摘要
目的探讨^(18)F-FDG全身PET/CT动态采集获得的时间-活度曲线(TAC)及靶本比(TBR)对肝脏恶性肿瘤诊断的增益价值。方法回顾性分析2019年12月至2021年10月间在复旦大学附属中山医院行60 min全身PET/CT动态采集的109例肝细胞癌(HCC;27例)、肝内胆管癌(ICC;61例)和肠癌肝转移(CRLM;21例)患者[男65例,女44例,年龄(59.3±9.3)岁]的影像学资料。将动态采集获得的TAC分为灌注相和代谢相。动脉期定义为灌注相腹主动脉活度峰值后15 s。将代谢相肿瘤TAC形态分为A、B、C型。采用单因素方差分析比较不同组TBR_(30/60)差异;采用ROC曲线评估TBR_(30/60)的诊断效能。结果以快进作为HCC的诊断标准,其灵敏度、特异性、阳性预测值和阴性预测值分别为66.7%(18/27)、75.6%(59/78)、48.6%(18/37)和86.8%(59/68);以B型曲线作为HCC的诊断标准,其灵敏度、特异性、阳性预测值和阴性预测值分别为44.4%(12/27)、85.4%(70/82)、50.0%(12/24)和82.4%(70/85)。HCC、ICC和CRLM的TBR_(30/60)分别为0.38±0.19、0.49±0.18和0.64±0.20(F=10.89,P<0.001)。当TBR_(30/60)截断值取0.43时,鉴别HCC与ICC和CRLM的AUC为0.72,灵敏度和特异性分别为70.5%(55/78)和65.2%(15/23);当TBR_(30/60)截断值取0.64时,鉴别ICC和CRLM的AUC为0.71,灵敏度和特异性分别为61.9%(13/21)和82.5%(47/57)。结论全身PET/CT动态显像获得的TAC结合TBR_(30/60)可以为肝肿瘤诊断提供增益价值。
Objective To explore the added value of time-activity curve(TAC)and target-to-background ratio(TBR)obtained by ^(18)F-FDG total-body PET/CT dynamic imaging in the diagnosis of liver malignant tumors.Methods From December 2019 to October 2021,109 patients(65 males,44 females;age(59.3±9.3)years)with hepatocellular carcinoma(HCC;n=27),intrahepatic cholangiocarcinoma(ICC;n=61)and colorectal cancer with liver metastasis(CRLM;n=21)who underwent 60 min ^(18)F-FDG total-body PET/CT dynamic imaging in Zhongshan Hospital,Fudan University were retrospectively enrolled.Dynamic PET/CT images were divided into perfusion-weighted(PW)phase and metabolism-weighted(MW)phase.The arterial phase was defined as the 15 s after the abdominal aorta peak frame at PW.TACs at MW were divided into three types as Graph A,Graph B and Graph C.One-way analysis of variance was used to compare difference of TBR_(30/60) among groups.ROC curve analysis was used to evaluate diagnostic effectiveness.Results With hypervascularity as the diagnostic standard of HCC,the sensitivity,specificity,positive predictive value(PPV)and negative predictive value(NPV)were 66.7%(18/27),75.6%(59/78),48.6%(18/37)and 86.8%(59/68),respectively.With Graph B as the diagnostic standard of HCC,the sensitivity,specificity,PPV and NPV were 44.4%(12/27),85.4%(70/82),50.0%(12/24)and 82.4%(70/85),respectively.The TBR_(30/60) of HCC,ICC and CRLM was 0.38±0.19,0.49±0.18 and 0.64±0.20 respectively(F=10.89,P<0.001).When the cut-off value of TBR_(30/60) was 0.43,the AUC of distinguishing HCC from ICC and CRLM was 0.72,with the sensitivity and specificity of 70.5%(55/78)and 65.2%(15/23).When the cut-off value of TBR_(30/60) was 0.64,the AUC of distinguishing ICC from CRLM was 0.71,with the sensitivity and specificity of 61.9%(13/21)and 82.5%(47/57).Conclusion TAC graph types and TBR_(30/60) obtained by total-body PET/CT dynamic imaging display potential value for differentiation between hepatic tumor types.
作者
迪丽比热·阿迪力
蔡丹杰
曹炎焱
石洪成
Dilibire Adili;Cai Danjie;Cao Yanyan;Shi Hongcheng(Department of Nuclear Medicine,Zhongshan Hospital,Fudan University Nuclear Medicine Institute of Fudan University Shanghai Institution of Medical Imaging Cancer Center,Zhongshan Hospital,Fudan University,Shanghai 200032,China)
出处
《中华核医学与分子影像杂志》
CAS
CSCD
北大核心
2022年第12期724-728,共5页
Chinese Journal of Nuclear Medicine and Molecular Imaging
基金
上海市临床重点专科项目 (shslczdzk03401)
促进市级医院临床技能与临床创新能力三年行动计划 (SHDC2020CR3079B)。
