^(18)F-脱氧葡萄糖联合^(18)F-脱氧胸苷双示踪剂诊断肺结节的价值  

Positron Emission Tomography Scanning with ^(18)F-FDG and ^(18)F-FLT in the Evaluation of Pulmonary Nodule

作　　者：陈燕[1] 蒲朝煜[1] 毛新远[1] 周卫华[1] 蔡莉[1] 张海英[1] 李菲[1] 张驰[1] 

机构地区：[1]武警总医院核医学科,北京100039

出　　处：《中华保健医学杂志》2011年第6期480-482,共3页Chinese Journal of Health Care and Medicine

摘　　要：目的探讨18F-脱氧葡萄糖(18F-fluorodeoxy glucose,18F-FDG)联合18F-脱氧胸苷(18F-Fluoro-3'-Deoxy-3'-L-fluorothymidine,18F-FLT)正电子发射计算机显像(PET/CT)检查在肺脏孤立结节诊断中的价值。方法 12例肺脏孤立结节或肿块,直径<5cm的患者接受了18F-FDG和18F-FLT双示踪剂PET/CT显像。所有病例诊断通过病理或密切随访6～13个月(病变治疗有效)或有明确证据证实。结果 12例患者中,18F-FDG和18F-FLTPET/CT检查发现肺脏肿瘤病灶直径1.5～4.9cm,平均3.2cm;8例为恶性病变均经病理证实,4例为良性病变保守治疗有效。肺结节的自动测量最大平均标准化摄取值(SUVmax)18F-FLT显像明显低于18F-FDG显像,但是恶性病变的SUVmax18F-FLT和18F-FDG显像均大于良性病变。18F-FDGSUVmax诊断准确率为69.4%,灵敏度及特异性分别为88.2%、65.0%;18F-FLTSUVmax诊断准确率为70.4%,灵敏度及特异性分别为70.1%、86.2%。结论 18F-FLT对肺脏结节的鉴别诊断有一定价值。当18F-FDG和18F-FLT示踪剂联合应用时可以提高PET/CT对肺癌诊断的准确率,降低漏诊和误诊的概率,为肺癌确定治疗方案和随访提供了可靠的诊断依据。Objective To evaluate Positron Emission Tomography（PET）in diagnosis of pulmonary nodule with 18F-Fluoro-3＇-Deoxy-3＇-L-fluorothymidine（18F-FLT） and 18fluorodeoxy glucose（18F-FDG）.Methods Series 18F-FLT and 18F-FDG PET/CT imagings were performed in 12 cases with suspicious pulmonary nodule.Final diagnosis of pulmonary nodule was made based on the pathological finding and 6-13month followed up.It was compared using semi-quantitative Standardized Uptake values（SUVmax） and FLT/FDG ratio.Results Out of them,8 cases with malignant tumor by pathology and 4 cases with benign tumor by drug treatment and followed up.The diameter of tumor was 1.5～4.9 cm,average 3.2 cm.In accordance with 18F-FLT and 18F-FDG uptake,the SUVmax was significantly lower on 18F-FLT than on 18F-FDG imaging.However,the SUVmax was greater for malignant tumor than for benign tumor on either 18F-FLT or 18F-FDG imaging.The diagnosis accuracy,sensitivity and specificity of SUVmax were 69.4%,88.2%,65.0% on 18F-FDG and 70.4%,70.1%,86.2% on 18F-FLT imaging.Conclusions 18F-FLT PET/CT imaging was better than 18F-FDG PET/CT imaging in differential diagnosis of pulmonary malignant and benign tumor.Combination of 18F-FLT imaging and 18F-FDG imaging shows not only improving diagnosis accuracy,but also helpful in evaluating pulmonary tumour virulence for treatment and following up.

关 键 词：肺脏肿瘤 18F-脱氧胸苷 18F-脱氧葡萄糖 正电子发射断层显像 

分 类 号：R817.4[医药卫生—影像医学与核医学]