PET/CT超级迭代与普通迭代技术在孤立性肺结节诊断、肿瘤侵袭程度中评估价值比较及与Ki-67相关性

Comparison of PET/CT Super⁃Iterative and Ordinary Iterative Techniques in the Diagnosis of Solitary Pulmonary Nodules and the Evaluation of Tumor Invasiveness and Their Correlation with Ki-67

目的探究PET/CT超级迭代与普通迭代技术在孤立性肺结节(SPN)诊断、肿瘤侵袭程度评估中的应用价值及与Ki-67的相关性。方法选取2020年3月至2021年8月经病理证实的恶性SPN患者53例作为恶性组,根据1∶1匹配病例对照原则选取同期良性SPN患者53例作为良性组,均行PET/CT检查,比较两组一般资料、PET/CT超级迭代与普通迭代技术下获取的最大摄取标准值(SUV_(max))、平均摄取标准值(SUV_(mean))及图像质量[对比噪声比(CNR)、信噪比(SNR)],通过受试者工作特征(ROC)曲线分析PET/CT超级迭代与普通迭代技术SUV_(max)、SUV_(mean)诊断SPN良恶性的价值,并比较恶性组不同肿瘤侵袭程度、Ki-67表达情况患者两种技术下SUV_(max)、SUV_(mean),采用Spearman相关系数模型分析两种技术下SUV_(max)、SUV_(mean)与恶性SPN肿瘤侵袭程度、Ki-67表达的相关性。结果恶性组PET/CT超级迭代与普通迭代技术下SUV_(max)、SUV_(mean)均高于良性组(P<0.05);PET/CT超级迭代技术检查恶性及良性SPN的CNR、SNR均高于普通迭代技术(P<0.05);超级迭代技术下SUV_(max)、SUV_(mean)诊断的曲线下面积(AUC)(0.738、0.847)高于普通迭代技术(0.712、0.796)(P<0.05);恶性组患者超级迭代与普通迭代技术下SUV_(max)、SUV_(mean)均随肿瘤侵袭程度加重逐渐升高,且Ki-67阳性患者SUV_(max)、SUV_(mean)均高于阴性患者(P<0.05);PET/CT超级迭代与普通迭代技术下SUV_(max)、SUV_(mean)均与恶性SPN肿瘤侵袭程度、Ki-67表达呈正相关(P<0.05),其中超级迭代技术下SUV_(max)、SUV_(mean)与恶性SPN肿瘤侵袭程度、Ki-67表达的相关性更紧密。结论与普通迭代技术相比,PET/CT超级迭代技术下SUV_(max)、SUV_(mean)诊断SPN的价值更高,且与恶性SPN肿瘤侵袭程度、Ki-67表达的相关性更紧密。

Objective To explore the application value of PET/CT super iteration and common iteration technique in the diagnosis of solitary pulmonary nodules(SPN)and the assessment of tumor invasion,and their correlation with Ki⁃67.Methods 53 patients with malignant SPN confirmed by pathology in our hospital from March 2020 to August 2021 were se⁃lected as the malignant group,and 53 patients with benign SPN during the same period were selected as the benign group according to the 1∶1 matching case⁃control principle,and all underwent PET/CT examination.Comparison of general data,maximum uptake standard value(SUV_(max)),average uptake standard value(SUV_(mean))and image quality[noise ratio(CNR),signal⁃to⁃noise ratio(SNR)]obtained under PET/CT super iteration and common iterative techniques between the two groups.Receiver operating characteristic(ROC)curve was used to analyze the value of PET/CT super iterative and or⁃dinary iterative techniques SUV_(max) and SUV_(mean) in diagnosing benign and malignant SPN,and compared the SUV_(max) of the two techniques in patients with different tumor invasion degrees and Ki⁃67 expression in the malignant group,SUV_(mean),Spearman correlation coefficient model was used to analyze the correlation between SUV_(max),SUV_(mean) and malignant SPN tumor invasion degree and Ki⁃67 expression under the two techniques.Results The SUV_(max) and SUV_(mean) of the malignant group under PET/CT super⁃iteration and ordinary iterative techniques were higher than those of the benign group(P<0.05);The CNR and SNR of malignant and benign SPN detected by PET/CT super⁃iterative technique were higher than those of ordinary iterative technique(P<0.05);The AUC(0.738,0.847)of SUV_(max) and SUV_(mean) diagnosis under the su⁃per iterative technique was higher than that of the ordinary iterative technique(0.712,0.796)(P<0.05);The SUV_(max) and SUV_(mean) of the malignant group patients under the super⁃iteration and ordinary iterative techniques were gradually in⁃creased with the aggravation of tumor invasion,and the SUV_(max) and SUV_(mean) of the Ki⁃67 positive patients were higher than those of the negative patients(P<0.05);Both SUV_(max) and SUV_(mean) under PET/CT super⁃iteration and ordinary iterative techniques were positively correlated with the degree of invasion of malignant SPN tumors and the expression of Ki⁃67(P<0.05).67 expression was more closely correlated.Conclusion Compared with ordinary iterative techniques,SUV_(max) and SUV_(mean) under PET/CT super⁃iterative technique have higher value in diagnosing SPN,and are more closely correlated with the degree of tumor invasion and Ki⁃67 expression in malignant SPN.