双时相PET显像在肺良恶性病变鉴别诊断中的应用

Dual time point ^(18)F-FDG PET imaging for differentiating malignant from benign lung nodules

目的 评价双时相显像在肺部结节良恶性鉴别诊断中的应用价值。方法 对 3 2例肺癌患者和 15例肺良性病变患者进行1 8F 脱氧葡萄糖 (FDG)PET双时相显像 ,早期显像于注射FDG后40～ 65min ,延迟显像于注射后 1.5～ 2 .5h进行 ,测定两次显像病灶的标准摄取值 (SUV) ,并计算两次显像SUV变化率 (ΔSUV)。结果 肺癌组早期显像SUV为 4.3 2± 2 .5 9,延迟显像为 6.71± 4.2 6,ΔSUV为 ( 5 4.5 9± 2 8.96) %。而肺部良性病变早期显像SUV为 2 .83± 1.3 6,延迟显像为 3 .3 1± 1.95 ,ΔSUV为 ( 18.11± 2 5 .3 9) %。结论 双时相显像方法简便 ,在临床上具有一定的实用价值。肺恶性病变延迟显像SUV升高的幅度高于良性病变 。

Objective To evaluate the value of dual time point 18F-FDG PET imaging in differentiation of malignant from benign lung nodules. Methods Thirty-two patients with malignant lung lesions and 15 patients with benign lesions underwent dual time point 18F-FDG PET imaging. The final diagnoses of these patients were proved either by histopathology or by biopsy, or by a clinical and radiographic follow-up. The imaging protocol included torso PET scanning (2～3 bed) at 40～65 min post-injection of 370～555 MBq FDG and then a whole body PET scanning at 1.5～2.5 h. The standardized uptake value (SUV) was calculated for both time points. All results were expressed as the percentage change in SUV. Results The SUV of delayed images from malignant lesions increased over time compared with those of early images (54.59±28.96)%. By contrast, the SUV of benign lung nodules remained stable or increased slightly over time (18.11±25.39)%. Conclusions Dual time point imaging is a simple and practical method for detection of malignant lung lesions. The preliminary data suggests that malignant nodules have a greater rise of SUV in the delay images as compared to benign nodules, but pulmonary tuberculosis and granulomatous disease also have increased SUV.