Diagnostic performance of CT, PET, side-by-side, and fused image interpretations for restaging of non-Hodgkin lymphoma
Diagnostic performance of CT, PET, side-by-side, and fused image interpretations for restaging of non-Hodgkin lymphoma
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DOI：
10.1007/s12149-007-0015-1
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发表时间：
2007-06-01
影响因子：
2.6
通讯作者：
Sugimura, Kazuro
中科院分区：
文献类型：
--
作者：
Nogami, Munenobu;Nakamoto, Yuji;Sugimura, Kazuro
目的 本研究的目的是比较单独的正电子发射断层扫描（PET）、单独的计算机断层扫描（CT）、并排读取和融合图像对恶性淋巴瘤患者的再分期或随访的诊断性能。方法对 50 例经组织学证实的非霍奇金淋巴瘤患者进行（18）氟-2-脱氧葡萄糖（FDG）-PET 扫描，然后进行 CT 扫描。单独使用 CT、单独 PET、并排读取和融合图像，使用五点分级量表对以下八个区域进行单独和视觉解读：颈部、锁骨上、腋窝、纵隔、主动脉旁至髂骨、肠系膜、腹股沟和结外。根据组织学确认和/或临床病程确定的最终诊断来比较诊断准确性。 结果 对于所有区域组合，单独 PET 的解释（敏感性 = 86.1%、特异性 = 99.4%、准确性 = 91.0%）、并排读取（96.0%、99.4%、98.9%）和融合图像（98.0%、99.4%、 99.2%）的诊断性能明显高于单独 CT 的诊断性能（59.4%、96.1%、91.0%；P < 0.001）。与单独使用 CT 或单独使用 PET 相比，使用 PET 可以更准确地诊断颈部、锁骨上和结外区域（P < 0.05），而使用并排读取和融合图像对主动脉旁至髂骨区域的诊断更加准确（P < 0.05）。结论 虽然融合图像具有临床价值，但并排读取显示出相同的性能，而单独使用 PET 的解释可以产生相当高的诊断性能。恶性淋巴瘤患者的重新分期或随访。
Objective The purpose of this study was to compare the diagnostic performance of positron emission tomography (PET) alone, computed tomography (CT) alone, side-by-side reading, and fused images for restaging or follow-up of patients with malignant lymphoma.Methods Fifty patients with histologically confirmed non-Hodgkin lymphoma underwent an (18)fluoro-2-deoxyglucose (FDG)-PET scan, followed by a CT scan. CT alone, PET alone, side-by-side reading, and fused images were interpreted separately and visually using a five-point grading scale for the following eight regions: cervical, supraclavicular, axillary, mediastinal, para-aortic to iliac, mesenteric, inguinal, and extra-nodal. Diagnostic accuracy was compared on the basis of the final diagnoses determined by histological confirmation and/or clinical course.Results For all regions combined, the interpretation of PET alone (sensitivity = 86.1%, specificity = 99.4%, accuracy = 91.0%), side-by-side reading (96.0%, 99.4%, 98.9%), and fused images (98.0%, 99.4%, 99.2%) yielded significantly higher diagnostic performance than that of CT alone (59.4%, 96.1%, 91.0%; P < 0.001). The cervical, supraclavicular, and extra-nodal regions were more accurately diagnosed with PET (P < 0.05), whereas the para-aortic to iliac regions were diagnosed more acccurately with side-by-side reading and fused images than with CT alone or PET alone (P < 0.05).Conclusions Although fused images are clinically valuable, side-by-side reading showed equivalent performance, whereas the interpretation of PET alone yielded reasonably high diagnostic performance for restaging or follow-up of patients with malignant lymphoma.