18F-FDG PET/CT显像在胰腺肿瘤诊断中的应用价值

摘要

Objective To evaluate the diagnostic value of 18F-FDG PET/CT in patients with pancreatic neoplasm.Methods Fifty-three patients (36 males,17 females; age:(60.3±8.9) years) who underwent 18F-FDG PET/CT examination for suspected pancreatic tumor were retrospectively analyzed.Thirtytwo of them underwent dual-time point imaging.The characteristics of PET/CT images and serum CA19-9 were reviewed.Pathological results were used as a gold standard for evaluating the diagnostic value of PET/CT.Two-sample t test,paired t test and ROC curve analysis were used for data analysis.Results Thirtynine patients were finally diagnosed with pancreatic cancer and the other fourteen patients with benign disease.With SUVmax cutoff value of 3.13,the sensitivity and specificity of single-time point 18F-FDG PET/CT for diagnosis of pancreatic cancer were 92.3％ (36/39) and 9/14,respectively.The SUVmax was significant different between pancreatic cancer group and benign disease group (6.16±2.89 vs 3.37± 1.58; t =4.46,P＜0.01).Combined with the level of CA19-9,the diagnostic sensitivity and specificity were 69.2％ (27/39)and 13/14,respectively.The SUVmax of the early scan (5.45±2.43) was significantly different from that of the delayed scan (6.87±2.93) in pancreatic cancer group (t =8.25,P＜0.01),whereas no difference could be found in the benign group (3.18±1.28 vs 4.18±2.49; t=2.24,P＞0.05).With the SUVmax cutoff value of 3.3,the sensitivity,specificity and accuracy in the early scan were 87.0％ (20/23),6/9 and 81.2％ (26/32),respectively.While with the SUVmax cutoff value of 3.0,the sensitivity,specificity and accuracy in the delayed scan were 95.7％ (22/23),5/9 and 84.4％ (27/32),respectively.Conclusion 18 F-FDG PET/CT is a useful tool in the differential diagnosis of benign from malignant pancreatic diseases.%目的 探讨18F-FDG PET/CT显像在胰腺肿瘤诊断中的应用价值.方法 回顾性分析53例临床疑似胰腺肿瘤患者[男36例,女17例,年龄(60.3±8.9)岁]的18F-FDG PET/CT影像资料及血清CA19-9结果,其中32例患者行双时相显像.以病理结果为“金标准”,评价18F-FDG PET/CT诊断胰腺肿瘤的价值.采用两样本t检验、配对t检验和ROC曲线分析处理数据.结果 53例中,恶性39例,良性14例.ROC曲线示,常规显像以SUVmax3.13为判断肿瘤良恶性的界值时,诊断效能最高,灵敏度及特异性分别为92.3％ (36/39)及9/14.恶性肿瘤组SUVmax(6.16±2.89)较良性病变组高(3.37±1.58;t=4.46,P＜0.01).常规显像结合血清CA19-9水平诊断的灵敏度及特异性分别为69.2％(27/39)及13/14.双时相显像时,恶性肿瘤组(23例)早期及延迟SUVmax差异有统计学意义(5.45±2.43和6.87±2.93;t=8.25,P＜0.01),而良性病变组(9例)的差异则不具有统计学意义(3.18±1.28和4.18±2.49;t=2.24,P＞0.05).2组间早期相和延迟相的SUVmax差异均有统计学意义(早期相:t=3.43;延迟相:t=2.58;均P＜0.05).早期相取SUVmax 3.3为界值时的诊断效能最高,灵敏度、特异性及准确性分别为87.0％ (20/23)、6/9及81.2％ (26/32);延迟相取SUVmax 3.0为界值时的诊断效能最高,指标分别为95.7％(22/23)、5/9及84.4％ (27/32).结论 18F-FDG PET/CT是一种较好的胰腺良恶性病变鉴别方法.