摘要
目的：评价非小细胞肺癌PET/CT显像中非增强CT对FDG摄取阴性病灶的临床价值。材料和方法：回顾2006年5～12月期间在本中心接受18F-FDG PET/CT检查并具有病理结果的119例非小细胞肺癌患者。记录FDG低/无摄取病灶即FDG摄取阴性病灶，根据Ford研究中的标准，分为有显著价值组、有部分价值组及无显著价值组3种。结果：119例非小细胞肺癌患者中，55.5％（66/119）为初次分期，44.5％（53/119）为治疗后再分期或疗效评价。283个FDG摄取阴性的异常病灶主要分布在头颈部（n＝40）、胸部（n＝97）、腹部和盆腔（n＝128）、骨骼（n＝18）。其中显著价值组n=9（3%）、部分价值组n=121（43%）、无显著价值组n=153（54%）。本次研究中检出9个有显著价值异常病灶，包括转移性肺结节4个、成骨性转移病灶1个、脑转移病灶1个、肝血管瘤1个和肾脏占位2个。结论：PET/CT中非增强CT扫描不仅可进行衰减校正和解剖定位，而且低剂量CT还可以提供一定的诊断信息；非小细胞肺癌患者FDG摄取阴性的异常病灶中仅少数病灶具有重要的价值，临床上需要进一步处理；诊断性CT无疑可得到更多的诊断信息。
Abstract
Objective: To evaluate the clinical value of abnormalities that do not show increased 18F-FDG uptake on non-enhanced CT of integrated PET/CT in patients with non-small cell lung cancer. Materials and Methods: The study consisted of a retrospective analysis of consecutive PET/CT scans obtained at our PET center between May and December 2006. During the eight-month period, there were 119 patients had a diagnosis of non-small cell lung cancer. All scans were obtained with integrated PET/CT scanner(Siemens Biograph Sensation 16). Each case was interpreted independently by two experienced PET/CT physicians. All abnormalities with negative 18F-FDG uptake were recorded. The abnormalities were classified as being of major, moderate or minor significance according to the definitions previously by Ford. Results: There were 119 patients with non-small cell lung cancer underwent initial staging(66/119, 55.5%)， restaging or treatment monitoring(53/119, 44.5%) PET/CT imaging during the study period. The abnormalities were located in the head and neck(n=40), thorax(n=97), abdomen and pelvis(n=128), and bony skeleton(n=18). The clinical importance of these abnormalities was classified as major n=9(3%), moderate n=121(42%), or minor n=153(54%). Major abnormalities noted in the study included 4 cases of small lung nodules, 1 case of osteolytic lesion and 1 case of brain lesion suggestive of metastasis, as well as 1 case of liver mass and 2 cases of renal mass. Conclusions: CT scan in PET/CT can not be only a tool for attenuation correction and anatomic landmarks alone. Even low-dose CT can provide important diagnostic information. There is a high prevalence of CT abnormalities in non-small cell lung cancer that do not show 18F-FDG uptake, but small proportion of which has clinical significance. Diagnostic CT should be done to get more significant information in PET/CT interpretation.
关键词
癌 /
非小细胞肺 /
放射性核素显像
Key words
Carcinoma /
non-small-cell lung /
Radionuclide imaging
任树华;华逢春;左传涛;赵 军;管一晖.
非小细胞肺癌PET/CT显像中非增强CT对FDG摄取阴性病灶的价值[J]. 中国临床医学影像杂志. 2008, 19(3): 168-170
REN Shu-hua;HUA Feng-chun;ZUO Chuan-tao;ZHAO Jun;GUAN Yi-hui.
Abnormalities with negative 18F-FDG uptake detected using non-enhanced CT of PET/CT in non-small cell lung cancer[J]. Journal of China Clinic Medical Imaging. 2008, 19(3): 168-170
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