肺部单发结节^(18)F-FLT与^(18)F-FDG PET/CT诊断比较

Diagnosis of solitary pulmonary nodule with ^(18)F-FDG and ^(18)F-FLT PET/CT

目的探讨18F-氟脱氧葡萄糖(18F-FDG)联合18F-氟脱氧胸苷(18F-FLT)PET/CT在诊断孤立性肺结节(SPN)中的价值。方法采用前瞻性研究方法,选择肺部单发结节病人行18F-FDG及18F-FLT双显像剂PET/CT显像,以病理结果和随访半年以上的临床结果为最终诊断,通过SUVmax半定量法、FLT/FDG比值法等研究两种显像剂PET/CT显像对单发肺结节的诊断价值。结果入选的单发肺结节患者15例,其中6例为恶性肿瘤,9例为良性病变。18F-FLTPET显像中病灶的SUVmax值明显低于18F-FDG显像,但是恶性病变的SUVmax值无论18F-FDG还是18F-FLT其SUVmax值均大于良性病变,18F-FDGSUV值法诊断的准确性为66.7%,敏感性及特异性分别为83.3%、55.6%。18F-FLTSUV值法的准确性为66.7%,敏感性及特异性均为66.7%。FLT/FDG比值法准确性为80%,敏感性及特异性分别为66.7%、88.9%。结论 18F-FLT作为反映细胞增殖特性的新型PET/CT显像剂对肺结节诊断有一定的价值。当18F-FDG、18F-FLT联合使用时,可以提高肺部单发结节的诊断效能。

Objective To study the diagnostic value of combined 18F-fluorothymidine（18F-FDG） and 18F-fluorodeoxiglucose（18F- FLT） PET/CT imaging for solitary pulmonary nodule（SPN）. Methods 18F-FDG and 18F-FLT PET/CT imaging were performed for patients with SPN. Final diagnosis of SPN was made based on the findings of pathological examination and 6-month follow-up. The diagnostic value of 18F-FDG and 18F-FLT PET/CT for SPN was compared using semi-quantitative SUVmax and FLT/FDG ratio. Results Malignant and benign tumors were found in 6 and 9 of the 15 SPN patients, respectively. The SUVmax was significantly lower on 18F-FLT imaging than on 18F-FDG imaging. However, the SUVmax was greater for malignant tumor than for benign tumor on either 18F-FDG or on 18F-FLT image. The diagnostic accuracy, sensitivity and specificity of SUVmax were 66.7%, 83.3%, 55.6% on 18F-FDG PET/CT imaging and 80%, 66.7%, 88.9% on 18F-FLT imaging. Conclusion 18F-FLT, as a novel imaging tracer of PET/CT for the characteristics of cell proliferation is of certain diagnostic value for SPN. 18F-FDG combined with 18F-FLT can increase the diagnostic value for SPN.