口服小剂量利尿剂延迟18F-FDG PET/CT显像诊断泌尿生殖系统肿瘤

摘要

目的 评估口服小剂量利尿剂延迟18F-FDG PET/CT显像对泌尿生殖系统恶性肿瘤的诊断价值.方法 将可疑泌尿生殖系统肿瘤的患者分为常规剂量利尿组(n=12)和小剂量利尿组(n=35),常规PET/CT全身显像后分别口服40 mg、20 mg呋塞米,充分水化后行延迟PET/CT显像.比较口服利尿剂前后尿液最大标准摄取值(SUVmax)、病灶/尿液SUVmax比值(T/U)的差异.计算小剂量利尿组的诊断泌尿生殖系统恶性肿瘤的效能.结果 小剂量利尿组和常规剂量利尿组组内常规显像和延迟显像尿液SUVmax和T/U差异均有统计学意义(P均＜0.05),组间常规显像和延迟显像SUVmax和T/U差异均无统计学意义(P均＞0.05).小剂量利尿组延迟及常规显像的灵敏度96.77％ (30/31)、61.29％(19/31),特异度75.00％(3/4)、50.00％(2/4),阳性预测值96.77％(30/31)、90.48％(19/21),阴性预测值75.00％(3/4)、14.29％(2/14),准确率94.29％(33/35)、60.00％(21/35);灵敏度和准确率差异有统计学意义(P＜0.001).结论 口服小剂量呋塞米利尿剂延迟PET/CT显像可达到与常规剂量利尿法相同的效果,有助于诊断泌尿生殖系统恶性肿瘤.%Objective To investigate the value of delayed 18F-FDG PET/CT with oral intake small dosage diuretics for diagnosing urogenital cancers.Methods Patients with suspected urogenital system cancers were divided into routine dosage diuretic group (n=12) and small dosage diuretics group (n=35).All patients underwent whole-body PET/CT followed by delayed scanning after oral 40 mg or 20 mg Furosemide respectively.The urine maximum standard uptake value (SUVmax) and T/U (the ratio of urine and lesion SUVmax) before and after diuresis were compared respectively.Diagnostic efficacy for malignant urogenital system cancers of small dosage group was calculated.Results The urine SUVmax and T/U were statistically different between routine whole body and delayed scans in both groups (P＜0.05).SUVmax and T/U of routine and delayed scans had no statistical differences between the two groups (P＞0.05).In small dosage group,the sensitivity,specificity,positive predictive value,negative predictive value and accuracy of delayed imaging and routine imaging was 96.77％ (30/31)and 61.29％ (19/31),75.00％ (3/4) and 50.00％ (2/4),96.77％ (30/31) and 90.48％ (19/21),75.00％ (3/4)and 14.29％ (2/14),94.29％ (33/35) and 60.00％ (21/35),respectively.The sensitivity and accuracy were statistically different between routine and delayed imaging (P＜0.001).Conclusion Delayed PET/CT imaging with oral small dosage Furosemide has the same efficacy as PET/CT using routine dosage diuretics,which is useful for diagnosing urogenital cancers.