Dual-time point 18F-FDG PET/CT scan for differentiation between 18F-FDG-avid non-small cell lung cancer and benign lesions
Dual-time point 18F-FDG PET/CT scan for differentiation between 18F-FDG-avid non-small cell lung cancer and benign lesions
复制标题
DOI：
10.1007/s12149-009-0260-6
复制
发表时间：
2009-07-01
影响因子：
2.6
通讯作者：
Matsunaga, Naofumi
中科院分区：
文献类型：
--
作者：
Suga, Kazuyoshi;Kawakami, Yasuhiko;Matsunaga, Naofumi
本研究的目的是阐明双时间点PET/CT扫描上FDG活跃的非小细胞肺癌（NSCLC）和各种病因相关良性病变之间F-18 FDG摄取动力学的差异，并确定分化的最佳参数。研究材料为76例患者中的76例FDG活跃的孤立性NSCLC和61例患者中的57例FDG活跃的孤立性良性病变。静脉注射 4.4 MBq/kg F-18 FDG 后 60 和 120 分钟进行 FDG PET/CT 扫描。测量早期和延迟扫描的最大标准化摄取值 (SUVmax) 以及两个时间点之间 SUVmax 的百分比变化 (%Delta SUVmax)。通过接受者操作特征曲线分析和诊断准确性评估来确定最佳差异参数。早期 SUV max、延迟 SUVmax 和 %Delta SUVmax 的平均值 +/- A SD 分别为 8.3 +/- A 5.2 和 10.2 +/- A 6.5，FDG 亲和 NSCLC 中为 21.9% +/- A 18.9，3.8 +/- A 3.2、4.0 +/- A FDG 丰富的良性病变中分别为 3.7 和 11.3% +/- A 26.0。 NSCLC 中的延迟 SUVmax 显着高于早期 SUVmax (P < 0.0001)；而良性病变则没有什么不同。 NSCLC 中 SUVmax 的变化百分比也显着高于良性病变（P < 0.01）。分化的最佳参数是延迟 SUVmax > 5.5，灵敏度为 77.6%，特异性为 80.7%，准确度为 78.9%，这比使用 %Delta SUVmax 或早期 SUVmax > 2.5 的传统参数提供了更好的分化效果。然而，11 个（19.2%）良性病变与 NSCLC 无法区分。尽管延迟 PET/CT 扫描增强了 FDG 活跃的 NSCLC 和良性病变之间 FDG 摄取的差异，并且与早期扫描相比，使用延迟 SUVmax > 5.5 似乎可以改善这些代谢亢进病变的分化，但仍需要仔细解释和管理以正确区分。
The aim of this study is to clarify the difference of F-18 FDG uptake kinetics between FDG-avid non-small-cell lung cancer (NSCLC) and benign lesions associated with various etiologies on dual-time point PET/CT scan, and to determine the optimal parameter for differentiation.The materials were 76 FDG-avid solitary NSCLC in 76 patients and 57 FDG-avid solitary benign lesions associated with various etiologies in 61 patients. FDG PET/CT scan was performed at 60 and 120 min after intravenous injection of 4.4 MBq/kg F-18 FDG. The maximum standardized uptake value (SUVmax) on early and delayed scans and the percent change of SUVmax (%Delta SUVmax) between the two time points were measured. The optimal differential parameter was determined by receiver-operating characteristic curve analysis and evaluation of diagnostic accuracy.The mean +/- A SD of early SUV max, delayed SUVmax and %Delta SUVmax were 8.3 +/- A 5.2, and 10.2 +/- A 6.5, and 21.9% +/- A 18.9 in FDG-avid NSCLC, and 3.8 +/- A 3.2, 4.0 +/- A 3.7, and 11.3% +/- A 26.0 in FDG-avid benign lesions, respectively. Delayed SUVmax in NSCLC was significantly higher than early SUVmax (P < 0.0001); while not different in benign lesions. Percent change of SUVmax in NSCLC was also significantly higher than that in benign lesions (P < 0.01). The optimal parameter for the differentiation was delayed SUVmax > 5.5 and yielded sensitivity of 77.6%, specificity of 80.7% and accuracy of 78.9%, which provided better differentiation than the use of %Delta SUVmax or the traditional parameter of early SUVmax > 2.5. However, 11 (19.2%) benign lesions were indistinguishable from NSCLC.Although delayed PET/CT scan enhances the difference of FDG uptake between FDG-avid NSCLC and benign lesions, and the use of delayed SUVmax > 5.5 appears to improve the differentiation of these hypermetabolic lesions compared with an early scan, careful interpretation and management for correct differentiation are still required.