PET/CT联合胸部能谱CT对肺癌及其分型的诊断价值  

Diagnostic value of PET/CT combined with chest energy spectral CT for lung cancer and its classification

作　　者：王群 张在炬 胡波 陈亚明[1] WANG Qun;ZHANG Zai-ju;HU Bo;CHEN Ya-ming(Department of Nuclear Medicine,WanbeiGeneral Hospital of Wanbei Coal Power Group,Suzhou234000,Anhui,China;Department of Imaging,WanbeiGeneral Hospital of Wanbei Coal Power Group,Suzhou234000,Anhui,China)

机构地区：[1]皖北煤电集团总医院核医学科,安徽宿州234000 [2]皖北煤电集团总医院影像科,安徽宿州234000

出　　处：《生物医学工程与临床》2024年第5期661-667,共7页Biomedical Engineering and Clinical Medicine

摘　　要：目的探究正电子发射计算机体层摄影术(PET)/CT联合胸部能谱CT对肺癌及其分型的诊断价值。方法选择2022年7月至2023年8月在皖北煤电集团总医院收治的疑似肺癌患者70例,其中男性55例,女性15例;年龄37~85岁,平均年龄66.34岁;经病理诊断肺癌60例,存在淋巴结转移或远处转移19例,无淋巴结转移或远处转移41例。全部病例均接受PET/CT、能谱CT检查,对比两种检查方式单独及联合对肺癌的诊断效能,对比不同肺癌分型的PET/CT、能谱CT检查特征参数,分析两种检查中各参数单独及联合对腺癌、鳞癌的诊断价值。结果经病理诊断10例非肺癌,60例肺癌,其中非小细胞肺癌54例(腺癌31例、鳞癌21例、鳞腺癌2例)、小细胞肺癌6例。PET/CT检查诊断54例肺癌,16例非肺癌;能谱CT诊断51例肺癌,19例非肺癌。PET/CT+能谱CT诊断出62例肺癌,8例非肺癌。PET/CT+能谱CT诊断肺癌的灵敏度、准确度及阴性预测值高于二者单独诊断,漏诊率低于二者单独诊断(P<0.05)。不同肺癌分型PET/CT检查的最大标准化摄取值(SUVmax)差异明显,非小细胞肺癌PET/CT检查的SUVmax比较,腺癌>鳞癌>鳞腺癌(21.61±1.52>13.60±1.39>6.65±1.27)(P<0.05);小细胞肺癌与非小细胞肺癌SUVmax(14.17±1.82 vs 17.94±1.65)比较,差异有显著统计学意义(P<0.001);不同非小细胞肺癌分型能谱CT检查的有效原子系数、钙含量、碘基值、斜率K比较,差异有统计学意义(P<0.05);小细胞肺癌有效原子系数、钙含量、碘基值、斜率K[7.91±0.08、(6.89±1.68)mg/mL、(11.43±0.79)g/L、2.23±0.24]与非小细胞肺癌比较[7.77±0.12、(3.73±1.36)mg/mL、(7.02±1.18)g/L、1.69±0.30],差异有统计学意义(P<0.05);PET/CT、能谱CT检查各参数联合诊断腺癌、鳞癌的曲线下面积分别为0.923、0.939(P<0.05)。结论PET/CT、胸部能谱CT联合应用可提高对肺癌的诊断效能,且PET/CT、能谱CT检查各参数对不同肺癌分型的有较高诊断价值。Objective To explore the value of positron emission tomography(PET)/CT combined with chest spectral CT in diagnosis and classification of lung cancer.Methods From July 2022 to August 2023,a total of 70 patients with suspected lung cancer were enrolled,which included 55 males and 15 females,aged 37-85 years old with mean age of 66.34 years old;pathological diagnosis of lung cancer in 60 cases,lymph node metastasis or distant metastasis in 19 cases,non-lymph node metastasis or distant metastasis in 41.All of them performed PET/CT and spectral CT,and the diagnostic efficacy of 2 examinations in individually and jointly for lung cancer was compared;the characteristic parameters of PET/CT and spectral CT in different types of lung cancer were compared.The diagnostic value of each parameter between 2 examinations alone and jointly for adenocarcinoma and squamous cell carcinoma was analyzed.Results There were 10 cases of non-lung cancer and 60 of lung cancer after diagnosing by pathology,which included 54 cases of non-small cell lung cancer(31 of adenocarcinoma,21 of squamous cell carcinoma,2 of squamous adenocarcinoma)and 6 cases of small cell lung cancer.Fifty-four cases of lung cancer and 16 of non-lung cancer were diagnosed by PET/CT;51 cases of lung cancer and 19 of non-lung cancer were diagnosed by spectral CT.Notably,PET/CT+spectral CT diagnosed 62 cases of lung cancer and 8 of non-lung cancer.The sensitivity,accuracy and negative predictive value of PET/CT+spectral CT in diagnosis of lung cancer were significantly higher than those of diagnosis in individually,and the missed diagnosis rate was significantly lower than that of single diagnosis(P<0.05).The maximum standardized uptake value(SUVmax)of PET/CT examination in different lung cancer types was significantly different,the SUVmax of PET/CT examination in non-small cell lung cancer was adenocarcinoma>squamous cell carcinoma>squamous adenocarcinoma(21.61±1.52>13.60±1.39>6.65±1.27)(P<0.05);the difference of SUVmax between small cell lung cancer(14.17±1.82)

关 键 词：肺癌 能谱CT PET/CT SUVMAX 能谱曲线斜率 

分 类 号：R734.2[医药卫生—肿瘤] R730.44[医药卫生—临床医学]