18F-FDG符合线路显像与异机CT图像融合诊断非小细胞肺癌复发转移的价值 |
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引用本文: | 张敬勉,赵新明,王建方,王颖晨,张召奇,李德志,戴春暖,孙莉,江志华. 18F-FDG符合线路显像与异机CT图像融合诊断非小细胞肺癌复发转移的价值[J]. 中华核医学杂志, 2008, 28(3) |
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作者姓名: | 张敬勉 赵新明 王建方 王颖晨 张召奇 李德志 戴春暖 孙莉 江志华 |
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作者单位: | 河北医科大学第四医院核医学科,石家庄,050011 |
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基金项目: | 河北省普通高等学校强势特色学科肿瘤学科组课题 |
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摘 要: | 目的 评价18F-脱氧葡萄糖(FDG)符合线路显像与异机CT图像融合诊断非小细胞肺癌(NSCLC)术后放化疗后复发转移的价值.方法 对可疑复发转移的40例NSCLC患者行18F-FDG符合线路显像,并于显像前后1周内行CT扫描.用三维(3D)图像融合软件进行图像融合.结果 在18F-FDG符合线路显像与CT扫描相同的范围内,40例患者共检出病灶58处,其中恶性52处,良性6处.融合图像诊断NSCLC复发转移的灵敏度、特异性、准确性、阳性预测值、阴性预测值、阳性似然比及阴性似然比分别为94.23%(49/52),5/6,93.10%(54/58),98.00%(49/50),5/8,5.65及0.07.图像融合灵敏度、准确性明显高于CT.单纯18F-FDG符合线路显像诊断效能与图像融合无差别,但与CT图像融合可明显提高对病灶的定位诊断(提高44.83%).结论 18F-FDG符合线路与CT图像融合诊断NSCLC术后放化疗后复发转移灵敏度高,定位准确,值得推广应用.
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关 键 词: | 癌,非小细胞肺 肿瘤复发,局部 肿瘤转移 体层摄影术 发射型计算机,单光子 体层摄影术,X线计算机 脱氧葡萄糖 |
Image fusion diagnostic value of 18F-FDG coincidence image and spiral CT in non-small cell lung cancer recurrence and metastases |
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Abstract: | Objective The aim of this study was to evaluate the clinical value of software based imaging fusion of 18F-fluorodeoxyglucose (FDG) coincidence study and diagnostic CT in re-staging non small cell lung cancer (NSCLC). Methods Forty NSCLC patients were included for re-staging. All had 18F-FDG coincidence image and diagnostic CT within one week. The software based imaging fusion was done automatically by three-dimension (3D) image fusion software (syngo, Siemens). The gold standard of lesion identification was either histopathology or clinical follow-up. Results With the help from fusion technique, 58 lesions from 40 NSCLC patients were detected. Of the 58 lesions, 52 were malignant and 6 were benign. The sensitivity, specificity, accuracy, positive predictive value, negative predictive value, positive likelihood ratio and negative likelihood ratio of the software based imaging fusion results were 94.23%(49/52),5/6,93.10%(54/58),98.00%(49/50),5/8,5.65 and 0.07, respectively. As compared with the results from diagnostic CT, the sensitivity and accuracy in lesions detection were significantly higher with fusion technique. Though no statistical difference between 18F-FDG coincidence image alone or combined with diagnostic CT (with fusion), the clinical impact of fusion technique was to improve the localization of lesions up to 44.83%. Conclusions With the fusion technique, the localization of lesions at lung can be improved. Therefore, the re-staging at T- and N- status for NSCLC can be further improved. |
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Keywords: | Carcinoma non-small cell lung Neoplasm recurrence local Neoplasm metastasis Tomography emission-cmputed single-photon Tomography X-ray computed Deoxyglucose |
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