评价双时相18F-FDG PET/CT显像对肺结节临床诊断的价值

摘要

目的:评价双时相18F-FDG PET/CT显像肺部病灶标准摄取值(Standardized uptake value,SUV)、病灶体积和病灶糖酵解(Lesion glycolysis,LG)变化率在肺结节诊断中的临床价值.资料和方法:31例患者行双时相18F-FDG PET/CT显像(常规显像是在注射18F-FDG后60 min,延迟显像是在注射18F-FDG后120 min开始扫描).男25例,女6例.年龄(57.90±13.38)岁.肺部良性病灶12例(炎症4例、肺结核8例),肺腺癌和鳞癌15例,肺转移性肿瘤4例.所有患者的数据选择SharpIR+VUE HD+TOF(Time of flight,TOF)重建PET图像.采用GE PET VCAR工具获得病灶最大SUV (SUVmax)和平均SUV(SUVav)、体积和LG的值以及变化率.结果:双时相18F-FDG PET/CT显像在炎症、肺结核、炎症+肺结核、原发肺癌和肺转移性肿瘤延迟显像中,肺部病灶SUVmax 、SUVav均具有不同程度增加,SUVmax增加的程度大于SUVav;炎症SUVmax和SUVav增加程度最高为17.97％,而原发性肺癌增加程度最低为2.62％.但是病灶的体积和LG却是既有增高也有降低.肺结核组患者的体积降低最明显,为-35.4％,原发性肺癌LG降低最明显,为-19.00％.结论:采用双时相18F-FDG PET/CT显像,病灶SUVmax和SUVav变化率并不能鉴别肺部病灶的良恶性,病灶体积和LG变化率有潜力提高对肺结节诊断的准确性,以实现对肺癌早期诊断的目的.%Objective: To evaluate the clinical value of dual phase 18F-FDG imaging in the diagnosis of indeterminate pulmonary nodules. Standard uptake value(SUV), rate of change of lesion volume and lesion glycolysis(LG) were analyzed and evaluated. Materials and Methods: Thirty-one cases were included in this study, all had dual phase 18F-FDG PET/CT. Scanning began after 60 min injection of 18F—FDG, was the conventional imaging, and 120 min after injection was the delayed scanning. In the patients, 25 were male and 6 were female, the average age was 57.09±13.38 years old. Twelve cases had benign pulmonary lesions (4 were granulomatous inflammatory lesion, 8 were tuberculosis), adenocarcinoma and squamous cell carcinoma in 15 cases, metastatic tumors in 4 cases. The data of SharpIR+VUE HD+TOF in all patients were selected to reconstruct PET images. GE PET VCAR tool was used to obtain maximaum SUV (SUVmax), average SUV (SUVav), volume of lesion, LG value and rate of change. Results: On dual phase 1SF-FDG PET delayed imaging, the SUVmax and SUVav of granulomatous inflammatory lesion, tuberculosis, inflammation+tuberculous lesion, primary pulmonary carcinoma and metastatic tumor all had various degrees of increase. The degree of increase in SUVmax was more marked than SUVav. In inflammatory lesion the increase of SUVmax and SUVav was most obvious, that was 17.97%, and the increase in primary carcinoma was the least being 2.6%. There was either increase or decrease in volume of lesion and LG value. In tuberculosis the decrease in lesion volume was most marked that was -35.4%. The decrease of LG value in primary lung cancer was most marked, being -19.00%. Conclusion: The changes of SUVmax and SUVav in dual phase '8F-FDG PET/CT is not useful in differentiating benign and malignant pulmonary nodules. Lesion volume and LG change rate has potential capability in increasing the accurate diagnosis of indeterminate pulmonary nodules, and can be useful in the early diagnosis of primary pulmonary carcinoma.