一体化^(18)F-FDG PET/MRI用于诊断胰腺肿瘤

Integrated^(18)F-FDG PET/MRI for diagnosis pancreatic tumors

目的探讨一体化^(18)F-FDG PET/MRI鉴别胰腺良、恶性病变和检测淋巴结和/或远处转移的价值。方法回顾性分析45例临床疑诊胰腺肿瘤并接受^(18)F-FDG PET/MRI患者,包括38例胰腺恶性病变和7例良性病变,以病理或随访结果为标准,评价一体化PET/MRI诊断胰腺良、恶性病变的效能。结果取3.20为最大标准摄取值(SUV_(max))的截断值,^(18)F-FDG PET/MRI诊断胰腺癌的敏感度、特异度、准确率、阳性预测值和阴性预测值分别为89.47%(34/38)、85.71%(6/7)、88.89%(40/45)、97.14%(34/35)和60.00%(6/10);以1.78作为平均表观弥散系数(ADC_(mean))的截断值时,其敏感度、特异度、准确率、阳性预测值和阴性预测值分别为97.37%(37/38)、71.43%(5/7)、93.33%(42/45)、94.87%(37/39)和85.71%(6/7);联合应用二者则分别为100%(38/38)、71.43%(5/7)、95.56%(43/45)、95.00%(38/40)和100%(5/5)。15例检查前未发现肝、肺、骨及淋巴结转移患者中,根据^(18)F-FDG PET/MRI结果,12例的治疗方案获得修正。结论一体化^(18)F-FDG PET/MRI是检测胰腺癌淋巴结和/或远处转移的较好方法;SUV_(max)与ADC_(mean)对于鉴别胰腺良、恶性病变具有较高价值。

Objective To explore the value of integrated ^(18)F-FDG PET/MRI in differential diagnosis of benign and malignant pancreatic lesions and detecting regional lymph node and/or distant metastases.Methods Data of 45 patients with suspected pancreatic tumor who underwent ^(18)F-FDG PET/MRI were retrospectively analyzed,including 38 cases of pancreatic malignant lesions and 7 cases of benign lesions.The diagnostic efficacy of ^(18)F-FDG PET/MRI for benign and malignant pancreatic lesions were evaluated according to pathological or follow-up results.Results Taken 3.20 as the cutoff value of the maximum standard uptake value(SUV_(max)),the sensitivity,specificity,accuracy,positive and negative predictive value of ^(18)F-FDG PET/MRI for diagnosing pancreatic cancer was 89.47%(34/38),85.71%(6/7),88.89%(40/45),97.14%(34/35)and 60.00%(6/10),respectively.Taken 1.78 as the cutoff value of the mean apparent diffusion coefficient(ADC_(mean)),the above indexes was 97.37%(37/38),71.43%(5/7),93.33%(42/45),94.87%(37/39)and 85.71%(6/7),respectively.Combining SUV_(max) and ADC_(mean) values,the sensitivity,specificity,accuracy,positive and negative predictive value of ^(18)F-FDG PET/MRI for diagnosing pancreatic cancer was 100%(38/38),71.43%(5/7),95.56%(43/45),95.00%(38/40)and 100%(5/5),respectively.Distant metastases in liver,lung,bone and regional lymph nodes metastases were detected in 15 cases in whom metastases were not detected with other imaging methods.Based on ^(18)F-FDG PET/MRI findings,the treatment plans of 12 cases were modified.Conclusion Integrated ^(18)F-FDG PET/MRI was a useful tool for detecting regional metastatic lymphadenopathy and distant metastases of pancreatic cancer.Both SUV_(max) and ADC_(mean) had high value in differentiating benign and malignant pancreatic lesions.