The prognostic value of radiomics based on ^(18)F-FDG PET/CT imaging in advanced non-small cell lung cancer

Objective:To investigate the prognostic value of radiomics features based on ^(18)F-FDG PET/CT imaging for advanced non-small cell lung cancer(NSCLC)treated with chemotherapy.Methods:A sample of 146 NSCLC patients stagedⅢor stageⅣwere included in this retrospective study who received ^(18)F-FDG PET/CT before treatment.All patients were treated with standardized chemotherapy after PET/CT examination and were divided into training group and validation group in an 8:2 ratio randomly.Radiomics features were extracted.In the training group,the minimum absolute contraction and selection operator(LASSO)algorithm and Cox risk proportional regression model were used to screen radiomics and clinical prognostic factors of progression-free survival(PFS).The radiomic model,clinical model and complex model were established respectively.The corresponding scores were calculated,then verified in the validation group.Results:The LASSO algorithm finally screened four radiomics features.ROC results showed that in the training group,the AUC of PFS predicted by the radiomics model was 0.746,and that in the verification group was 0.622.COX multivariate analysis finally included three clinical features related to PFS in NSCLC patients,namely pathological type,clinical stage and MTV30.The AUC for predicting PFS by clinical model,radiomics model and composite model were 0.746,0.753 and 0.716,respectively.The radiomics model had the highest diagnostic efficacy,and its sensitivity and specificity were 0.663 and 0.833,respectively.Delong test verified that there was no statistical difference in the predictive efficacy between the radiomics model and the composite model(Z=1.777,P=0.076)and the clinical imaging model(Z=0.323,P=0.747).Conclusion:The radiomics model based on PET/CT has a good predictive value for the prognosis of advanced NSCLC treated with chemotherapy,but it needs further validation before it can be widely used in clinical practice.

Analysis of Local Diagnostic Reference Levels for Pediatric Patients Undergoing 18F-FDG PET/CT Imaging for Oncology

Background: The PET/CT imaging studies have two doses components the dose from the PET radiopharmaceutical and the other from the low dose CT used for PET images attenuation correction. We have one PET/CT scanner at our institution a Philips Time of Flight scanner. Our local patient’s radiation protection rules requires continuous assessment of radiation doses delivered to our patients. Purposes: The objectives of this study are to develop a weight- based facility DRLs for paediatric F-18-FDG PET-CT imaging for oncology in a large tertiary hospital and to determine whether the calculated DRLs compares with internationally published DRLs. Materials & Methods: Radiation dose data and patient demographics of two-hundreds and sixteen paediatric PET-CT oncology patients imaging procedures from one large tertiary hospital were selected and analysed in order to establish a facility paediatric DRLs. Statistical analysis was performed. Results: The PET dose reference levels ranged between [62 - 525] MBq of injected activity for a range of pediatric age groups. The CTDIvol values were between 3.5 and 16.5 mGy for all age groups. Comparison with current EANM and SNMMI recommendations of patient’s dose are discussed. Conclusion: Our pediatric PET/CT reference levels are higher than the ones reported internationally with notable variations. .

Application of ^(18) F-FDG PET/CT Imaging in Diagnosing Bladder Tumor Metastasis Lesions

Bladder tumor is the most common malignant tumor in urinary system and always com- panied with lymph node metastasis. The accurate staging plays a significant role in treatment for bladder tumor and prognostic evaluation, and the distant metastasis predicts worse prognosis. The objective of this study was to assess the clinical significance of 18F-FDG PET/CT imaging in diagnosing bladder tumor metastasis lesions. A retrospective analysis of 60 patients with bladder tumor from October 2008 to May 2010 was done. The patients were stratified based on the imaging technique. Among all 60 cases, besides the primary lesion, 81 suspected lesions were spotted and 73 confirmed as metastasis, including 50 lymph node metastases, 22 distant metastases, and 1 bone metastasis. For PET/CT imaging, its sensitivity was 94.5%, specificity 87.5%, positive predictive value 98.6%, negative predictive value 63.6% and accuracy 93.8% respectively. For CT, its sensitivity was 82.2%, specificity 50%, positive predictive value 93.8%, negative predictive value 23.5% and accuracy 79% respectively. PET/CT im- aging was superior to CT in sensitivity, specificity and accuracy. In conclusion, 18F-FDG PET/CT imaging is more significant in diagnosing bladder tumor metastasis lesions.

^(18)F-PBR06 PET/CT imaging of inflammation and differentiation of lung cancer in mice

The present study explored the 18-kDa translocator protein radioligand ^(18)F-PBR06 as a PET imaging biomarker for diagnosis of inflammation and compared it with ^(18)F-FDG for differentiation of inflammation and lung tumors in animals.^(18)F-PBR06 was synthesized with an average decay-corrected radiochemical yield of 30–40%(end of synthesis, EOS), and the radiochemical purity was greater than 99%. The inflammation-to-blood ratio of ^(18)FPBR06(3.53 ± 0.26) was higher than the tumor-to-blood ratio(1.77 ± 0.35)(P \ 0.001). The inflammation-tomuscle ratio of ^(18)F-PBR06(2.33 ± 0.64) was also higher than the tumor-to-muscle ratio(1.45 ± 0.14)(P = 0.036).Micro-PET/CT images showed high uptake of ^(18)F-FDG in both inflamed muscles and lung tumor tissues. However,^(18)F-PBR06 uptake in inflamed muscles remained higher than that in the lung tumor tissues, following 90 min of dynamic Micro-PET/CT imaging. Further, macrophages in the inflammatory regions showed a higher fluorescence signal than in lung tumor tissues. Results of the study confirmed that ^(18)F-PBR06 PET/CT imaging allowed for diagnosis of inflammation. Moreover,^(18)F-PBR06 uptake in the inflammatory regions was significantly higher than in lung tumor tissues, suggesting that ^(18)F-PBR06 PET/CT imaging has potential to differentiate between peripheral lung cancer and inflammation nodules.

A generalized method of converting CT image to PET linear attenuation coefficient distribution in PET/CT imaging

The accuracy of attenuation correction in positron emission tomography scanners depends mainly on deriving the reliable 511-keV linear attenuation coefficient distribution in the scanned objects. In the PET/CT system, the linear attenu- ation distribution is usually obtained from the intensities of the CT image. However, the intensities of the CT image relate to the attenuation of photons in an energy range of 40 keV-140 keV. Before implementing PET attenuation correction, the intensities of CT images must be transformed into the PET 511-keV linear attenuation coefficients. However, the CT scan parameters can affect the effective energy of CT X-ray photons and thus affect the intensities of the CT image. Therefore, for PET/CT attenuation correction, it is crucial to determine the conversion curve with a given set of CT scan parameters and convert the CT image into a PET linear attenuation coefficient distribution. A generalized method is proposed for con- verting a CT image into a PET linear attenuation coefficient distribution. Instead of some parameter-dependent phantom calibration experiments, the conversion curve is calculated directly by employing the consistency conditions to yield the most consistent attenuation map with the measured PET data. The method is evaluated with phantom experiments and small animal experiments. In phantom studies, the estimated conversion curve fits the true attenuation coefficients accurately, and accurate PET attenuation maps are obtained by the estimated conversion curves and provide nearly the same correction results as the true attenuation map. In small animal studies, a more complicated attenuation distribution of the mouse is obtained successfully to remove the attenuation artifact and improve the PET image contrast efficiently.

The Role of PET/CT Imaging in Lung Cancer

Lung cancer presents a high prevalence around the world and constitutes the leading cause of death due to cancer in men and women. Proper staging is essential in order to provide the correct treatment and estimate survival. PET/CT imaging is the method of choice for the staging of lung cancer patients with a better performance than the traditional imaging methods. It allows defining the primary tumor more clearly, separating it from the atelectasis and neighboring fibrotic changes, thus achieving an improved T evaluation while optimizing the target definition for radiotherapy. It presents greater sensibility and specificity than Computed Tomography (CT) when assessing the extra-thoracic and thoracic lymph nodes, modifying the N stage with regard to the traditional study in up to 25% of patients. PET/CT imaging is the method with the best performance for detecting extra-encephalic metastasis and for detecting unexpected lesions in up to 30% of patients. In order to achieve proper encephalic staging, a Magnetic Resonance Imaging scan must be performed or, a CT scan of the brain concomitant to the PET/CT. One to eight percent of lung cancer patients who are subjected to PET/CT imaging present a synchronous secondary extra pulmonary or pulmonary cancer when being diagnosed, with significant prognostic and therapeutic implications. PET/CT imaging has proven to be a valuable tool for survival prognosis with regard to the initial uptake of the tumor and the early response (interim) or final response to chemotherapy, although it is not routinely used for evaluating therapy. The PET/MRI is an emerging hybrid technique with certain advantages, such as less exposure to radiation in comparison to PET/CT and greater contrast resolution of the MRI images. However, its usefulness has not been validated yet for lung cancer patients.

Differential Diagnosis of Warthin's Tumor Complicated with Lung Adenocarcinoma by 18F- FDG PET/CT Imaging and Radioisotope Scanning with Tc-99m Pertechnetate:A Case Report and Literature Review

A seventy eight years old male patient underwent a whole body 18F- FDG PET/CT imaging to diagnose the lesion which was showed in the right lung by a chest X ray test and CT scan before. Besides the intense 18F- FDG uptake of the lesion in the right lung, a lesion in the left parotid gland also showed intense 18F- FDG uptake. To evaluate the pathology of the lesion in the left parotid gland, a parotid gland scintigraphy imaging with Tc-99m pertechnetate was done and revealed a Warthin＇s tumor. Later a fine needle aspiration（FNA） confirmed that it was a Warthin＇s tumor.

Strategies to Improve CT Dose Optimization for Hybrid PET/CT Imaging

Background: To evaluate whether current dose reduction strategies for the CT component of hybrid Positron Emission Tomography—Computed Tomography (PET/CT) systems could reduce patient dose with maintaining adequate image quality for PET/CT studies. Materials and Methods: Literature survey was initially based on the selection of keywords and years of publication to identify potentially relevant articles, then the further search was conducted on the authors and references from these articles. The abstract of each article was first appraised to decide whether the content was relevant to this research question. The articles were classified into five groups: studies on dosimetry, studies on radiation-induced diseases, studies on dose reduction methods for CT-based attenuation correction (CTAC), studies on dose reduction methods for CT localization, and studies on reducing the need for a full-dose diagnostic CT in PET/CT imaging. 58 peer-reviewed articles were selected and appraised and 29 articles were used to compose this literature review. Results: The published nuclear medicine and medical physics literature were reviewed. CT dose contributed 47% - 81% of the total effective dose of a standard PET/CT study and was associated with radiation-induced diseases. The dose reduction techniques were extracted and divided into three categories: reducing the CT dose for attenuation correction (AC) and localization, selectively localizing CT use, and reducing the need for a full-dose diagnostic CT. Conclusion: Three strategies have been demonstrated, with high potential for reducing patient dose while maintaining an adequate CT image quality, used for CTCA localization and diagnosis, respectively.

Role of F-18 FDG PET/CT imaging in the diagnosis of paraneoplastic neurological syndromes

Paraneoplastic neurological syndromes(PNS) is a series of rare neurologic disorders which happen with an underlying malignancy. It has various clinical symptoms proceding to the diagnosis of tumors. Although the abnormality of anti-neuronal antibodies is suggestive of PNS and tumors, there exist many false positive and false negative cases. The diagnosis of PNS is usually a challenge in clinic. Positron emission tomography/computed tomography(PET/CT) imaging is an anatomical and functional fusion imaging method, which provides the whole-body information by single scan. Fluorodeoxyglucose(FDG) PET/CT imaging can not only detect potential malignant lesions in the whole body, but also assess functional abnormality in the brain. In this review, the mechanism, clinical manifestation, diagnostic procedure and the recent progress of the utility of FDG PET/CT in PNS are introduced respectively.

Optimal Threshold of Stimulated Serum Thyroglobulin Level for ^(18)F-FDG PET/CT imaging in Patients with Thyroid Cancer

This study was to explore the optimal threshold of thyroid-stimulating hormone(TSH)-stimulated serum thyroglobulin(s-Tg) for patients who were to receive18F-fluorodeoxyglucose(18F-FDG) PET/CT scan owing to clinical suspicion of differentiated thyroid cancer(DTC) recurrence but negative post-therapeutic 131I whole-body scan(131I-WBS). A total of 60 qualified patients underwent PET/CT scanning from October 2010 to July 2014. The receiver operating characteristic(ROC) curve analyses showed that s-Tg levels over 49 μg/L led to the highest diagnostic accuracy of PET/CT to detect recurrence, with a sensitivity of 89.5% and a specificity of 90.9%. Besides, bivariate correlation analysis showed positive correlation between s-Tg levels and the maximum standardized uptake values(SUVmax) of18F-FDG in patients with positive PET/CT scanning, suggesting a significant influence of TSH both on Tg release and uptake of18F-FDG. So, positive PET/CT imaging is expected when patients have negative 131I-WBS but s-Tg levels over 49 μg/L.

Unusual Metastases to Diaphragm and Spleen from Adenocarcinoma of Lung Detected by 18F-FDG PET/CT Imaging:A Case Report

Globally,carcinoma of lung is the predominant cause of cancer death among both men and women.While hematogenous spread from primary lung cancer to multiple other organs is frequently reported,metastases of malignant tumors to diaphragm and spleen are rare.Nowadays,Positron emission tomography(PET)with 18 F-fluorodeoxyglucose(FDG)has emerged in such a way that it has become an effective imaging technology for the evaluation of different carcinomas,particularly for cancer staging and follow up after therapy.PET scan is able to provide metabolic information.In this case,we present an attractive unified PET/CT scan image in a patient with lung carcinoma having unusual diaphragm and splenic metastases.So,PET/CT imaging could strongly identified rare and unusual metastatic sites of cancer and added more appropriate staging in patient with carcinoma of lung.

Transparent and Accurate COVID-19 Diagnosis:Integrating Explainable AI with Advanced Deep Learning in CT Imaging

In the current landscape of the COVID-19 pandemic,the utilization of deep learning in medical imaging,especially in chest computed tomography(CT)scan analysis for virus detection,has become increasingly significant.Despite its potential,deep learning’s“black box”nature has been a major impediment to its broader acceptance in clinical environments,where transparency in decision-making is imperative.To bridge this gap,our research integrates Explainable AI(XAI)techniques,specifically the Local Interpretable Model-Agnostic Explanations(LIME)method,with advanced deep learning models.This integration forms a sophisticated and transparent framework for COVID-19 identification,enhancing the capability of standard Convolutional Neural Network(CNN)models through transfer learning and data augmentation.Our approach leverages the refined DenseNet201 architecture for superior feature extraction and employs data augmentation strategies to foster robust model generalization.The pivotal element of our methodology is the use of LIME,which demystifies the AI decision-making process,providing clinicians with clear,interpretable insights into the AI’s reasoning.This unique combination of an optimized Deep Neural Network(DNN)with LIME not only elevates the precision in detecting COVID-19 cases but also equips healthcare professionals with a deeper understanding of the diagnostic process.Our method,validated on the SARS-COV-2 CT-Scan dataset,demonstrates exceptional diagnostic accuracy,with performance metrics that reinforce its potential for seamless integration into modern healthcare systems.This innovative approach marks a significant advancement in creating explainable and trustworthy AI tools for medical decisionmaking in the ongoing battle against COVID-19.

Analysis of Imaging Characteristics and Dynamic Changes of 3 Cases of Severe Novel Coronavirus Pneumonia in Qinghai Province

Objective:To analyze the characteristics,dynamic changes,and outcomes of the first imaging manifestations of 3 patients with severe COVID-19 in our hospital.Methods:Computed tomography(CT)findings of 3 patients with severe COVID-19 who tested positive by the nucleic acid test in our hospital were selected,mainly focusing on the morphology,distribution characteristics,and dynamic changes of the first CT findings.Results:3 patients with severe pneumonia were older,with one aged 80.The first chest CT examination for all 3 patients differed.Imaging showed a leafy distribution of consolidation,primarily affecting the lower lobes of both lungs and extending subpleurally.A grid-like pattern was observed,along with changes in the consolidation and air bronchogram.These changes had slower absorption,especially in patients with underlying diseases.Conclusion:CT manifestations of severe COVID-19 have specific characteristics and the analysis of their characteristics and dynamic changes provide valuable insights for clinical treatment.

Analysis of The Value of Multi-Slice Spiral CT and Magnetic Resonance Imaging in The Diagnosis of Carpal Joint Injury

Objective:To analyze the value of multi-slice spiral computed tomography(CT)and magnetic resonance imaging(MRI)in the diagnosis of carpal joint injury.Methods:A total of 130 patients with suspected wrist injuries admitted to the Department of Orthopedics of our hospital from January 2023 to January 2024 were selected and randomly divided into a single group(n=65)and a joint group(n=65).The single group was diagnosed using multi-slice spiral CT,and the joint group was diagnosed using multi-slice spiral CT and magnetic resonance imaging,with pathological diagnosis as the gold standard.The diagnostic results of both groups were compared to the gold standard,and the diagnostic energy efficiency of both groups was compared.Results:The diagnostic results of the single group compared with the gold standard were significant(P<0.05).The diagnostic results of the joint group compared with the gold standard were not significant(P>0.05).The sensitivity and accuracy of diagnosis in the joint group were significantly higher than that in the single group(P<0.05).The specificity of diagnosis in the joint group was higher as compared to that in the single group(P>0.05).Conclusion:The combination of multi-slice spiral CT and MRI was highly accurate in diagnosing wrist injuries,and the misdiagnosis rate and leakage rate were relatively low.Hence,this diagnostic program is recommended to be popularized.

新型^(18)F-FES PET/CT无创功能性诊断乳腺癌迟发性肺转移致霍纳综合征一例

激素受体阳性、人表皮生长因子受体2型阴性(HR^(+)/HER2^(-))乳腺癌是最常见的乳腺癌分子亚型,可表现为术后10~15年以上的迟发性复发,且其肺转移病灶需与原发性肺癌相鉴别。本文报道1例HR^(+)/HER2^(-)乳腺癌术后16年迟发性肺转移致霍纳综合征患者,采用^(18)F-FDG PET/CT难以判断肿瘤来源,穿刺活检风险高,经北京协和医院新型^(18)F-FES PET/CT无创功能性诊断为乳腺癌肺上叶雌激素受体(estrogen receptor,ER)阳性转移,给予CDK4/6抑制剂+芳香化酶抑制剂内分泌解救治疗后获得缓解。本文总结该患者的临床表现及诊治经过,为新型^(18)F-FES PET/CT评估乳腺癌患者转移灶的ER表达情况及指导后续个体化诊疗提供借鉴。

COVID-19 vaccine related hypermetabolic lymph nodes on PET/CT:Implications of inflammatory findings in cancer imaging

We observed several patients presenting 2-[^(18)F]FDG uptake in the reactive axillary lymph node at PET/CT imaging,ipsilateral to the site of the COVID-19 vaccine injection.Analog finding was documented at[^(18)F]Choline PET/CT.The aim of our study was to describe this source of false positive cases.All patients examined by PET/CT were included in the study.Data concerning patient anamnesis,laterality,and time interval from recent COVID-19 vaccination were recorded.SUVmax was measured in all lymph nodes expressing tracer uptake after vaccination.Among 712 PET/CT scans with 2-[^(18)F]FDG,104 were submitted to vaccination;89/104 patients(85%)presented axillary and/or deltoid tracer uptake,related to recent COVID-19 vaccine administration(median from injection:11 days).The mean SUVmax of these findings was 2.1(range 1.6–3.3).Among 89 patients with false positive axillary uptake,36 subjects had received chemotherapy due to lymph node metastases from somatic cancer or lymphomas,prior to the scan:6/36 patients with lymph node metastases showed no response to therapy or progression disease.The mean SUVmax value of lymph nodal localizations of somatic cancers/lymphomas after chemotherapy was 7.8.Only 1/31 prostate cancer patients examined by[^(18)F]Choline PET/CT showed post-vaccine axillary lymph node uptake.These findings were not recorded at PET/CT scans with[^(18)F]-6-FDOPA,[^(68)Ga]Ga-DOTATOC,and[^(18)F]-fluoride.Following COVID-19 mass vaccination,a significant percentage of patients examined by 2-[^(18)F]FDG PET/CT presents axillary,reactive lymph node uptake.Anamnesis,low-dose CT,and ultrasonography facilitated correct diagnosis.Semi-quantitative assessment supported the visual analysis of PET/CT data;SUVmax values of metastatic lymph nodes were considerably higher than post-vaccine lymph nodes.[^(18)F]Choline uptake in reactive lymph node after vaccination was confirmed.After the COVID-19 pandemic,nuclear physicians need to take these potential false positive cases into account in daily clinical practice.

个性化护理干预对肿瘤患者^(18)F-FDG PET/CT检查质量及图像质量的影响研究

目的探讨个性化护理干预对肿瘤患者^(18)F-FDG PET/CT检查质量及图像质量的影响。方法选取2020年1月至2022年12月在广西医科大学附属肿瘤医院行^(18)F-FDG PET/CT检查的100例肿瘤患者作为研究对象,随机分为观察组和对照组,每组各50例。对照组实施常规护理干预,观察组实施个性化护理干预,比较两组患者的检查质量及图像质量。结果观察组在显像剂外漏(P=0.017)、注射次数(P=0.042)、肠道摄取增高(P=0.046)、声带摄取增高(P=0.037)、眼肌摄取增高(P=0.027)、全身肌肉摄取增高(P=0.037)发生率均低于对照组,差异有统计学意义(P<0.05)。结论对肿瘤患者在^(18)F-FDG PET/CT显像检查过程中实施个性化护理干预,有利于提高检查质量和图像质量,使患者和医护人员共同获益,值得推广。

^(18)F-FDG PET/CT显像和血清学指标对前列腺肿瘤的诊断价值

目的 研究^(18)F-氟代脱氧葡萄糖(^(18)F-fluorodexyglucose,^(18)F-FDG)PET/CT显像和前列腺血清学指标诊断前列腺肿瘤的价值。方法 回顾性分析2013年8月至2021年12月在浙江大学医学院附属第二医院经病理证实的95例疑似前列腺肿瘤患者的^(18)F-FDG PET/CT图像与前列腺血清学指标。根据病理检查结果分为恶性组(n=77)和良性组(n=18)。采用受试者工作特征(receiver operating characteristic,ROC)曲线分析前列腺病灶的最大标准摄取值(maximum standardized uptake value,SUV_(max))与血清总前列腺特异性抗原(total prostate specific antigen,tPSA)、游离前列腺特异性抗原(free prostate specific antigen,fPSA)及游离/总前列腺特异性抗原比值(free/total prostate specific antigen,f/t-PSA)诊断前列腺良恶性病灶的最佳截断界值。结果 ROC曲线显示,SUV_(max)、tPSA、fPSA和f/t-PSA诊断前列腺良恶性病灶的最佳截断值分别为4.47、46.67 ng/mL、11.11 ng/mL和0.10。SUV_(max)、tPSA、fPSA和f/t-PSA的ROC曲线下面积(area under the curve,AUC)分别为0.658、0.897、0.842和0.836。^(18)F-FDG PET/CT显像、tPSA、f PSA和f/t-PSA对前列腺肿瘤的诊断敏感度分别是81.8%、97.4%、92.2%和83.1%,特异度分别是61.1%、27.8%、50.0%和50.0%,准确度分别是77.9%、84.2%、84.2%和76.8%。恶性组SUV_(max)、tPSA和fPSA均高于良性组,f/t-PSA低于良性组(均P<0.05)。^(18)F-FDG PET/CT检查显示,72例有远处转移病灶。结论 SUV_(max)、tPSA、fPSA和f/t-PSA均能鉴别前列腺良恶性病灶。^(18)F-FDG PET/CT显像在探测远处病灶方面更具有优势,能够为临床决策提供更好的帮助。

^(18)F-FDG PET-CT联合MRI对于前列腺癌的临床诊断价值

目的探讨^(18)F-FDG PET-CT联合MRI在前列腺癌诊断及分期中的应用价值。方法选取我院2020年8月—2023年8月期间收治的70例疑似前列腺癌患者为研究对象,纳入患者均接受PET-CT及MRI检查,以病理穿刺活检结果作为诊断金标准,评价二者联合诊断的诊断效能。结果70例疑似前列腺癌患者,经过穿刺活检确诊为前列腺癌50例,前列腺良性病变20例;其中MRI诊断出前列腺癌43例,前列腺良性病变27例;PET-CT诊断出前列腺癌48例,前列腺良性病变23例;PET-CT+MRI诊断出前列腺癌51例,前列腺良性病变19例;PET-CT联合MRI诊断的准确度、敏感度高于单一诊断,漏诊率低于单一诊断(P<0.05),而二者联合诊断前列腺癌的特异度及误诊率无统计学差异(P>0.05)。病理分期诊断上,50例经病理活检确诊为前列腺癌的患者,低分化腺癌13例;T期40例(T1~T2期11例,T3期22例,T4期7例),N期10例;对于前列腺癌T分期评价,PET-CT+MRI检查的准确度高于单一检查(P<0.05)。结论PET-CT联合MRI相比二者任一检查对前列腺癌及其病理分期具有较高的诊断效能,可减少漏诊率及误诊率。

^(68)Ga-DOTATATE PETCT显像在神经内分泌肿瘤诊断及病理分级中的应用研究

目的探讨^(68)Ga-DOTATATE正电子发射断层成像(PET)/计算机断层成像(CT)在神经内分泌肿瘤(NET)诊断及病理分级中的应用价值。方法选择我院2022年1月到2023年6月期间86例疑似NET的患者为研究对象,经手术病理或病理活检结果确认74例为胃肠胰NET,12例为非NET。患者均接受多层螺旋CT(MSCT)、核磁共振成像(MRI)、^(68)Ga-DOTATATE PET-CT检查,分析患者影像学检查结果,探讨^(68)Ga-DOTATATE PET-CT显像在NET诊断及病理分级中的应用价值,按照病理诊断分级将G1级、G2级、G3级患者分别纳入A组、B组、C组,比较三组间病灶最大径、最大标准摄取值(SUV__(max))、平均标准摄取值(SUV_(mean))、肿瘤/本底比值(TBR)的差异。结果3种检查方法中,^(68)Ga-DOTATATE PETCT诊断效能最高,灵敏度为95.95%,特异度为83.33%,准确度为94.19%,kappa=0.766。三组间病灶最大径、SUV__(max)、SUV_(mean)差异有统计学意义(P<0.05);A组病灶最大径小于B组、C组,B组病灶最大径小于C组,差异有统计学意义(P<0.05);A组SUV__(max)和SUV_(mean)大于B组、C组,B组SUV__(max)和SUV_(mean)大于C组,差异有统计学意义(P<0.05)。结论^(68)Ga-DOTATATE PET-CT显像可以提高NET诊断价值,利于指导NET病理分级,有望为临床针对性治疗提供参考。