摘要
目的探讨^18F-脱氧胸腺嘧啶核苷（FLT）和^18F-脱氧葡萄糖（FDG）最大标准摄取值（SUVmax）在肺结节良恶性定性诊断上的价值。方法自2006年1月至2007年6月，6个PET／CT中心对肺结节样病变开展了^18F-FLT和^18F-FDG PET／CT显像的多中心临床研究。共有55例患者被纳入该研究[男33例，女22例，年龄（53．3±17．1）岁]，所有病例均行2种显像剂显像，并通过病理检查或随访确诊。对2种PET／CT显像结果分别进行视觉分析和半定量分析。采用SPSS 13．0软件进行统计学处理。结果（1）良性病变39例，恶性病变16例。（2）以病理检查或随访结果作为肺癌确诊的“金标准”，与“金标准”进行比较，单独以^18F-FDG的SUVmax〉2．5和^18F-FLT的SUVmax〉1．35为阈值，对肺癌诊断的灵敏度、特异性、准确性分别为93．8％（15／16）、25．6％（10／39）、45．5％（25／55）和93．8％（15／16）、41．0％（16／39）、56．4％（31／55）；^18F-FDG及^18F-FLT双盲和集体阅片诊断肺癌的灵敏度、特异性、准确性分别为87．5％（14／16）、59．0％（23／39）、67．3％（37／55）和68．8％（11／16）、76．9％（30／39）、74．5％（41／55）；^18F-FDG＋^18F-FLT双盲和集体阅片诊断肺癌的灵敏度、特异性、准确性分别为81．3％（13／16）、87．2％（34／39）、85．5％（47／55）。（3）^18F-FDG诊断肺癌的受试者工作特征（ROC）曲线下面积为0．744；^18F-FLT诊断肺癌的ROC曲线下面积为0．783。（4）55例病例的^18F-FLT、^18F-FDG的SUVmax Pearson相关系数（r）=0．614，P〈0．05，表明二者呈线性相关。结论^18F-FDG诊断肺癌的灵敏度较^18F-FLT高，但特异性低；^18F-FLT的诊断能力较^18F-FDG好；二者具有一定的相关性；二者联合诊断可以明显提高诊断准确性。
Objective Although ^18F-fluorodeoxyglucose （FDG） PET/CT is recognized as a diagnosis of higher sensitivity in lung nodules than other conventional imaging methods, its false positive uptake by some benign lesions handicaps its value in the differential diagnosis of pulmonary nodules. A muhicentre clinical trial was recently conducted in order to explore the feasibility of using a dual-tracer ^18F-FDG/^18F- fluorothymidine （FLT） PET/CT imaging to enhance the diagnosis of lung nodules. Methods Six medical centers participated in the prospective, randomized and blind clinical trial. The studied subjects underwent PET/CT imaging twice using ^18F-FLT and ^18F-FDG in a random order. The acquisition, collection and process of data were restrictively standardized according to the principle of good clinical practice （GCP）. The uptake of the two radiotracers was measured as the maximum standardized uptake value （ SUVmax ） and the images were interpreted by a collective of readers in different reading strategies. The diagnostic performance of each interpretation strategy was comparatively analysed with the confirmed diagnosis from either pathological evidence or 12-month follow-up. SPSS 13.0 was used to analyse the data. Results From January 2006 to June 2007, 55 patients [33 men ,22 women, mean age （53.3 ± 17.1 ） year] were collected. In 16 malignant and 39 benign lesions, the sensitivity, specificity, accuracy of ^18F-FDG （cutoff SUVmax = 2.5 ） alone were 93.8% （15/16） , 25.6% （ 10/39 ） , 45.5% （ 25/55 ）, respectively. The corresponding figures of ^18F-FLT（eutoff SUVmax = 1.35） alone were 93.8% （15/16）, 41.0% （16/39）, 56. 4% （31/55）, respectively. The sensitivity, specificity, accuracy of ^18F-FDG in combination of ^18F-FLT were 81.3% （ 13/16）, 87.2% （34/39）, 85.5% （47/55）, respectively. The areas under the receiver operating characteristic （ROC） curves were 0.744 for ^18F-FDG and O. 783 for ^18F-FLT. The ^18F-FLT uptake correlated moderately with that o
出处
《中华核医学杂志》
CAS
CSCD
北大核心
2008年第3期147-150,共4页
Chinese Journal of Nuclear Medicine
基金
黑龙江省科技计划攻关项目（GB05CA02-06）
