FDG PET对非小细胞肺癌纵隔淋巴结分期的价值

Value of FDG PET for mediastinal lymph node staging in non-small cell lung cancer

目的 评价FDGPET显像对非小细胞肺癌 (NSCLC)纵隔淋巴结分期的价值。方法 对 70例经病理证实为NSCLC的病例进行FDGPET显像 ,以纵隔淋巴结FDG摄取增高及SUV≥ 2 .5作为阳性判断标准 ,进行纵隔淋巴结分期 ,并与CT结果比较。结果 PET对纵隔淋巴结转移诊断的灵敏度、特异性和准确率分别为 10 0 %、93 %和 94% ,且阳性淋巴结数目和部位与病理结果完全符合 ,使 12例术前临床分期得以纠正。CT的灵敏度、特异性和准确率分别为 70 %、77%和 76%。结论 PET对NSCLC纵隔淋巴结的准确分期有很高的应用价值 。

Objective To evaluate the diagnostic significance of FDG PET in preoperative mediastinal lymph node staging for NSCLC. Methods Whole body FDG PET imaging was performed in 70 patients with NSCLC. All patients received thoracic CT examination 2 weeks before PET scan or 1 week after PET scan, and then were given thoracotomy with hilar and mediastinal lymph nodes dissection. After intravenous administration of 18 F FDG (150 μCi/kg), PET scan was performed in 3 7 bed positions with 2D acquisition and OSEM reconstruction. For quantitative evaluation, a region of interest (ROI) was placed over the mediastinal lymph node which had abnormal uptake of radiation activity, then the standardized uptake value (SUV) were calculated. If SUV≥2.5 or uptake activity was higher than the blood pool of mediastinal on the basis of visual inspection, it was considered to be positive. Results The sensitivity, specificity and accuracy of PET were 100%, 93% and 94%, respectively. The positive lymph nodes diagnosed by PET correctly corresponded to pathological results. PET changed the clinical staging of 12 patients. The sensitivity, specificity and accuracy of CT were 70%, 77% and 76%, respectively. Conclusion PET is an effective modality for accurate mediastinal lymph node staging in patients with NSCLC. It is valuable for determining clinical treatment.