摘要
目的探讨^(18)F-FDG PET/CT术前诊断结直肠癌区域淋巴结转移的价值及其最佳诊断阈值。资料与方法结直肠癌初诊患者76例,均在PET/CT检查后1周内行结直肠癌根治术,将所有与PET/CT相匹配的淋巴结依据其与原发肿瘤的位置关系分为近端和远端淋巴结,同时以病理结果为"金标准",生成淋巴结短径与最大标准化摄取值(SUVmax)的受试者工作特性(ROC)曲线,分析其诊断效能。结果近端与远端淋巴结ROC曲线示淋巴结短径、SUVmax的最佳阈值为6.5 mm、1.9和5.5 mm、1.81,淋巴结短径最佳阈值时诊断近端淋巴结转移的敏感度、特异度、准确度分别为84.85%、73.02%、77.52%,诊断远端淋巴结转移的敏感度、特异度、准确度分别为97.62%、65.45%、79.38%;SUVmax最佳阈值时诊断近端淋巴结转移的敏感度、特异度、准确度分别为84.85%、95.81%、91.64%,诊断远端淋巴结转移的敏感度、特异度、准确度分别为92.86%、94.55%、93.81%。SUVmax最佳阈值时诊断特异度、准确度均高于淋巴结短径最佳阈值(P<0.01),且SUVmax最佳阈值时与病理结果一致性较高(Kappa=0.813、0.874,P<0.01)。结论最佳阈值法能提高^(18)F-FDG PET/CT对结直肠癌区域淋巴结转移的诊断效能,且SUVmax标准优于淋巴结短径标准。
Purpose To discuss the diagnostic value and the optimal diagnostic threshold of preoperative （18）F-FDG PET/CT imaging on regional lymph node metastasis in colorectal cancer. Materials and Methods Seventy-six patients with newly diagnosed colorectal cancer underwent radical resection of colorectal cancer within one week after PET/CT examination. All lymph nodes matching PET/CT were divided into proximal and distal lymph nodes on the basis of their location relative to the primary tumor. Meanwhile, the receiver operating characteristic（ROC） curves of the lymph node short diameter and maximum standardized uptake value（SUVmax） were created according to the pathological findings which were considered as the gold standard, and the diagnostic efficacies were analyzed. Results The proximal and distal lymph node ROC curves showed that the optimum thresholds of lymph node short diameter, SUVmax were 6.5 mm, 1.9 and 5.5 mm, 1.81. The sensitivity, specificity and accuracy of the diagnosis of proximal lymph node metastasis under the optimum threshold of lymph node short diameter were 84.85%, 73.02% and 77.52%, respectively; and those of distal lymph node metastasis were 97.62%, 65.45% and 79.38%, respectively. The sensitivity, specificity and accuracy of the diagnosis of proximal lymph node metastasis under the optimum threshold of SUVmax were 84.85%, 95.81% and 91.64%, respectively; those of distal lymph node metastasis were 92.86%, 94.55% and 93.81%, respectively. The specificity and accuracy of the optimum threshold of SUVmax were higher than those of the optimum threshold of lymph node short diameter（P〈0.01）. The homogeneity of optimum threshold of SUVmax was excellent in comparison with the pathological results（Kappa=0.813 and 0.874, P〈0.01）. Conclusion Optimum threshold method improves the diagnostic efficacy of （18）F-FDG PET/CT in regional lymph node metastasis of colorectal cancer. Moreover, the SUVmax standard is superior to lymph node short diameter standard.
作者
田蓉蓉
薄云峰
张毅勋
原凌
赵铭
张红雨
TIAN Rongrong;BO Yunfeng;ZHANG Yixun;YUAN Ling;ZHAO Ming;ZHANG Hongyu(Department of PET/CT Center,Shanxi Tumor Hospital,Taiyuan 030013,China)
出处
《中国医学影像学杂志》
CSCD
北大核心
2017年第11期801-806,共6页
Chinese Journal of Medical Imaging
