肺癌骨转移病灶^(18)F-FDG PET/CT图像分析  

Analysis of bone metastases in lung cancer patients with ^(18)F-FDG PET/CT

作　　者：张冬萍[1] 吴湖炳[1] 王全师[1] 叶香华[1] 李洪生[1] 王丽娟[1] 

机构地区：[1]南方医科大学南方医院PET中心,广东广州510515

出　　处：《中国临床医学影像杂志》2009年第6期435-438,共4页Journal of China Clinic Medical Imaging

摘　　要：目的:探讨成骨性和溶骨性骨转移癌18F-FDG摄取的差异,分析骨转移癌18F-FDG摄取与肺癌病理类型之间的关系。方法:肺癌骨转移的初诊患者60例,皆行18F-FDGPET/CT全身显像。采用感兴趣区(ROI)技术计算转移灶的SUV,根据同机CT显示的密度改变确定骨转移灶为成骨性或溶骨性。结果:PET/CT显像检出骨转移病灶392个,其中PET表现为18F-FDG摄取增高的病灶为389个,18F-FDG摄取无明显增高而CT出现明显骨质密度改变的病灶3个,以上392个病灶均经临床随访证实。392个病灶中CT表现为溶骨性病灶201个(51.3%)、成骨性病灶75个(19.1%),骨密度无明显改变者116个(29.6%),这3组病灶的SUV分别为3.5±1.3、2.7±0.6、3.0±1.2,溶骨性骨转移癌的SUV高于后两者(P值均<0.01),而后两组间的SUV无统计学差异(P>0.05)。腺癌组、鳞癌组、大细胞癌组、小细胞癌组的骨转移灶的SUV分别为3.4±1.3、3.1±1.4、3.3±1.1、2.5±0.6,小细胞肺癌组骨转移癌的SUV低于肺腺癌及大细胞癌组(P值均<0.01),但与鳞癌组间无统计学差异;后3组骨转移癌的SUV无统计学差异(P值均>0.05)。结论:PET对肺癌骨转移的检出率明显高于同机CT,溶骨性骨转移灶的18F-FDG摄取较成骨性转移灶的高,CT与PET对于肺癌骨转移灶的检出优势互补。Objective： To investigate the distinction of 18F-FDG uptake between osteolytie and osteogenic bone metastases and the cmTelation between LSF-FDG uptake of bone metastases and different pathological types of lung cancer. Methods： 18F- FDG PET/CT scans were performed in 60 patients who were histologically proved as lung cancer at initial diagnosis with bone metastases. The SUVs of bone metastases were automatically measured by drawing the regions of interest （ROD. The osteolytic or osteogenic bone metastases were definited according to their densities dispalyed in integrated CT. Results： Three hundred and ninety-two bone metastases were confirmed by clinical follow-up, in which 389 bone metastases had intense 18F-FDG up- take. The other three lesions without intense ISF-FDC uptake had intense bone density change on CT. There were 201 lesions of osteolytic bone metastases, 75 of osteogenic bone metastases and 116 without bone density change. The SUV of them were 3.5±1.3, 2.7±0.6, 3.0±1.2, respectively. The SUVs of osteolytic bone metastases were higher than those of the latter two groups （P〈0.01）, while there were no statistical difference between the latter two groups （P〉0.05）. The SUVs of bone metastases of adenocarcinoma, squamous carcinmna, big and small cell carcinoma group were 3.4±1.3, 3.1±1.4, 3.3±1.1, 2.5±0.6, respectively. The SUV of small cell lung cancer group was lower than that of adenocarcinoma and big cell lung cancer groups, but no significant difference with squamous carcinoma. There were no significant differences of 18F-FDG uptake between the bone metastase of adenocarcinoma, squamous carcinoma, big and small cell carcinoma groups （P〉0.05）. Conclusions： The detection rate of bone metastasis of lung cancer in PET is higher than that in integrated CT. The osteolytic bone metastase has a high- er FDG uptake than osteogenic ones. The role of PET and integrated CT can complement and confirm each other in the de- tection of bone metastastatic lesions of lung cancer.

关 键 词：肺肿瘤 骨肿瘤 肿瘤转移 正电子发射断层显像术 体层摄影术 X线计算机 

分 类 号：R734.2[医药卫生—肿瘤] R738.1[医药卫生—临床医学]