MRI (58 lesions) or by diagnostic CT (107), with some imaged by both. The original reader's interpretation was used to determine the diagnostic validity of each modality. The F-18-FDG PET/CT findings were then re-stratified using the ratio of the SUVmax of the liver lesion to the SUVavg of liver background (SUVTLR). The standard of reference was histopathology and/or imaging follow-up. Eighty-nine out of the 134 lesions were positive for metastases. Two-tailed P values were calculated using a chi-square test.Results: A SUVTLR greater than 2.0 strongly correlated with metastasis, while less than 2.0 strongly correlated with benign activity. Based on the original interpreter's visual analysis (PETVA), F-18-FDG PET/CT had an accuracy of 74.6% with a high sensitivity (95.5%), but limited specificity (33.3%). Using the SUVTLR cutoff value of 2.0 to objectively re-stratify these cases, there was improvement in accuracy to 97.8%, sensitivity to 100%, and specificity to 93.3%. These values were statistically significant by chi-square analysis, with P = 0.0001 for both PETVA and SUVTLR. The 58 MRI lesions and 107 diagnostic CT lesions that were reviewed had accuracies of 70.7% (P = 0.008) and 73.8% (P = 0.0001), respectively.Conclusion: Using a cutoff value of 2.0 for SUVTLR to objectively evaluate for potential hepatic metastases on F-18-FDG PET results in a significant improvement in diagnostic accuracy over subjective visual analysis alone. In this limited study, use of SUVTLR more accurately characterized hepatic lesions than the original CT or MRI interpretations.