摘要
目的探讨18F-氟代脱氧葡萄糖正电子发射型计算机断层显像/计算机断层显像(18F-FDG PET/CT)半定量代谢参数(参数)检测乳房外Paget’s病(EMPD)淋巴结转移的价值。方法收集19例首次确诊为EMPD患者的PET/CT图像,纳入代谢异常的淋巴结47个(同区域有多个异常淋巴结时只选取1个代谢最高的淋巴结),通过阈值自动分割法测量淋巴结18F-FDG PET/CT半定量代谢指标,包括最大标准摄取值(SUVmax)、平均标准摄取值(SUVmean)、病灶糖酵解总量(TLG)、肿瘤代谢体积(MTV)。所有患者均在PET/CT检查后1周内手术,按是否有转移将47个淋巴结分为转移组与非转移组,比较各参数,用受试者工作特征(ROC)曲线获得各参数鉴别淋巴结良恶性病变的最佳阈值。结果转移组淋巴结9个,非转移组淋巴结38个。转移组SUVmax、SUVmean、TLG均高于非转移组(P均<0.05)。SUVmax、SUVmean、TLG鉴别转移淋巴结与非转移淋巴结的最佳截断值分别6.535(AUC=0.795,P=0.006)、4.085(AUC=0.792,P=0.007)、6.22 cm3(AUC=0.772,P=0.012),灵敏度分别为77.8%、77.8%、77.8%,特异度分别为73.7%、81.6%、68.4%。结论18F-FDG PET/CT半定量代谢参数对鉴别EMPD是否出现淋巴结转移具有中度诊断价值。
Objective To evaluate the value of semi-quantitative metabolic parameters of 18F-deoxyglucose positron emission tomography/computer tomography(18F-FDG PET/CT)in detecting lymph node metastasis in patients diagnosed with extramammary Paget’s disease(EMPD).Methods PET/CT images of 19 patients initially diagnosed with EMPD were collected.A total of 47 lymph nodes with abnormal metabolism were collected(only one lymph node with the highest metabolism was selected in each region).Semi-quantitative metabolic parameters of 18F-FDG PET/CT of the lymph nodes were measured by automatic segmentation algorithm method,which included the maximum standardized uptake values(SUVmax),mean standardized uptake values(SUVmean),total lesion glycolysis(TLG)and metabolic tumor volume(MTV).All patients underwent the surgery within one week after PET/CT examination.Forty-seven lymph nodes were divided into the metastasis and non-metastasis groups.Each parameter was statistically compared between two groups.The optimal cut-off values for differentiating malignant from benign lymph nodes were obtained by the receiver operating characteristic(ROC)curve analysis.Results A total of 9 lymph nodes were detected in the metastasis group and 38 lymph nodes were found in the non-metastasis group.The SUVmax,SUVmean and TLG in the metastasis group were significantly higher compared with those in the non-metastasis group(all P<0.05).The optimal cut-off values of SUVmax,SUVmean and TLG for differentiating metastatic from non-metastatic lymph nodes were 6.535(AUC=0.795,P=0.006),4.085(AUC=0.792,P=0.007)and 6.22 cm3(AUC=0.772,P=0.012),respectively.The sensitivity was calculated as 77.8%,77.8%and 77.8%,respectively.The specificity was 73.7%,81.6%and 68.4%,respectively.Conclusion Semi-quantitative metabolic parameters of 18F-FDG PET/CT have moderate diagnostic value for lymph node metastasis in EMPD patients.
作者
李建芳
秦露平
谢良骏
查悦明
吕杰
李锦萍
程木华
Li Jianfang;Qin Luping;Xie Liangjun;Zha Yueming;Lyu Jie;Li Jinping;Cheng Muhua(Department of Nuclear Medicine,the Third Affiliated Hospital of Sun Yat-sen University,Guangzhou 510630,China)
出处
《新医学》
2019年第11期818-821,共4页
Journal of New Medicine
基金
广东省医学科研基金（A2019499）
