18F-FDG与18F-FLT PET/CT在肺结核瘤与恶性肿瘤鉴别诊断中的应用

陈文新; 林美福; 田嘉禾; 杨小丰; 于丽娟; 王雪梅; 辛军; 冯慧如; 陈萍; 赵周社; 郭莘; 陈国宝

中国临床医学影像杂志 ›› 2012, Vol. 23 ›› Issue (12) : 837-840.

论著

18F-FDG与18F-FLT PET/CT在肺结核瘤与恶性肿瘤鉴别诊断中的应用

陈文新1，林美福1，田嘉禾2，杨小丰3，于丽娟4，王雪梅5，
辛军6，冯慧如7，陈萍8，赵周社9，郭莘1，陈国宝1

作者信息 +

Differential diagnosis of pulmonary tuberculomas and malignant nodules using18F-FLT and 18F-FDG PET/CT imaging

CHEN Wen-xin1, LIN Mei-fu1, TIAN Jia-he2, YANG Xiao-feng3, YU Li-juan4, WANG Xue-mei5,
XIN Jun6, FENG Hui-ru7, CHEN Ping8, ZHAO Zhou-she9, GUO Shen1, CHEN Guo-bao1

Author information +

文章历史 +

摘要

目的：探讨18F-FDG与18F-FLT显像在诊断与鉴别肺结节尤其是肺结核与恶性肿瘤中的效能。方法：肺结节患者163例，年龄17~92岁，其中结核瘤组29例，其它良性结节组46例，恶性结节组88例，以盲法集中读片、前瞻性多中心临床研究标准方案进行18F-FDG与18F-FLT显像和读片，获得病灶最大值SUVFDG和SUVFLT并对病灶进行定量分析。结果：肺结节的最大SUVFDG及最大SUVFLT中位值均以恶性结节、肺结核、其他良性结节之序依次减低；SUVFDG、SUVFLT恶性结节组与结核组对照有显著性差异（P<0.001）；据ROC曲线分析，FDG、FLT显像SUVmax分别以5.9、2.4为界值可鉴别结核瘤与恶性结节，FLT显像诊断的灵敏度为80.68%，特异性为75.86%，准确性为79.49%，诊断效能高于FDG（P<0.001）。SUVFLT/SUVFDG比值的诊断效能高于单独FDG、FLT显像SUV值。结论：在鉴别诊断肺结核瘤与恶性结节中，FLT显像的诊断效能高于FDG显像，双示踪剂显像明显提高鉴别诊断的准确性。SUVFLT/SUVFDG比值在肺结节鉴别诊断中有重要价值。

Abstract

Objective: To investigate the diagnostic efficacies of 18F-FLT and 18F-FDG PET/CT in pulmonary nodules, focusing on diagnosis and differential diagnosis of pulmonary tuberculomas and malignant nodules. Materials and Methods: 163 patients with solitary pulmonary nodules undergoing dual-tracer imaging were certified by histological findings. The patients were collected from a multicenter clinical trial and were divided into the group of pulmonary tuberculoma(n=29), group of other benign nodule(n=48) and group of malignant nodule(n=88). The images were read in a standardized, blind, collective reading. The standardized uptake value(SUV) of 18F-FDG and 18F-FLT were compared and analyzed. Results: The SUVs of FDG and FLT in groups of malignant nodule, tuberculoma and other benign nodule were in a decreasing order. Both SUVFDG and SUVFLT showed significant difference in the group of malignant nodule and tuberculoma(P<0.001). ROC curve showed that a SUV cutoff of 5.9 on FDG PET/CT and 2.4 on FLT PET/CT provided the best separation of tuberculomas and malignancies. FLT PET/CT had higher diagnostic efficacy than FDG PET/CT(P<0.001). The ratio between SUVs of 18F-FLT and 18F-FDG improved the diagnostic efficacy in comparison with single tracer imaging. Conclusions: Dual-tracer imaging using 18F-FDG/18F-FLT PET/CT provides a better diagnostic efficacy in these clinically challenging patients with pulmonary lesions. A SUV cutoff of 5.9 on FDG PET/CT and 2.4 on FLT PET/CT provide the best separation of tuberculomas and malignancies. The ratio between SUVs of 18F-FLT and 18F-FDG provides great potential benefits in separating tuberculomas and malignancies.

导出引用

陈文新;林美福;田嘉禾;杨小丰;于丽娟;王雪梅;辛军;冯慧如;陈萍;赵周社;郭莘;陈国宝. 18F-FDG与18F-FLT PET/CT在肺结核瘤与恶性肿瘤鉴别诊断中的应用[J]. 中国临床医学影像杂志. 2012, 23(12): 837-840

CHEN Wen-xin;LIN Mei-fu;TIAN Jia-he;YANG Xiao-feng;YU Li-juan;WANG Xue-mei;XIN Jun;FENG Hui-ru;CHEN Ping;ZHAO Zhou-she;GUO Shen;CHEN Guo-bao. Differential diagnosis of pulmonary tuberculomas and malignant nodules using18F-FLT and 18F-FDG PET/CT imaging[J]. Journal of China Clinic Medical Imaging. 2012, 23(12): 837-840

中图分类号： Ｒ521 R734.2 Ｒ817.4