摘要
目的对比观察氟-18-脱氧葡萄糖(18F-FDG)和氟-18-胸腺嘧啶(18F-FLT)PET/CT显像以及两者联合显像对肺癌诊断的敏感性、特异性和准确性。资料和方法以规范化操作、随机、前瞻方式收集胸部CT诊断困难的肺部病变38例,分别行18F-FLTPET/CT和18F-FDGPET/CT显像,分析比较18F-FLTPET/CT和18F-FDGPET/CT显像以及两者联合显像这3种检测方案的诊断效率。结果 18F-FDG诊断肺癌的灵敏度为84.6%(22/26),特异度仅为66.7%(8/12),准确性为78.9%(30/38);18F-FLT诊断肺癌的灵敏度仅为69.2%(18/26),特异度为91.7%(11/12),准确性为76.3%(29/38)。双示踪剂联合显像诊断肺癌的灵敏度为96.2%(25/26),特异度为100%(12/12),准确性为97.4%(37/38)。与18F-FDG与18F-FLT单一检查比较,双示踪剂PET/CT显像诊断敏感性比18F-FLT高(P<0.05),特异性比18F-FDG高(P<0.05),准确性比两者均高(P<0.05)18F-FDG的特异性较低,18F-FLT的敏感性较差,两者联合诊断效能最高。[FLTSUV]/[FDGSUV]比值以0.4~0.9为阈,可最大程度区分肺癌和良性病灶。结论 18F-FDG的特异性较低,18F-FLT的敏感性较差,两者联合诊断效能最高。双示踪剂PET/CT联合显像可以克服单一显像的局限性,明显改善肺癌的诊断准确率。
Purpose To compare the sensibility, specificity and accuracy of 18F-FDG,18F-FLT PET/CT and the dual-tracer imaging in lung cancer. Materials and Methods Thirty-eight cases with lung lesions undergoing dual-tracer imaging of 18F-FDG and 18F-FLT were collected in a randomized, standardized and prospective trial. The diagnostic efficiency of all the diagnosing protocols were analyzed and compared. Results The sensitivity, specificity and accuracy of 18F-FDG-PET/CT were 84.6% (22/26), 66.7% (8/12) and 78.9% (30/38); of 18F-FLT PET/CT were 69.2% (18/26), 91.7% (11/12) and 76.3% (29/38);and of dual-tracer imaging, were 96.2% (25/26), 100% (12/12) and 97.4% (37/38). Dual-tracer PET/CT was proved to be the best protocol to diagnose pulmonary nodules compared to single tracer with higher sensitivity than 18F-FLT(P0.05), higher specificity than 18F-FDG(P0.05)and more accurate than any single tracer. The best differentiation of malignancies and benign lung tumors was achieved when FLT/FDG SUV ratio of 0.4~0.9 was used as the threshold. Conclusion The combination of 18F-FDG and 18F-FLT PET/CT imaging may overcome the limitations of single tracer imaging with complimentary information and improving the diagnostic efficiency. [
出处
《中国医学影像学杂志》
CSCD
北大核心
2011年第11期830-834,共5页
Chinese Journal of Medical Imaging