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1.
摘要目的回顾性分析18F-脱氧葡萄糖正电子发射/计算机体层成像(FDG-PET/CT)和CT对部分实性的T1期非小细胞肺癌(NSCLC)淋巴结分期的诊断准确性和影像学表现。方法对2005年1月—2011年5月期间的160例经病理证实为部分实性的T1期NSCLC进行淋巴结分期。采用FDG-PET/CT和CT评价淋巴结分期诊断的准确性。采用最大标准摄取值(SUVmax)和原发肿瘤的CT表现评估淋巴结转移的特征。结果160例病人中9例(5.6%)有淋巴结转移。 相似文献
2.
Dual-time-point FDG-PET for evaluation of lymph node metastasis in patients with non-small-cell lung cancer 总被引:3,自引:1,他引:2
Nishiyama Y Yamamoto Y Kimura N Ishikawa S Sasakawa Y Ohkawa M 《Annals of nuclear medicine》2008,22(4):245-250
OBJECTIVE: The objective of this study was to retrospectively evaluate whether delayed additional F-18-fluorodeoxyglucose positron emission tomography (FDG-PET) imaging can improve the certainty of this modality in evaluating lymph node metastasis in patients with non-small-cell lung cancer (NSCLC). METHODS: Eighty-three patients with NSCLC were examined. FDG-PET imaging (whole body) was performed at 1-h (early) post-FDG injection and repeated 2 h (delayed) after injection only in the thoracic area. The PET images were evaluated qualitatively for regions of focally increased metabolism. If a lymph node was visible on the PET image, the semi-quantitative analysis using the standardized uptake value (SUV) was determined for both early and delayed images (SUV(early) and SUV(delayed), respectively). Retention index (RI) was then calculated on the basis of the following equation: (SUV(delayed) - SUV(early)) x 100/SUV(early). The RI value of more than 0% was taken to be the PET criterion for malignancy. RESULTS: For early and delayed PET, sensitivities for lymph node staging were 54% and 62%, respectively, specificities were 89% for both, and accuracies were 78% and 81%, respectively. The results of combined delayed PET and RI showed a sensitivity of 62%, specificity of 96%, and accuracy of 86%. CONCLUSIONS: Dual-time-point FDG-PET (combined delayed PET and RI) showed better (although not statistically significant) specificity, positive predictive value, and accuracy than early or delayed PET alone for lymph node staging in NSCLC. 相似文献
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Accuracy of integrated FDG-PET/contrast-enhanced CT in detecting pelvic and paraaortic lymph node metastasis in patients with uterine cancer 总被引:1,自引:0,他引:1
Kazuhiro Kitajima Koji Murakami Erena Yamasaki Yasushi Kaji Kazuro Sugimura 《European radiology》2009,19(6):1529-1536
The purpose is to evaluate the accuracy of integrated 18F-fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography ((CT) with intravenous contrast medium in
detecting pelvic and paraaortic lymph node metastasis in patients with uterine cancer, with surgical and histopathological
findings used as the reference standard. Forty-five patients with endometrial or uterine cervical cancer underwent radical
hysterectomy, including pelvic lymphadenectomy with or without paraaortic lymphadenectomy, after PET/CT. PET/CT findings were
interpreted by two experienced radiologists in consensus. The criterion for malignancy on PET/CT images was increased tracer
uptake by the lymph node, independent of node size. The overall node-based sensitivity, specificity, PPV, NPV and accuracy
of PET/CT for detecting nodal metastases were 51.1% (23/45), 99.8% (1,927/1,931), 85.2% (23/27), 98.9% (1,927/1,949) and 98.7%
(1,950/1,976), respectively. The sensitivity for detecting metastatic lesions 4 mm or less in short-axis diameter was 12.5%
(2/16), that for between 5 and 9 mm was 66.7% (16/24), and that for 10 mm or larger was 100.0% (5/5). The overall patient-based
sensitivity, specificity, positive predictive value ((PPV), negative predictive value (NPV), and accuracy were 50% (6/12),
90.9% (30/33), 66.7% (6/9), 83.3% (30/36) and 80.0% (36/45), respectively. Integrated FDG-PET/contrast-enhanced CT is superior
to conventional imaging, but only moderately sensitive in predicting lymph node metastasis preoperatively in patients with
uterine cancer. 相似文献
4.
Dimitris J. Apostolopoulos Efstratios N. Koletsis Trifon Spyridonidis Anna Paschali Nikolaos Papandrianos Eleni Stamou Pavlos J. Vassilakos Dimitrios Dougenis 《Annals of nuclear medicine》2014,28(5):463-471
Objective
To investigate the potential role of Tc-99m depreotide (Tc-DEPR) in the preoperative lymph node (N) staging of non-small-cell lung cancer (NSCLC).Methods
Sixty-one patients with NSCLC at the potentially operable stage were enrolled and underwent scintigraphy before surgery (n = 56) or mediastinoscopy (n = 5). Imaging was performed with a hybrid single photon emission computed tomography/computed tomography (SPECT/CT) system. Depreotide uptake in N stations was evaluated visually and semi-quantitatively and compared to histology. Quantification was carried out in attenuation-corrected SPECT slices. Different sites of normal uptake were used as a reference for comparison with lesional uptake. Receiver operating characteristic analysis was employed to identify the most preferable reference area and the cut-off best discriminating disease-free from disease-involved lymph nodes.Results
With reference to 53 Ν1 hilar and 147 Ν2/Ν3 sampled stations, sensitivity of scintigraphy by visual interpretation was 100 and 94 %, specificity 43 and 59 % and accuracy 55 and 67 %, respectively. No patient was down-staged, but 52 % were incorrectly up-staged and 44 % were misclassified as inoperable. Compared to scintigraphy, preoperative contrast-enhanced diagnostic CT demonstrated lower sensitivity (36 % for hilar and 73 % for N2/N3 stations), higher specificity (79 and 75 %) and similar accuracy (70 and 75 %). Regarding the ultimate N-stage and the prediction of surgical disease, diagnostic CT was wrong in 51 and 34 % of cases. Dichotomy of quantitative scintigraphic data by the use of certain N-to-spine ratio cut-offs resulted in a significant increase of specificity (76 % for hilar and 89 % for N2/N3 stations), while sensitivity remained high (82 % in both circumstances) and accuracy for Ν2/Ν3 stations was substantially improved (88 %). By this quantitative approach, misclassifications as to the N-stage and patient operability (25 and 16 %) were considerably less than that of visual Tc-DEPR and diagnostic CT interpretations.Conclusion
Tc-99m depreotide SPECT/CT seems to have a role in the N-staging of NSCLC, mainly because of its high sensitivity and negative predictive value. Quantification of uptake can improve specificity, at a low cost of sensitivity. If F-18 fluoro-deoxyglucose positron emission tomography is not available, this method may be used as a surrogate to conventional staging modalities. 相似文献5.
Lee HY Chung JK Jeong JM Lee DS Kim DG Jung HW Lee MC 《Annals of nuclear medicine》2008,22(4):281-286
OBJECTIVE: We compared the F-18 fluorodeoxyglucose positron emission tomography (FDG-PET) findings of brain metastasis between patients with non-small-cell lung cancer (NSCLC) and small cell lung cancer (SCLC). METHODS: A whole-body FDG and a brain PET were performed in 48 patients (31 men, 17 women; 57 +/- 9 years, 42 NSCLC, 6 SCLC), who had brain metastasis on magnetic resonance (MR). All primary lung lesions were detected by FDG-PET and confirmed pathologically. We analyzed the PET findings, lesion sizes, and the pathological result of primary lung cancer. RESULTS: Of the 48 patients, 31 (64.6%) showed hypermetabolic lesions on FDG-PET of the brain image, and 14 (29.2%) showed hypometabolic lesions. Three patients (6.3%) had both hypermetabolic and hypometabolic lesions. On the lesion-based analysis, 74 lesions (67.3%) showed hypermetabolism on FDG-PET, and 36 lesions (32.7%) showed hypometabolism. All primary lung lesions were hypermetabolic on FDG-PET. When the FDG findings of metastatic brain lesions were analyzed with the pathological types of primary lung cancer, NSCLC was more frequently associated with hypermetabolic metastatic brain lesions than SCLC (80% and 26.7%, respectively, P < 0.01). On comparing the sizes of metastatic lesions between SCLC (1.3 +/- 1.2 cm) and NSCLC (1.8 +/- 1.2 cm), lesions of <1 cm were more frequent in SCLC than in NSCLC (P = 0.012). But no significant relationship was found between the size and PET finding of metastatic lesion (P = 0.412). CONCLUSIONS: Even when the primary lesion of lung cancer showed hypermetabolism in FDG-PET, FDG accumulation in metastatic brain lesions was variable. One-third of brain metastases from lung cancer showed hypometabolism. NSCLC was more frequently associated with hypermetabolic metastatic brain lesions than SCLC. The PET findings of brain lesions were affected not only by the size of lesion but also by its biological characteristics. 相似文献
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Kubota K Murakami K Inoue T Itoh H Saga T Shiomi S Hatazawa J 《Annals of nuclear medicine》2011,25(10):777-786
Objective
This study was a controlled multicenter clinical study to verify the diagnostic effects of additional FDG-PET to contrast-enhanced CT for mediastinal lymph node metastasis in patients with operable non-small cell lung cancer (NSCLC). 相似文献8.
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Atsushi Nambu Satoshi Kato Yoko Sato Hideto Okuwaki Keiichi Nishikawa Akitoshi Saito Keiko Matsumoto Tomoaki Ichikawa Tsutomu Araki 《Annals of nuclear medicine》2009,23(3):269-275
Purpose To evaluate the relationship between SUVmax of primary lung cancers on FDG-PET and lymph node metastasis.
Method and materials The subjects were a total of consecutive 66 patients with lung cancer who were examined by FDG-PET and subsequently underwent
surgery between October 2004 and January 2008. There were 41 males and 25 females, ranging in age from 45 to 83 years with
an average of 68 years. The pathological subtypes of the lung cancers consisted of 49 adenocarcinomas, 11 squamous cell carcinomas,
2 adenosquamous carcinoma, 1 large cell carcinoma, 1 small cell carcinoma, 1 pleomorphic carcinoma and 1 mucoepidermoid carcinoma.
We statistically compared (1) the mean SUVmax of lung cancer between the groups with and without lymph node metastasis (2)
the frequency of lymph node metastasis between higher and lower SUVmax of lung cancer groups that were classified by using
the median SUVmax of lung cancer, and (3) evaluated the relationship between the SUVmax of lung cancer and frequency of lymph
node metastases, and (4) correlations between the SUVmax of lung cancer and number of the metastatic lymph nodes and pathological
n stages.
Results The difference in the average of the SUVmax of lung cancer between the cases with and without lymph node metastases was statistically
significant (p = 0.00513). Lymph node metastasis was more frequently seen in the higher SUVmax of lung cancer group (17/33, 52%) than in
the lower SUVmax of lung cancer group (7/33, 21%) with a statistically significant difference. There was no lymph node metastasis
in lung cancers with an SUVmax of lung cancer less than 2.5, and lung cancers with an SUVmax of lung cancer more than 12 had
a 70% frequency of lymph node metastasis. There were moderate correlations between SUVmax of lung cancer, and the number of
the metastatic lymph nodes (γ = 0.404, p = 0.001) and pathological n stage (γ = 0.411, p = 0.001).
Conclusions The likelihood of lymph node metastasis increases with an increase of the SUV of a primary lung cancer. 相似文献
10.
Hidenori Suzuki Katsuhiko Kato Masami Nishio Tsuneo Tamaki Yasushi Fujimoto Mariko Hiramatsu Nobuhiro Hanai Takeshi Kodaira Yoshiyuki Itoh Shinji Naganawa Michihiko Sone Yasuhisa Hasegawa 《Annals of nuclear medicine》2017,31(7):514-520
Objectives
We investigated a possible correlation between the maximum standardized uptake value (SUVmax), which is assessed by pretreatment 18F-fluorodeoxyglucose positron emission tomography with computed tomography, and the overall survival (OS) in patients with hypopharyngeal squamous cell carcinoma from two institutions on long-term follow-up, and examined whether SUVmax is correlated with several survival outcomes, including lung metastasis-free survival.Methods
A total of 81 patients were enrolled. The survival rate was calculated by the Kaplan–Meier method. Both univariate and multivariate survival analyses were assessed by a Cox proportional hazards model.Results
SUVmax ≥15.2 in institution A (p = 0.0306) or SUVmax ≥8 in institution B (p = 0.0132) was significantly predictor of a lower OS. We disaggregated the data by high SUVmax (SUVmax ≥15.2 from institution A and SUVmax ≥8 from institution B) and low SUVmax (SUVmax <15.2 from institution A and SUVmax <8 from institution B). Patients with a high SUVmax exhibited a significantly lower OS in both univariate (p = 0.001) and multivariate (p = 0.0046) analyses for adjusted for the clinical stage and treatment group. The patients with a high SUVmax exhibited significantly shorter disease-specific (p = 0.0068), distant metastasis-free (p = 0.0428), and lung metastasis-free (p = 0.0328) survivals.Conclusions
High SUVmax was significantly correlated with a lower OS, disease-specific survival, distant metastasis-free survival, and lung metastasis-free survival in a multi-institutional retrospective study.11.
磨玻璃结节(GGN)是指在薄层肺窗CT影像上观察到局部密度增加,但不遮盖肺内血管和支气管的模糊影。肺癌筛查中可以检出影像表现为GGN且病理结果为肺腺癌的病人。影像表现为GGN肺腺癌病理亚型不尽相同,早期诊断和准确鉴别对病人的治疗及改善预后具有重要的临床价值。就GGN的CT、MRI及PET/CT影像特征在鉴别表现为GGN的肺腺癌病理亚型方面的研究进展予以综述。 相似文献
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螺旋CT增强扫描对食管癌淋巴结转移的诊断价值 总被引:3,自引:0,他引:3
目的探讨多层螺旋CT(MSCT)强化扫描评价食管癌淋巴结转移的价值。方法35例食管癌患者行MSCT增强扫描(安射力(320mg/100ml)90ml,注射速度2.5ml/s,延迟55s扫描),扫描范围从舌骨水平至肝下缘,将原始数据重建为层厚1.25mm,层间隔1mm,应用多平面重建(MPR)进行图像后处理。CT扫描以气管食管沟淋巴结短径大于5mm、其余区域淋巴结及腹腔淋巴结短径大于10mm为转移标准统计。淋巴结分组按照Korst提出的食管癌淋巴结简化分组标准进行分组。所有患者均接受手术治疗,切除组织均经病理证实。以病理结果为标准,分析MSCT在诊断食管癌淋巴结转移方面的灵敏度、特异度、准确率。结果35例食管癌患者中鳞癌33例,腺癌1例,鳞腺癌1例,手术共清除淋巴结318枚,病理证实66枚有转移。MSCT共诊断淋巴结转移74枚,正确诊断56枚转移淋巴结,其灵敏度、特异度、准确率分别为84.8%、92.9%、91.2%。结论MSCT强化扫描发现食管癌淋巴结转移有较高的准确性和特异性,可为临床术前确定治疗方案提供重要的帮助。 相似文献
15.
G Juliani G Gandini T Avataneo G Cortese M Mancuso C Casadio G Maggi 《La Radiologia medica》1989,78(3):172-177
The CT, surgical and histological findings were examined of 350 lymph nodes in a perspective study of 50 patients affected with lung cancer. CT accuracy could thus be evaluated in assessing the size of hilar and mediastinal lymph nodes; the incidence of histologically-proven metastases in nodes more/less than 10 cm in diameter could also be determined, together with CT diagnostic accuracy for nodal metastases. Finally, CT capabilities were also evaluated in distinguishing N0 from N1-N2 patients. CT proved to have high negative predictive value and low positive predictive value, which caused the authors to raise the normal threshold value of CT evaluation of the greatest diameter for hilo-mediastinal nodes from 10 to 20 mm. 相似文献
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Objective
F-18-FDG-avid lymph node (LN) metastasis may preferentially occur along the lymphatic drainage pathway (LDP) from the tumor-bearing lobe in patients with non-small cell lung cancer (NSCLC) on FDG PET/CT. This study evaluated whether the identification of metastatic LNs according to LDP-based visual image interpretation can improve LN staging on FDG PET/CT in these patients.Methods
FDG PET/CT study was performed in 265 patients with NSCLC. The presence and LN station of metastatic LNs were determined by surgery or the clinical course. In the LDP-based interpretation, FDG-avid LNs, which were located along the preferential LDP from each tumor-bearing lobe and visually more intense in FDG uptake compared with the remaining LNs straying away from the preferential LDP, were diagnosed as metastatic. The result was compared with the quantitative method using a cutoff value of 2.5 for the maximum standardized uptake value.Results
Of the total 1031 mediastinal and hilar LN stations with FDG-avid LNs in 265 patients, 179 stations in 66 patients were metastatic and the remaining 852 were benign. All the metastatic LN stations except for 2 stations showing skip metastasis were located along the main preferential LDP or another preferential LDP via a direct anatomic pathway from each tumor-bearing lung lobe. The specificity, accuracy, and PPV for identifying metastatic LN stations by LDP-based interpretation were 97.9, 95.7 and 89.5 %, respectively, which were significantly greater compared with those of 92.7, 90.8 and 70.3 % by the SUV-based method (P < 0.001).Conclusions
The present study shows that FDG-avid LN metastasis preferentially occurs along the LDP from the tumor-bearing lobe in NSCLC patients. LDP-based visual image interpretation on FDG PET/CT can improve LN staging in these patients.19.
M Shozushima M Suzuki T Nakasima Y Yanagisawa K Sakamaki Y Takeda 《Dento maxillo facial radiology》1990,19(4):165-170
The role of ultrasonic (US) examination in the detection of cervical lymph node metastasis from head and neck cancer has been evaluated. The subjects were 57 patients with carcinoma of the oral cavity, maxillary sinus or oropharynx who underwent radical neck dissection. The preoperative US and postoperative histopathological findings were compared in 181 lymph nodes (LNs) of 5 mm or more in diameter. LNs were evaluated by US with reference to their size, shape, boundary and internal echoes. The histologically positive rate was higher for larger LNs on US scans: 96% (44/46) of LNs of 15 mm or more were positive. On the other hand, 95% (18/19) of the flat LNs were negative. The positive rate was higher for well delineated than poorly delineated LNs, but similar among the homogeneous, heterogeneous and reflective core patterns of internal echoes. No LNs were detected by US in six of the 57 patients, of which four were true negative and the other two false negative. In the two false negative patients, histopathological examination showed a total of four LNs with two showing extensive extranodal spread of tumour and fibrosis of the surrounding tissue due to previous radiotherapy. Whether LNs are metastatic or not is difficult to determine directly by US. However, the positive rate can be enhanced by evaluation of the size, shape and boundary of the LN. US is indispensable for diagnosing cervical lymph node metastasis in patients with malignant head and neck tumours. 相似文献
20.
Hideyuki Hayashi Kazuto Ashizawa Yukihiro Ogihara Akifumi Nishida Keitaro Matsumoto Naoya Yamasaki Takeshi Nagayasu Minoru Fukuda Sumihisa Honda Masataka Uetani 《Japanese journal of radiology》2017,35(3):109-115