肺癌18F-FDG PET-CT与高分辨CT的临床应用

目的分析肺癌18F-FDG PET-CT与HRCT的表现并探讨其在诊断及分期方面的价值。方法回顾分析65例经病理证实肺癌的PET-CT与HRCT资料并与其病理分型作对照,分析肿瘤大小与SUVmax关系,统计学方法采用双变量相关分析;其中23例常规扫描后1 h行延迟扫描,计算滞留指数(RI)。结果对于65例肺癌患者中原发灶的检出,PET-CT敏感性100%,准确性93.8%;肺部HRCT敏感性96.9%,准确性72.3%;PET敏感性93.8%,准确性90.7%。肺癌中61例为实性结节或软组织肿块,SUVmax为9.78±5.63;4例细支气管肺泡癌为磨玻璃灶,SUVmax为0.91±0.14;肺孤立结节(SPN)延迟扫描SUVmax为11.76±5.40,SUVmax升高值为3.2±1.3,RI为(39.31±3.62)%。实性原发灶SUVmax与肿瘤大小呈正相关(r=0.51,t=4.56,P<0.000 5)。结论 PET-CT双时相扫描结合HRCT对肺癌性质判断及分期具有重要的价值。

Clinical application of 18F-FDG PET-CT and HRCT for lung cancer

Objective To evaluate the value of 18F-FDG PET-CT and HRCT in the diagnosis and staging of the lung cancer.Methods Clinical data of 65 cases of lung cancer confirmed by operation and pathology,were analyzed retrospectively.The relationship between PET-CT imaging features and pathological typies,and between tumor size and SUVmax were analyzed.Statistical analysis was performed using bivariate correlation analysis.Twenty-three cases were scanned at 1 h after routine scanning,and retention index(RI) of FDG was calculated.Results In 65 cases of lung cancer,the diagnostic sensitivity of PET-CT was 100%,and the diagnostic specificity was 93.8%.The diagnostic sensitivity of HRCT and PET were 96.9% and 93.8% respectively,and the diagnostic specificities were 72.3% and 90.7%,respectively.The main PET-CT characteristics of primary lesions were nodules or masses in lungs in 61 cases,and the mean SUVmax was 9.78±5.63.Four cases of bronchioalveolar carcinomas manifestied the glass opacity,and the mean SUVmax was 0.91±0.14.Mean SUVmax of delayed scanning in solitary pulmonary nodule was 11.76±5.40,and RI was(39.31±3.62)%.The SUVmax of tumor was positively correlated with the tumor size(r=0.51,t=4.56,P<0.000 5).Conclusion Dual time point PET-CT combining with HRCT is proved to be more effective than any single diagnostic technique for accurately detecting and staging the lung cancer.