18F-FDGPET／CT在宫颈癌诊治中的应用

准确的临床分期对宫颈癌患者治疗方案确定、疗效监测、预后评估及治疗方案的调整等有重要价值。应用18F-FDGPET／CT全身肿瘤代谢显像,可较清楚地了解宫颈癌原发灶及转移灶的代谢变化,有利于指导宫颈癌的临床分期、治疗方案选择,也有利于监测疗效和评估预后。     

18F-FDG PET/CT和增强CT对胰腺病变定性诊断的价值比较

目的评价^18F-脱氧葡萄糖（FDG）PET／CT对胰腺良、恶性病变定性诊断的价值。方法对15例胰腺恶性病变，6例良性病变患者行全身^18F-FDGPET／CT和增强CT检查，根据PET、增强CT和PET／CT图像上的表现分别诊断，并将结果进行比较。结果PET和PET／CT准确诊断全部恶性病变，而增强CT准确诊断全部良性病变。PET和PET／CT在6例良性病变诊断中分别显示2例和1例假阳性，而增强CT在15例恶性病变中有2例假阴性，但在上述3种诊断方法中分别出现的假阳性或假阴性都得到了相互间的纠正。增强CT、PET和PET／CT三者在诊断胰腺恶性肿瘤上的准确性分别为90．5％，90．5％和95．2％。此外，PET／CT比增强CT检出了更多的肝脏、淋巴结和骨转移灶；两者检出病灶数量分别为35，41，9和16，24，3个。结论PET／CT在胰腺良、恶性病变定性诊断上有价值，PET／CT和增强CT联合应用有利于进一步提高对胰腺恶性肿瘤的诊断和分期准确性。     

^18F-FDGPET／CT影像特征对甲状腺结节的诊断效能

目的研究甲状腺结节^18F-FDGPET／CT影像特征对甲状腺结节良恶性的鉴别诊断效能。方法回顾性研究68例[男24例,女44例,平均年龄（52．8±10．58）岁]2006年1月至2012年12月间经PET／CT检查发现甲状腺结节且有术后病理结果的患者,分析其PET／CT图像特征并获得特征参数,包括结节边界清晰度、密度均匀性、钙化情况、包膜情况、平均CT值、结节大小及SUVmax。以术后病理结果为“金标准”,采用Mann-Whitney u检验、x^2检验及ROC曲线对各参数的诊断效能进行统计分析。结果68例患者中,病理结果显示恶性18例,良性50例。结节密度是否均匀、有无钙化灶、有无包膜对于甲状腺结节良恶性鉴别均无统计学意义（x^2=0．21、0．01、0．43,均P〉0．05）,结节平均CT值及结节大小亦无鉴别意义（均AUC〈0．5）。结节边界是否清晰对良恶性结节鉴别有统计学意义（x^2=8．06,P〈0．05）,其诊断灵敏度、特异性及准确性分别为55．6％（10／18）、80．0％（40／50）和73．5％（50／68）。良性结节SUVmax为3．16±1．84,恶性结节SUVmax为8．53±7．09,差异有统计学意义（u=-4．281,P〈0．01）。以SUVmax为评价指标,其ROC的AUC为0．841（95％CI：0．726—0．955）,最大约登指数（0．562）对应SUVmax为4．25,其诊断灵敏度、特异性及准确性分别为72．2％（13／18）、84．0％（42／50）和80．9％（55／68）。结论可依据^18F—FDGPET／CTSUVmax对甲状腺结节良恶性进行判断,但同机CT影像特征价值有限。     

CT未检出原发灶的胸腔积液或肺不张患者18F-FDG显像结果分析

目的评价^18F-脱氧葡萄糖(FDG)符合线路显像(DHTC)寻找CT未能发现原发灶的胸腔积液或肺不张患者的肺癌原发灶，及其对肺癌伴有胸腔积液的患者胸腔积液良恶性鉴别诊断的价值。方法110例CT未发现肺部原发病灶但疑为肺癌及肺癌转移可能的胸腔积液或肺不张患者(其中胸腔积液8．4例，肺不张26例)，进行^18F-FDG DHTC检查。结果38例患者最终确诊为肺癌，其中伴有胸腔积液30例，伴有肺不张8例；另72例为肺部良性病变。^18F-FDG DHTC对CT未能找到原发灶的胸腔积液或肺不张患者肺癌诊断的灵敏度、特异性和准确性分别为97％、78％和85％。30例伴有胸腔积液的肺癌患者中，21例确诊为恶性胸腔积液。^18F-FDG DHTC对良恶性胸腔积液鉴别诊断的灵敏度为86％，特异性为8／9例。结论^18F-FDG DHTC是寻找胸腔积液或肺不张患者肺癌原发灶灵敏可靠的方法，并对良恶性胸腔积液的鉴别诊断有一定的临床价值。     

18F-FDGPET／CT诊断腹膜转移瘤的临床价值

目的评价18F-脱氧葡萄糖（FDG）PET／CT在腹膜转移瘤诊断中的临床价值。方法回顾性分析22例有原发恶性肿瘤手术史或不明原因腹腔积液而临床高度怀疑腹膜转移的患者资料。所有病例均行18F—FDGPET／CT检查,经病理检查或临床随访证实。结果22例中,有18例18F-FDGPET／CT诊断阳性,其中16例确诊腹膜转移,2例确诊为腹腔结核;4例PET／CT诊断阴性,其中3例确诊为腹膜炎性病变,1例确诊为腹膜转移瘤。18F—FDGPET／CT诊断腹膜转移瘤的灵敏度为94．1％（16／17）,特异性为3／5,阳性预测值为88．9％（16／18）,阴性预测值为3／4,准确性为86．4％（18／22）。结论在诊断腹膜转移瘤方面,18F—FDGPET／CT是一种可靠的、准确性较高的无创性检查,有重要的临床应用价值。     

负荷双时相18F-FDGPET／CT心肌显像诊断心肌缺血的实验研究

目的探讨负荷双时相（早期相＋延迟相）18F—FDGPET／CT心肌显像诊断心肌缺血的价值。方法选取中华小型猪10头制作心肌缺血模型,分别进行如下3组显像：造模前负荷双时相显像（8头）、造模后静息双时相显像（8头）和造模后负荷双时相显像（10头）。（造模前、后）负荷双时相显像：实验猪显像前禁食12h以上,全程麻醉,按体质量静脉注射”F—FDG5MBq／kg,静息50win后连续采集PET图像10wi-（早期相）;后经静脉持续泵人多巴酚丁胺,50min后再次采集PET图像10win（延迟相）。造模后静息双时相显像：除未泵人多巴酚丁胺外,余步骤同负荷双时相显像。对显像结果进行分析：（1）定性分析。观察各显像组双时相显像左室心肌18F—FDG摄取情况,分为1～4级。1或2级均判定为无心肌缺血,3或4级中如果存在前壁或间壁局灶性摄取则判定为心肌缺血。利用配对疋。检验分别比较3组显像中早期相与延迟相发生缺血的心肌比例。（2）定量分析。测定左心室前壁和下壁SUVmean。并计算其比值K1利用Wilcoxon秩和检验分析K1（早期相）、K2（延迟相）间的差异。结果造模后CAG显示全部猪LAD冠脉狭窄程度均大于70％。造模前负荷双时相显像：早期相及延迟相中全部8头均为1或2级,判定为心肌缺血的比例均为0;K1、K2间差异无统计学意义（1．08±0．10和1．11±0．10;Z=-1．48,P〉0．05）。造模后静息双时相显像：早期相与延迟相中心肌缺血比例分别为1／8和3／8,差异无统计学意义（x2=0．50,P〉0．05）;K1、K2间差异也无统计学意义（1．47±0．28和1．28±0．40;Z=-2．02,P〉0．05）。造模后负荷双时相显像：早期相与延迟相的心肌缺血比例分别为4／10和10／10,差异有统计学意义（x2=4．17,P〈0．05）;K1、K2间差异也有统计学意义（1．55±0．32和1．86±0．39;Z=-2．49,P?     

~(18)F-FDGPET/CT棕色脂肪摄取的影像学分析

目的:分析18F-FDG PET/CT检查中棕色脂肪组织(BAT)摄取的规律和特点,以避免不必要的误诊。方法:回顾性分析行PET/CT全身检查的2350例受检者的图像。结果:34例(1.44%)有不同程度BAT摄取,其中恶性肿瘤患者9例(甲状腺癌术后4例)。BAT显影主要在寒冷季节出现,女性比例(2.57%)高于男性(0.76%);特征性表现为对称性分布于肩颈部、锁骨上区、脊柱两旁、纵隔、肾上腺及肾周区的高摄取灶,SUVmax为7.18±4.27。BAT显影部位的数目与摄取的SUVmax呈正相关(r=0.78,P<0.05);5例检查者进行了延迟扫描,延迟后BAT分布、形态无明显变化,SUVmax显著升高(P<0.05)。4例甲状腺癌术后复查病例的BAT摄取不同程度影响了对区域淋巴结的观察。结论:BAT摄取的分布及影像表现具有一定的特征性,显影部位越多,SUVmax越大,延迟扫描后SUVmax显著升高,容易干扰对显影区域病灶的观察。     

18F-FDGPET／CT对继发性周围神经恶性病变的诊断价值

目的 总结继发性周围神经恶性病变18F-脱氧葡萄糖（FDG）PET／CT影像特征,探讨18F—FDGPET／CT在继发性周围神经恶性病变中的应用价值。方法回顾性分析经病理检查或长期随访证实的8例周围神经恶性病变患者18F-FDGPET／CT影像学资料,比较继发性周围神经恶性病变与健侧周围神经PET／CT表现的异同,利用SPSS10．0软件对受累的周围神经及健侧对应部位周围神经的最大标准摄取值（SUVmax）行配对t检验。结果8例继发性周围神经恶性病变患者共发现病灶12个,PET示病灶均沿神经束或椎间孔走行,且表现为束条形、根块状或结节状FDG代谢异常增高,SUVmax为6．86±3．87,同机CT病灶表现为沿神经束或神经根管走行之束条形、根块状或结节状软组织密度影,病灶均与周围软组织及邻近脂肪间隙分界不清;健侧对应部位周围神经在18F—FDGPET及同机CT上均未见明确显影,其SUVmax为1．10±0．46;继发性周围神经恶性病变与健侧周围神经SUVmax比较,差异有统计学意义（t=9．231,P〈0．001）。结论18F—FDGPET／CT可以准确反映肿瘤对周围神经的侵犯及转移,显示病灶的大小、形态、分布及肿瘤活性,对继发性周围神经恶性病变的诊断具有重要价值。     

18F-FDGPET／CT联合腹部增强CT对诊断胰腺癌及评估肿瘤可切除性的临床应用

目的评价18F-脱氧葡萄糖（FDG）PET／CT联合腹部增强CT对诊断胰腺癌、鉴别诊断胰腺良恶性病变以及评估肿瘤可切除性的临床应用价值。方法回顾性分析行18F—FDGPET／CT和腹部增强CT检查并经病理检查或临床等方法证实的48例原发性胰腺病变患者的资料,其中胰腺癌34例,胰腺良性病变14例。对胰腺癌和胰腺良性病变患者最大标准摄取值（SUVmax）进行t检验;比较分析单独PET、腹部增强CT、PET／CT、PET／CT联合腹部增强CT4种方法的图像特征和诊断价值,对灵敏度和准确性进行x2检验,对特异性进行Fisher确切概率法检验。结果34例胰腺癌患者与14例胰腺良性病变患者的SUVmax（5．91±2．90和2．24±1．13）差异有统计学意义（t=4．56,P〈0．01）。PET／CT联合腹部增强CT诊断胰腺癌的灵敏度、特异性和准确性分别为97．1％（33／34）、92．9％（13／14）和95．8％（46／48）,与单纯PET的88．2％（30／34）、64．3％（9／14）和81．2％（39／48）相比,x2=0．863和P=0．352,P=0．038,X2=5．031和P=0．024;与腹部增强CT的76．5％（26／34）、71．4％（10／14）和75．0％（36／48）相比,x2=6．274和P=0．012,P=0．042,x2=8．362和P=0．003;与PET／CT的88．2％（30／34）、78．6％（11／14）和85．4％（41／48）相比,x2=0．863和P=0．352,P=0．048,x2=3．928和P=0．047。PET／CT全身显像几乎发现了全部转移灶,使14例胰腺癌患者避免了不必要的外科手术;PET／CT可对单独PET显像诊断的胰腺癌患者胰腺外假阳性病灶进行正确诊断,使1例胰头癌患者分期下调,进行了外科手术。腹部增强CT通过多期显像,可以准确判断肿瘤对胰腺周围主要血管的侵犯程度,腹部增强CT按血管受侵程度评估肿瘤可切除性的准确性为83．3％（15／18）,不可切除的准确性为9／9。结论PET／CT联合增强CT对于诊断胰腺癌、鉴别胰腺良恶性病变及评估肿瘤的可切除性准确性有一定临床价值。     

18F-FDG PET/CT显像诊断心包恶性病变的价值

目的 评价18F-脱氧葡萄糖（FDG）PET/CT对心包恶性病变的诊断价值.方法 对23例心包积液患者进行18F-FDG PET/CT显像,并采用两独立样本非参数检验分析良恶性病灶最大标准摄取值（SUVmax）差异有无统计学意义.结果 经病理检查证实恶性心包积液14例,良性心包积液9例.1例PET/CT假阴性,2例PET/CT假阳性.18F-FDG PET/CT鉴别诊断良恶性心包积液的灵敏度、特异性、准确性、阳性预测值、阴性预测值分别为92.9%（13/14）、7/9、87.0%（20/23）、86.7%（13/15）和7/8.良、恶性病变的SUVmax中位值分别为2.2和6.0,两者间比较差异有统计学意义（z=-3.279,P=0.001）.结论 18F-FDG PET/CT是评价心包恶性病变较好的无创性手段,对良恶性心包积液的诊断与鉴别诊断有一定临床价值.     

Hibernoma: Intense Uptake on F18-FDG PET/CT

Hibernoma is a rare benign but metabolically active tumor of brown fat origin, that can have cross-sectional imaging characteristics similar to those of other fat-containing tumors, such as lipomas and liposarcomas, and its presence can lead to false-positive interpretation by exhibiting increased F18-fluorodeoxyglucose (F18-FDG) activity. A 46-year-old woman was diagnosed with dermatofibrosarcoma protuberans underwent F18-FDG positron emission tomography/computed tomography (PET/CT) for detecting recurrence after excision. F18-FDG PET/CT showed incidental intense uptake in the back in addition to increased F18-FDG uptake at the previous lesion site. To our knowledge, this is the first case report of intense F18-FDG uptake in hibernoma in Korea.     

18F-FDG PET/CT在肺部占位性病变诊断中的价值

目的:探讨18F-FDG PET/CT在诊断肺部占位性病变中的价值.方法:对100例肺部占位性病变进行回顾性分析,比较PET/CT与PET及CT的诊断效度、不同大小肿瘤的SUV、不同病理类型肺癌的SUV.结果:①PET/CT的灵敏度、阴性预测值、准确率优于CT(P<0.01),PET/CT的特异度优于PET(P<0.05).②依据肿瘤大小分为<3cm、3～5cm、>5cm组,应用单向方差分析对比不同组间SUV,3组间SUV均有差异,P<0.01.各组间SUV两两比较,发现小于3cm组SUV<3～5cm组SUV<5cm以上组SUV.③鳞癌组与腺癌组SUV无显著差异(P=0.821,P>0.05).结论:18F-FDG PET/CT在诊断肺部占位性病变中将PET代谢学特征密切结合CT的形态学表现,可大大提高各项诊断效率,达到优势互补的目的.     

Up-front F18-FDG PET/CT in suspected salivary gland carcinoma

Annals of Nuclear Medicine - To investigate whether a 18F-FDG PET/CT (PET/CT)-based diagnostic strategy adds decisive new information compared to conventional imaging in the evaluation of salivary...     

AIDS并发播散性结核~(F-18)FDG PET/CT表现

目的：探讨F-18FDG PET/CT在AIDS合并播散性结核（DTB）复杂感染中的应用价值。方法：回顾性分析1例AIDS合并全身播散性结核患者的PET/CT影像学表现。结果：F-18FDG PET/CT在头颅、胸部、腹部、盆腔及骨骼系统发现多处高、低放射性摄取病灶。结论：F-18FDG PET/CT可以对AIDS并发播散性结核快速进行全身评估。     

胸腔积液量的多层螺旋CT定量研究

目的探讨多层螺旋CT轴位测量数据预测胸腔积液量的准确性方法。方法回顾性分析129例胸腔积液患者的胸部CT扫描数据,用VR胸水体积测量其胸腔积液的量;在轴位图像上分别于膈顶、隆突下及主动脉弓下3个平面测量胸腔积液的厚度并分别用A、B、C值代表;将体积与各个平面胸腔积液的厚度分别进行1次回归(线性回归)、2次回归和3次回归分析,并从中挑选出模型和系数显著且解释度最大的回归方程式。结果所有回归模型均具有统计学意义(P<0.01)。膈顶平面预测胸腔积液方程式为:胸腔积液量(ml)=22.804×A-0.061×A2-106.399,R2=0.898;隆突下平面预测胸腔积液方程式为:胸腔积液量(ml)=37.841×B-0.204×B2-235.935,R2=0.924;主动脉弓下平面胸腔积液方程式为:胸腔积液量(ml)=31.825×C-0.140×C2-17.278,R2=0.846。结论胸腔积液的厚度均能预测胸腔积液的量,尤其是隆突下平面的径线能更准确地反映积液的量。     

宝石能谱CT在结核性胸腔积液和癌性胸腔积液鉴别诊断中的应用

目的 探讨宝石能谱CT在结核性胸腔积液和癌性胸腔积液鉴别诊断中的应用价值.资料与方法 经临床确诊的8例结核性胸腔积液和8例癌性胸腔积液患者行宝石能谱扫描,分别测定结核性胸腔积液和癌性胸腔积液的混合能量CT值、能谱曲线斜率、脂基密度值、血基密度值及有效原子序数值,并进行比较.结果 结核性胸腔积液和癌性胸腔积液的能谱曲线互相交叉、重叠,无特定的分布规律;结核性胸腔积液和癌性胸腔积液的混合能量CT值、能谱曲线斜率、脂基密度值、血基密度值及有效原子序数比较,差异均无统计学意义(t=-0.891、0.69、0.085、0.581、0.201,P＞0.05).结论 宝石能谱CT的能谱成像中混合能量CT值、能谱曲线斜率、脂基密度值、血基密度值及有效原子序数尚不能用于鉴别诊断结核性胸腔积液和癌性胸腔积液.     

Dual-time-point [18F]-FDG PET/CT in the diagnostic evaluation of suspicious breast lesions

Purpose

The authors sought to evaluate whether the reacquisition of images 3 h after administration of radiotracer improves the sensitivity of fluorine-18 fluorodeoxyglucose positron emission tomography computed tomography ([¹⁸F]-FDG PET/CT) in patients with suspicious breast lesions.

Materials and methods

Forty-eight patients with 59 breast lesions underwent an [¹⁸F]-FDG PET/CT study in the prone position with a dual-time-point acquisition performed in the early phase 1 h after FDG administration (PET-1) and in the delayed phase 3 h after FDG administration (PET-2). Both examinations were evaluated qualitatively and semiquantitatively with calculation of the mean percentage variation of the standard uptake values (Δ% SUV_max) between PET-1 and PET-2. All lesions with an SUV_max ≥2.5 at PET-1 or a reduction in SUV between PET-1 and PET-2 were considered benign. The definitive histopathological diagnosis was available for all patients included in the study.

Results

The dual-time-point acquisition of [¹⁸F]-FDG PET/CT displayed an accuracy of 85% for lesions with an SUV_max ≥2.5 and/or positive Δ% SUV_max, with sensitivity and specificity values of 81% and 100% compared with 69%, 63% (both p<0.001) and 100% (p=n.s.), respectively, for the single-time-point acquisition. Malignant lesions showed an increase in FDG uptake between PET-1 and PET-2, with a Δ% SUV_max of 10±7 (p<0.04). In contrast, benign lesions showed a decrease in SUV between PET-1 and PET-2, with aΔ% SUV_max of ?21±7 (p<0.001).

Conclusions

The delayed repeat acquisition of PET images improves the accuracy of [¹⁸F]-FDG PET/CT in patients with suspicious breast lesions with respect to the single-time-point acquisition. In addition, malignant breast lesions displayed an increase in FDG uptake over time, whereas benign lesions showed a reduction. These variations in FDG uptake between PET-1 and PET-2 are a reliable parameter that can be used for differentiating between benign and malignant breast lesions.     

18F-FDG hPET/CT显像对肿瘤的诊断价值

目的探讨18F-脱氧葡萄糖(FDG)hPET/CT显像在肿瘤诊断中的价值.方法对27例经病理组织学或临床诊断的恶性肿瘤患者(包括15例原发性肿瘤、12例转移性肿瘤)和33例良性病变(18例甲状腺腺瘤、7例桥本氏甲状腺炎和8例肺部良性肿瘤)进行18F-FDG hPET/CT显像,勾画病灶感兴趣区(ROI),在对侧相应位置复制相同大小ROI,测定计数得靶/非靶比值(T/N),并对良恶性病变的T/N比值进行比较.结果27例恶性肿瘤患者中(T/N比值为10.47±8.22),22例FDG显像示单个或多处呈不同程度异常浓聚灶,5例未见异常FDG浓聚灶.33例良性病变中(T/N比值4.51±12.14),10例见病变处FDG异常摄取增高.以T/N比值≥2.0作为判断良恶性病变的标准,18F-FDG hPET/CT诊断的灵敏度为81.48%,特异性为69.70%,准确性为75.00%,阳性预测值为68.75%,阴性预测值为82.14%.结论18F-FDG hPET/CT显像对肿瘤良恶性鉴别、解剖定位的判断、分期及疗效观察具有一定的优势.     

Differential Diagnosis of Patients with Inconclusive Parkinsonian Features Using [18F]FP-CIT PET/CT

Purpose

It is often difficult to differentiate parkinsonism, especially when patients show uncertain parkinsonian features. We investigated the usefulness of dopamine transporter (DAT) imaging for the differential diagnosis of inconclusive parkinsonism using [¹⁸F]FP-CIT PET.

Methods

Twenty-four patients with inconclusive parkinsonian features at initial clinical evaluation and nine healthy controls were studied. Patients consisted of three subgroups: nine patients whose diagnoses were unclear concerning whether they had idiopathic Parkinson’s disease or drug-induced parkinsonism (‘PD/DIP’), nine patients who fulfilled neither the diagnostic criteria of PD nor of essential tremor (‘PD/ET’), and six patients who were alleged to have either PD or atypical parkinsonian syndrome (‘PD/APS’). Brain PET images were obtained 120 min after injection of 185 MBq [¹⁸F]FP-CIT. Imaging results were quantified and compared with follow-up clinical diagnoses.

Results

Overall, 11 of 24 patients demonstrated abnormally decreased DAT availability on the PET scans, whereas 13 were normal. PET results could diagnose PD/DIP and PD/ET patients as having PD in six patients, DIP in seven, and ET in five; however, the diagnoses of all six PD/APS patients remained inconclusive. Among 15 patients who obtained a final follow-up diagnosis, the image-based diagnosis was congruent with the follow-up diagnosis in 11 patients. Four unsolved cases had normal DAT availability, but clinically progressed to PD during the follow-up period.

Conclusion

[¹⁸F]FP-CIT PET imaging is useful in the differential diagnosis of patients with inconclusive parkinsonian features, except in patients who show atypical features or who eventually progress to PD.     

The Role and Pitfall of F18-FDG PET/CT in Surveillance of High Grade Pulmonary Lymphomatoid Granulomatosis

Lymphomatoid granulomatosis (LYG) is an uncommon angiocentric and angiodestructive T-cell rich, Epstein-Barr virus (EBV) positive B-cell multisystem lymphoproliferative disorder, predominately affecting the lungs. Since both clinical presentation and radiographic imaging findings, including X-ray and computed tomographic (CT), are nonspecific, the ultimate diagnosis of LYG relies on lung tissue sample diagnosis with its WHO grading based on the degree of cytologic atypia, necrosis and density of EBV positive B-cells. In addition, its histopathologic grading is correlated with clinical manifestation with high grade LYG mimicking aggressive B-cell lymphoma. Discordant grading between pulmonary and cutaneous LYG lesion has have been observed and might be a potential diagnostic and prognostic pitfall. F18-FDG PET/CT has been used to monitor disease progression and treatment response. In this study, we reviewed and summarized the clinical role of F18-FDG PET/CT in the surveillance of high grade pulmonary LYG, and examined its limitations in grading multisystem LYG.