不同重建方法对颞叶癫痫患者FDG PET图像质量及诊断效能的影响  

Impact of different reconstruction algorithms on PET image quality and diagnostic efficiency in patients with temporal lobe epilepsy

作　　者：尚琨[1] 胡杰[1] 王振明 王静娟 崔碧霄[1] 许潇尹 卢洁[1] Shang Kun;Hu Jie;Wang Zhenming;Wang Jingjuan;Cui Bixiao;Xu Xiaoyin;Lu Jie(Department of Radiology and Nuclear Medicine,Xuanwu Hospital,Capital Medical University,Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics,Beijing 100053,China)

机构地区：[1]首都医科大学宣武医院放射与核医学科、磁共振成像脑信息学北京市重点实验室,北京100053

出　　处：《中华核医学与分子影像杂志》2024年第11期678-683,共6页Chinese Journal of Nuclear Medicine and Molecular Imaging

基　　金：国家重点研发计划(2022YFC2406900)。

摘　　要：目的评估飞行时间(TOF)联合点扩散函数(PSF)重建对于颞叶癫痫(TLE)患者脑PET图像及病灶定位诊断的价值。方法回顾性收集2017年至2019年间首都医科大学宣武医院52例住院TLE患者[男30例、女22例,年龄(26.7±7.1)岁]和26名健康志愿者[男14名、女12名,年龄(31.7±6.8)岁]的脑18F-FDG PET显像数据,图像采用4种方式重建:有序子集最大期望值迭代法(OSEM)、OSEM+TOF、OSEM+PSF、OSEM+TOF+PSF。采用4分制法视觉评估所有被试的图像质量、清晰度、噪声以及患者病灶显示的清晰度,计算所有被试图像的信噪比(SNR)、对比度以及患者病灶的不对称指数(AI)。采用单因素方差分析对4种重建方式之间上述参数的差异进行比较。对PET图像定位致痫灶的效能进行ROC曲线分析。结果健康志愿者PET图像的视觉评分以OSEM+TOF+PSF组最高[(4.0±0.0)分],与OSEM组相比,OSEM+TOF+PSF组图像SNR降低46.6%(SNR数据越小,图像质量越好),图像对比度提升29.8%。TLE PET图像视觉评估显示,OSEM+TOF+PSF组、OSEM+PSF组、OSEM+TOF组和OSEM组的评分依次减低,分别为(4.0±0.0)、(3.4±0.5)、(2.3±0.4)和(1.0±0.0)分(F=884.0,P<0.001)。定量分析显示上述4组图像的SNR依次增高:(5.2±2.4)%、(6.2±2.4)%、(7.9±2.6)%、(8.9±3.5)%(F=18.82,P<0.001);图像对比度及病灶AI的4组排序则为OSEM+TOF+PSF组(对比度:0.81±0.03;AI:0.28±0.05)>OSEM+TOF组(0.74±0.05;0.23±0.06)>OSEM+PSF组(0.72±0.06;0.22±0.07)>OSEM组(0.64±0.05;0.19±0.06)(F值:107.10、19.94,均P<0.001)。52例TLE患者中32例MRI检出单侧海马硬化,20例为MRI阴性患者。ROC曲线分析示,发作间期OSEM+TOF+PSF PET图像目视法及病灶/对侧SUV比值(SUVR)对单侧海马硬化组定位致痫灶的AUC为0.874,对MRI阴性组定位致痫灶的AUC为0.932。结论TOF和PSF技术能够提高PET图像质量,二者联合应用后效果最佳并有助于定位TLE患者的致痫灶。Objective To evaluate the value of time-of-flight(TOF)combined with point spread function(PSF)reconstruction for the improvement of brain PET images and lesion localization in patients with temporal lobe epilepsy(TLE).Methods A retrospective collection of brain 18F-FDG PET imaging data of 52 hospitalized patients with TLE(30 males,22 females,age:(26.7±7.1)years)and 26 healthy volunteers(14 males,12 females,age:(31.7±6.8)years)from Xuanwu Hospital between 2017 and 2019 was conducted.Images were reconstructed and divided into 4 groups based on different algorithms:ordered subset expectation maximization(OSEM),OSEM+TOF,OSEM+PSF,and OSEM+TOF+PSF.The image quality,clarity,noise,and the clarity of lesion display of all subjects were visually analyzed using a four-point scale.The signal-to-noise ratio(SNR),contrast,and asymmetry index(AI)of the lesions were calculated.Differences in visual scores,SNR,contrast,and AI among the 4 groups were analyzed using one-way analysis of variance.The ROC curve was used to analyze the efficiency of PET images in localization of epileptogenic foci.Results The visual score of OSEM+TOF+PSF group was the highest(4.0±0.0)among healthy volunteers;compared with OSEM group,OSEM+TOF+PSF group showed lower SNR(decreased by 46.6%;the lower the SNR value,the better the image quality)and contrast(increased by 29.8%).Visual assessment of PET images of patients with TLE showed that the scores of OSEM+TOF+PSF group,OSEM+PSF group,OSEM+TOF group and OSEM group were decreased in order(4.0±0.0 vs 3.4±0.5 vs 2.3±0.4 vs 1.0±0.0;F=884.0,P<0.001);SNRs of those 4 groups were increased in order((5.2±2.4)%vs(6.2±2.4)%vs(7.9±2.6)%vs(8.9±3.5)%;F=18.82,P<0.001).The contrast and AI of the lesions in 4 groups were as follows:OSEM+TOF+PSF(contrast:0.81±0.03;AI:0.28±0.05)>OSEM+TOF(0.74±0.05;0.23±0.06)>OSEM+PSF(0.72±0.06;0.22±0.07)>OSEM(0.64±0.05;0.19±0.06)(F values:107.10,19.94,both P<0.001).MRI found unilateral hippocampal sclerosis in 32 patients,and the rest 20 patients with TLE were MRI-negativ

关 键 词：癫痫 颞叶 图像处理 计算机辅助 正电子发射断层显像术 氟脱氧葡萄糖F18 

分 类 号：R742.1[医药卫生—神经病学与精神病学] R817.4[医药卫生—临床医学]