18F-FDG和18F-FLTPET／CT显像在肺结节治疗决策中的作用

目的双显像剂FDG和FLTPET／CT显像对肺结节治疗决策的影响。方法采取前瞻性、多中心临床研究方法（6个PET／CT中心1，计算最大标准摄取值（SUVmax）作为反映代谢水平的半定量指标，以病理或临床随访6—17个月结果为诊断标准，并采取问卷调查方式了解临床治疗决策变化。结果55例病人纳入本研究，其中恶性病变16例，结核16例，其他良性病变23例。恶性病变的18F—FLT和18F—FDG的SUVmax值显著高于良I生病变。FDG—FLT显像使本组病例中26例（47％）的临床决策变化，18例（33％）临床诊治策略明显改变，8例（14％）为部分改变，如药物治疗方案改变等，大部分决策变化经临床随访证实是正确的，3例决策失误。结论FLT—FDG双显像剂PET／CT显像对临床决策有重要作用。

Role of 18F-FDG and 18F-FLT PET/CT imaging in making decision of treatment modalities for pulmonary nodules

Objective To study the role of dual tracer of FLT-FDG PET/CT imaging in decision of treatment modalities for pulmonary nodules. Methods A prospective multi-center clinical trial was performed to investigate the changes in decision of diagnosis and treatment of pulmonary nodules using the SUVmax as a semi-qualitative index for metabolic level, 6-17 month pathological and clinical follow-up data as the diagnostic criteria, and questionnaires. Results Malignant tumor, tuberculosis, and other benign lesions were detected in 16, 16 and 23 of the 55 patients. The SUVmax value on 18F-FLT and 18F-FDG was significantly higher for malignant lesions than for benign lesions. The decision of treatment modalities for pulmonary nodules was changed in 26（47%）, significantly changed in 18（33%）, and partially changed in 8（14%） of the 55 patients, respectively, according to the FDGFLT images. Most of the changes in decision of treatment modalities for pulmonary nodules, such as drug treatment protocol, were correct as confirmed during the follow-up. However, the change in decision of treatment modalities for pulmonary nodules in 3 patients was incorrect. Conclusion Dual-tracer PET/CT imaging using 18F-FDG and 18F-FLT plays an important role in making decision of treatment modalities for pulmonary nodules.