FDG-PET as a "metabolic biopsy" tool in thoracic lesions with indeterminate biopsy
FDG-PET as a "metabolic biopsy" tool in thoracic lesions with indeterminate biopsy
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DOI：
10.1007/s002590100563
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发表时间：
2001-09-01
期刊：
影响因子：
--
通讯作者：
Maisey, MN
中科院分区：
文献类型：
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作者：
Hain, SF;Curran, KM;Maisey, MN
临床医学中遇到的一个常见问题是常规成像上肺部病变（结节/不透明）的分类。活检的尝试通常是不成功的，或者是错误的安慰，并且将患者送去进行更具侵入性和潜在病态的手术的决定可能是困难的。我们的目的是研究氟-18氟脱氧葡萄糖正电子发射断层扫描（FDG-PET）在帮助更准确地识别恶性病变患者中的作用。63名患者在肺部病变活检失败后或在少数情况下，当活检尝试被认为太危险时进行FDG-PET扫描。通过组织学进行随访，如果无法获得，则通过临床进展至死亡或扫描后至少18个月进行随访。进行目视和定量分析。在视觉分析中，阳性和阴性预测值分别为90%和100%。在定量（SUV >2.5）分析中，阳性和阴性预测值分别为90%和85%。我们解释这些结果表明，在这种情况下，在患者中使用FDG-PET扫描是非侵入性的，在诊断恶性肿瘤方面具有高度敏感性。高阳性预测值表明，扫描阳性的患者必须接受进一步的检查，而100%阴性预测值意味着没有FDG摄取的患者可以安全地避免进一步的侵入性检查。
A common problem encountered in clinical medicine is the classification of a lung lesion (nodule/opacity) on conventional imaging. Often attempts at biopsy are unsuccessful or are falsely reassuring, and the decision to send the patient for more invasive and potentially morbid procedures can be difficult. Our aim was to investigate the role of fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) in helping to identify more accurately those patients with malignant lesions. Sixty-three patients underwent FDG-PET scans following unsuccessful biopsy of a lung lesion or, in a lesser number of cases, when an attempt at biopsy was considered too dangerous. Follow-up was by histology or, if this was unavailable, by clinical progress to death or a minimum of 18 months post scan. Visual and quantitative analysis was performed. On visual analysis, positive and negative predictive values were 90% and 100%, respectively. On quantitative (SUV >2.5) analysis, positive and negative predictive values were 90% and 85%, respectively. We interpret these results as showing that the use of FDG-PET scans in patients in this circumstance is non-invasive and highly sensitive in diagnosing malignancy. The high positive predictive value suggests that those with a positive scan must undergo further investigation, while the 100% negative predictive value means those with no FDG uptake can safely be spared further invasive investigations.