Presurgical staging of non-small cell lung cancer - Positron emission tomography, integrated positron emission tomography/CT, and software image fusion
Presurgical staging of non-small cell lung cancer - Positron emission tomography, integrated positron emission tomography/CT, and software image fusion
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DOI：
10.1016/s0012-3692(15)52634-2
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发表时间：
2005-10-01
期刊：
影响因子：
9.6
通讯作者：
Czernin, J
中科院分区：
文献类型：
--
作者：
Halpern, BS;Schiepers, C;Czernin, J
目的：比较正电子发射断层扫描 (PET) 和整合 PET/CT 的诊断准确性，并评估软件融合在非小细胞肺癌 (NSCLC) 分期中的性能。方法：36 例 NSCLC 患者（17 名男性和 19 名女性）接受整合 PET/CT 分期，然后进行纵隔淋巴结清扫和肿瘤切除。 36 名患者中的 25 名 (69%) 接受了单独的 CT 研究以进行图像软件融合。两名盲审员对所有 PET 图像进行了一致分析，并添加了一名经验丰富的放射科医生来评估集成和软件融合的 PET/CT 图像。组织病理学结果是确定所有方式诊断准确性的“金标准”。 结果：检查 PET 和综合 PET/CT 的评审员准确分类 T 分期的比例分别为 67%（30 名患者中的 20 名）和 97%（30 名患者中的 29 名）（p < 0.05）。总体而言，基于 PET 的分期正确率为 57%（30 名患者中的 17 名），超过分期的 6 名患者（20%），低于分期的 7 名患者（23%）。基于综合 PET/CT 的解释正确分期为 83%（30 名患者中的 25 名），分期过高的 3 名患者（10%），分期不足的 2 名患者（7%）。综合 PET/CT 的总体分期准确性显着高于 PET (p < 0.05)。分别获得的 PET 和 CT 研究的自动软件融合在 68% 的患者中成功，但在 32% 的患者中失败。在成功的软件融合案例中，软件融合在 T 分期和 N 分期方面的结果与集成 PET/CT 没有差异。结论：与单独 PET 相比，集成 PET/CT 的总体诊断准确性提高了 26%（p = 0.01）。软件融合方法未能为超过 30% 的患者提供可接受的联合配准。
Purpose: To compare the diagnostic accuracy of positron emission tomography (PET) and integrated PET/CT and to evaluate the performance of software fusion for staging of non-small cell lung cancer (NSCLC).Methods: Thirty-six patients (17 men and 19 women) with NSCLC underwent staging with integrated PET/CT followed by mediastinal lymph node dissection and tumor resection. Twenty-five of the 36 patients (69%) underwent separate CT studies for software fusion of images. Two blinded reviewers analyzed in consensus all PET images, and an experienced radiologist was added to assess integrated and software-fused PET/CT images. Histopathologic findings served as "gold standard" for determining the diagnostic accuracy of all modalities.Results: Reviewers examining PET and integrated PET/CT classified T stage accurately in 67% (20 of 30 patients) and 97% (29 of 30 patients), respectively (p < 0.05). Overall, interpretations based on PET staged 57% (17 of 30 patients) correctly, overstaged 6 patients (20%), and understaged 7 patients (23%). Interpretations based on integrated PET/CT correctly staged 83% (25 of 30 patients), overstaged 3 patients (10%), and understaged 2 patients (7%). The overall staging accuracy of integrated PET/CT was significantly higher than that of PET (p < 0.05). Automatic software fusion of separately obtained PET and CT studies was successful in 68% of the patients but failed in 32%. In successful software fusion cases, the results of software fusion with regards to T stage and N stage were not different from integrated PET/CT.Conclusions: Integrated PET/CT compared with PET alone was associated with 26% points-greater overall diagnostic accuracy (p = 0.01). The software fusion method failed to provide acceptable coregistration in > 30% of the patients.