结合PET／CT中CT征象与^18F-FDG最大SUV值提高诊断肺癌水平之方法学研究

Analysis on the Diagnostic Accuracy of Lung Cancer by Integrating CT and SUVmax of ^(18)F-FDG PET

目的:探讨结合PET/CT中低剂量CT得到的CT征象和18F-FDG最大SUV值提高对肺癌诊断准确度。材料和方法:多中心临床实验中16例病理证实的肺癌病人和39例非肺癌肺占位病人,对其7项CT征象及病灶SUV值进行判定,并对得到的资料进行logistic回归分析。结果:在PET/CT中低剂量CT的扫描条件下,病灶的分叶征、长毛刺征、周围病灶、淋巴结肿大及18F-FDG摄取被引入回归模型,其中分叶征、长毛刺征和18F-FDG摄取对病变判断的影响有统计学意义。得到的回归模型诊断效能为灵敏性68.8%、特异性94.9%、准确性87.3%。结论;CT征象对最大SUV值法诊断肺癌具有修正作用,其中长毛刺征和周围病灶的观察能明显降低最大SUV值法的假阳性率。

Purpose： The purpose of this study was to compare the diagnostic accuracy of low dose CT signs and SUVmax of ^18SF-FDG PET/CT in differential diagnosis of lung cancer. Materials and Methods： 16 patients of lung cancer and 39 patients of benign lesions were included in this study. The diagnosis of all patients was confirmed by pathology or by long-term followed up. Seven CT signs and the SUVmax of the lesions were used for making diagnosis. The diagnostic performance of CT signs and SUVs was statistically analyzed. Results： Using low close CT, 4 CT signs and the status of ^18F-FDG uptake of a lesion were proved of influence over the accuracy of diagnosis. Combining the CT signs and SUVs resulted in a sensitivity of 68.8%, specificity of 94.9%, and accuracy of 87.3% in our studied population. Conclusion： CT signs had complement value to the status of ^18F-FDG uptake in PET/CT imaging of pulmonary lesions. Especially, the signs of macrotrichia and satellite lesion were of value in avoiding the false positive result.