摘要
目的:探究双时相PET/CT扫描在脑肿瘤初诊及随访中的价值。方法:回顾性分析31例采用双时相18F-FDG PET/CT扫描的脑肿瘤初诊及随访病例,在以病理或影像检查进行定性分析的基础上,对两期扫描病变SUV_(max)值进行半定量分析,并根据ROC分析确定FDG PET/CT双期扫描的特定临界值,以区分肿瘤的活性。结果:延迟扫描对诊断病变有无活性的灵敏度、特异度、准确度有显著提升(常规扫描期:灵敏度80.6%、特异度99.9%、准确度96.3%;延迟扫描期:灵敏度88.9%、特异度100%、准确度97.9%,P<0.001),说明延迟扫描可以进一步明确病变性质。对于病灶有活性患者,对侧尾状核头(CCH)延迟扫描较常规扫描SUV_(max)值变化具有统计学意义(P<0.001);对侧脑白质(CWM)、同侧小脑皮质(ICC)与病变(T)的靶本比(T/CWM、T/ICC),有活性病变组以及整体(有活性病变组与无活性病变组)延迟期较常规扫描期半定量分析差异具有统计学意义(P<0.001);对变化百分比ROC分析得到准确度、灵敏度、特异度,综合3个参数可知,ICC>CWM>CCH(ΔT/CWM:灵敏度77.8%、特异度72.7%、准确度90.9%;ΔT/CCH:灵敏度88.9%、特异度54.5%、准确度91.1%;ΔT/ICC:灵敏度83.3%、特异度72.7%、准确度93.4%。结论:脑肿瘤双时相PET/CT检查对于提高脑肿瘤活性诊断准确率,具有一定的可行性和临床应用价值。
Objective To investigate the value of dual-phase PET/CT in the initial diagnosis and follow-up of brain tumor.Methods A retrospective analysis was conducted on the initial diagnosis and follow-up cases(n=31) of brain tumors using dual-phase18F-FDG PET/CT. Based on the qualitative analysis by pathological or imaging examination, the SUV_(max)value of the lesion in the dual-phase scans was semi-quantitatively analyzed, and the specific critical value of dual-phase FDG PET/CT scan was determined according to ROC analysis to distinguish the tumor activity. Results The sensitivity, specificity and accuracy of delayed scan were 88.9%, 100.0% and 97.9%, higher than 80.6%, 99.9% and 96.3% of routine scan(P<0.001),indicating that delayed scan can further clarify the nature of the lesion. In patients with viable lesions, the SUV_(max)of contralateral caudate nucleus head(CCH) of delayed scan differed from that of routine scan(P<0.001). The semi-quantitative analysis showed that there were statistical significance between delayed scan and routine scan in target ratios of contralateral white matter(CWM), ipsilateral cerebellar cortex(ICC) to viable lesion(Target, T), and the intergroup comparison between viable lesion and the overall(viable and nonviable lesions)(P<0.001). According to the accuracy, sensitivity and specificity obtained by ROC analysis on the percentage change, ICC had the optimal diagnostic efficiency, followed by CWM and CCH.The sensitivity, specificity, accuracy were 77.8%, 72.7%, 90.1% for ΔT/CWM, 88.9%, 54.5%, 91.1% for ΔT/CCH, and83.3%, 72.7%, 93.4% for ΔT/ICC. Conclusion Dual-phase PET/CT examination has certain feasibility and clinical application value for improving the accuracy of brain tumor activity diagnosis.
作者
王佳琦
崔勇
栾琨
李晨光
张艺宝
WANG Jiaqi;CUI Yong;LUAN Kun;LI Chenguang;ZHANG Yibao(Department of Medical Imaging,Chengwu Hospital,Heze 274200,China;Medical Imaging Center,the Second Hospital of Shandong University,Ji'nan 250033,China;Key Laboratory of Carcinogenesis and Translational Research(Ministry of Education/Beijing)/Department of Radiation Oncology,Peking University Cancer Hospital&Institute,Beijing 100142,China)
出处
《中国医学物理学杂志》
CSCD
2023年第2期157-162,共6页
Chinese Journal of Medical Physics
基金
国家自然科学基金(12275012)
北京市自然科学基金(Z210008)
北京大学肿瘤医院科学研究基金学科骨干项目(2021-1)
北大百度基金资助项目(2020BD029)
恶性肿瘤发病机制及转化研究教育部/北京市重点实验室开放基金(2022开放-2)
北京大学医学部教育教学研究立项项目(2020YB34)
北京大学新工科交叉专项/中央高校基本科研业务费(PKU2022XGK006)
国家重点研发计划(2019YFF01014405)
内蒙古自治区科技计划(2022YFSH0064)。
