18F-FDG和18F-FLTPET／CT不同诊断方法在肺部单发结节中的临床价值分析  

Differential diagnosis protocols of 18F-FDG and 18F-FLT PET/CT for solitary pulmonary nodules

作　　者：阿米娜·依布拉音 张奇洲[1] 李肖红[1] 李毓斌[1] 吕洁[1] 谢彬[1] 刘立水[1] 秦永德[1] 

机构地区：[1]新疆医科大学第一附属医院核医学科,乌鲁木齐830011

出　　处：《国际放射医学核医学杂志》2015年第4期295-299,共5页International Journal of Radiation Medicine and Nuclear Medicine

摘　　要：目的探讨18F-FDG和18F-胸腺嘧啶核苷（FLT）PET／CT不同的诊断方法对肺部单发结节的诊断价值。方法对40例发现肺部单发结节的患者行18F-FDG和18F-FLTPET／CT显像，所有病例均经病理或密切随访确诊，应用受试者工作特征（ROC）曲线比较18F-FDG SUVmax、18F-FLT SUVmax、18F-FLT SUVmax/同层面椎体SUVmax对肺部恶性肿瘤的诊断价值；18F-FDG和18F-FLTPET／CT两种显像结果均行视觉分析和半定量分析，比较不同诊断方法的诊断效能。结果18F-FDG SUVmax、18F-FLT SUVmax及18F-FLT SUVmax/同层面椎体SUVmaxROC曲线下面积分别为0．687、0．821和0．817。以18F-FDG SUVmax〉2．5、18F-FLT SUVmax〉2．0为恶性诊断标准、18F-FLTPET／CT视觉分析评分法、18F-FLTPET／CT视觉分析评分法4种方法诊断肺癌的灵敏度、特异度和准确率分别为88.2％、73．9％和80．0％；58．8％、82．6％和72．5％；94．1％、91．3％和92．5％；88．2％、65.2％和75．0％。结论18F-FLT SUVmax及18F-FLT SUVmax/同层面椎体SUVmax单独诊断肺部恶性肿瘤的价值较18F-FDG SUVmax高，且前两者可替换使用。18F-FLTPET／CT视觉评分法在肺部单发结节良恶性的诊断中效能最佳。Objective To investigate the diagnostic values of ＇SF-FDG and 3＇-deoxy-3＇-18F- fluorothymidine （18F-FLT） PET/CT for solitary pulmonary nodules. Methods 18F-FDG and 18F-FLT PET/ CT imaging were performed in 40 patients with solitary pulmonary nodules. All cases were confirmed by pathology or follow-up. The diagnostic values of 18F-FDG SUVmax, ISF-FLT SUVmax, and 18F-FLT/the same level of vertebral SUVmax for pulmonary malignant tumor were compared using the receiver operating characteristic （ROC） curves, 18F-FDG and 18F-FLT imaging results were analyzed by visual observation and semi-quantitative analysis. The diagnostic efficiencies of the different diagnostic methods were compared. Results Areas under the ROC curves of 18F-FDG SUVmax, lSF-FLT SUVmax, and 18F-FLT/same level of vertebral SUVmax were 0.687, 0.821, and 0.817, respectively. The diagnostic sensitivities, specificities, and accuracies of tested diagnostic tools were as follows： 18F-FDG SUVmax〉2.5 as the malignant diagnostic criteria, 88.2%, 73.9% and 80.0%;18F-FLT SUVmax〉2.0 as the malignant diagnostic criteria, 58.8%, 82.6% and 72.5%; 18F-FDG PET/CT visual analysis of scoring method, 94.1%, 91.3% and 92.5%; and 18F-FLT PET/CT for visual analysis of scoring method 88.2%, 65.2% and 75.0%. Conclusions lSF-FLT SUVmax and 18F-FLT/vertebral SUVmax showed higher accuracies in diagnosing solitary pulmonary modules compared with 18F-FDG SUVmax. 18F-FDG PET/CT visual scoring method was the most effective in diagnosing solitary pulmonary nodules.

关 键 词：单发肺结节 氟脱氧葡萄糖F18 胸腺嘧啶核苷 正电子发射断层显像术 体层摄影术 X线计算机 

分 类 号：R563[医药卫生—呼吸系统] R817.4[医药卫生—内科学]