摘要
目的:通过定量分析探讨肺良恶性病灶内18F-FDG代谢空间异质性(MSH)分布的差异,并探讨其对非小细胞肺癌(NSCLC)的诊断价值。方法:回顾性分析2012年1月至2016年8月期间温州医科大学附属第一医院因肺结节或肿块而行18F-FDG PET/CT显像的患者共367例。采用软件对病灶最大标准摄取值(SUVmax)不同代谢阈值进行感兴趣区(ROI)勾画,以同侧肺门角为参照点,测量并计算各代谢阈值ROI边界至同侧肺门角的最大距离。对所得不同代谢阈值的距离值进行直线拟合分析,计算相应直线斜率k值,以k值的绝对值代表病灶的代谢空间异质性,值越大则空间异质性越高。分别计算并比较SUVmax、延迟显像滞留指数(RI)、PET/CT联合诊断及MSH对NSCLC的诊断价值。结果:367例患者中,恶性252例,良性115例。良、恶性两组病灶斜率k绝对值的平均值分别为1.40±0.68、2.28±1.53,差异有统计学意义(P<0.001)。MSH对NSCLC诊断的灵敏度、特异度、准确性、阳性预测值、阴性预测值分别为72.62%、64.35%、70.03%、81.70%、51.75%。绘制MSH诊断NSCLC的ROC曲线,其曲线下面积为0.723,与SUVmax(0.474)、RI(0.597)、PET/CT(0.623)比较,差异有统计学意义(均P<0.05)。结论:肺良、恶性病灶18F-FDG MSH分布具有显著差异性,与传统PET/CT诊断指标相比,MSH定量分析对NSCLC的诊断价值较高。
Objective:To quantitatively analyze the metastatic spatial heterogeneity(MSH)of benign and malignant lung nodules,and evaluate the diagnostic value of MSH for non-small cell lung cancer(NSCLC).Methods:From January 2012 to August 2016,367 patients with pulmonary nodules from the First Affiliated Hospital of Wenzhou Medical University who underwent 18F-FDG PET/CT imaging were studied retrospectively.The ROIs of different metabolic thresholds of maximum standardized uptake value(SUVmax)were plotted.The ipsilateral hilar angle was taken as the reference point and the maximum distance from the ROI boundary of each metabolic threshold to the ipsilateral hilar angle was measured and calculated.Linear regression analysis was performed on the distance values of different metabolic thresholds,and the corresponding linear slope k value was calculated.The absolute value of k represented the spatial heterogeneity of the lesion.The larger the k value,the higher the spatial heterogeneity.The diagnostic value of SUVmax,retention index(RI),PET/CT and MSH in NSCLC were calculated and compared.Results:Of the 367 pulmonary lesions,252 were malignant and 115 were benign ones.The mean slope k values of the two groups were 1.40±0.68 and 2.28±1.53,respectively.The difference between the two groups was statistically significant(P<0.001).The diagnostic sensitivity,specificity,accuracy,PPV and NPV of MSH for NSCLC were 72.62%,64.35%,70.03%,81.70% and 51.75%,respectively.The AUC under the ROC curves of MSH was 0.723,which was significantly higher than that of SUVmax(0.474),RI(0.597)and PET/CT(0.623)(all P<0.05).Conclusion:There was significant difference of 18F-FDG metabolic heterogeneity between pulmonary benign and malignant nodules.Compared with conventional PET/CT methods,MSH may improve the value in diagnosis of NSCLC.
作者
林洁
郑祥武
王玲
殷薇薇
纪晓微
唐坤
LIN Jie;ZHENG Xiangwu;WANG Ling;YIN Weiwei;JI Xiaowei;TANG Kun(Department of PET/CT,the First Affiliated Hospital of Wenzhou Medical University,Wenzhou 325015,China)
出处
《温州医科大学学报》
CAS
2021年第2期123-127,共5页
Journal of Wenzhou Medical University
基金
温州市科技局科研基金资助项目(Y20170220)
浙江省基础公益技术应用研究项目(LGF19H180012)。
