[1]段晓蓓,陈相猛,黄斌豪,等.基于PET/CT、HRCT特征的评分系统鉴别诊断孤立性肺部病变的临床研究[J].国际放射医学核医学杂志,2017,41(1):8-14.[doi:10.3760/cma.j.issn.1673-4114.2017.01.002]
　Duan Xiaobei,Chen Xiangmeng,Huang Binhao,et al.Clinical study on diagnosis of solitary pulmonary lesions by scoring system based on PET/CT and high-resolution computed tomography features[J].International Journal of Radiation Medicine and Nuclear Medicine,2017,41(1):8-14.[doi:10.3760/cma.j.issn.1673-4114.2017.01.002]
点击复制

基于PET/CT、HRCT特征的评分系统鉴别诊断孤立性肺部病变的临床研究(/HTML)
分享到：

《国际放射医学核医学杂志》[ISSN:1673-4114/CN:12-1381/R]

卷:
41
期数:
2017年第1期
页码:
8-14
栏目:
论著
出版日期:
2017-01-25

文章信息/Info

Title:
Clinical study on diagnosis of solitary pulmonary lesions by scoring system based on PET/CT and high-resolution computed tomography features
作者:
段晓蓓1;  陈相猛2;  黄斌豪1;  邹伟强1;  吴月娥1;  秦贵磷1;  孙丽霞3
1. 529070, 中山大学附属江门医院核医学科;
2. 529070, 中山大学附属江门医院放射科;
3. 529070, 中山大学附属江门医院病理科
Author(s):
Duan Xiaobei1;  Chen Xiangmeng2;  Huang Binhao1;  Zou Weiqiang1;  Wu Yue’e1;  Qin Guilin1;  Sun Lixia3
1. Department of Nuclear Medicine, the Affiliated Jiangmen Hospital of Sun Yat-sen University, Jiangmen 529070, China;
2. Department of Radiology, the Affiliated Jiangmen Hospital of Sun Yat-sen University, Jiangmen 529070, China;
3. Department of Pathology, the Affiliated Jiangmen Hospital of Sun Yat-sen University, Jiangmen 529070, China
关键词:
孤立性肺病变; 正电子发射断层显像术; 体层摄影术; X线计算机
Keywords:
Solitary pulmonary lesions; Positron-emission tomography; Tomography; X-ray computed
DOI:
10.3760/cma.j.issn.1673-4114.2017.01.002
摘要:
目的 探讨基于PET/CT、HRCT影像学特征的评分系统对孤立性肺部良恶性病变的诊断价值。方法 回顾性分析行PET/CT检查的孤立性占位性肺病变112例，其中良性病变44例，恶性病变68例。对孤立性肺病变的12项PET/CT及HRCT影像特征进行评估，初步建立量化分级系统，采用受试者工作特征（ROC）曲线分析良恶性病变的最佳诊断评分临界值。结果 PET/CT及HRCT预测孤立性肺部病变的指标包括年龄≥60岁（2分）、病灶大小≥1.0 cm（2分）、密度不均匀（2分）、边界清楚（1分）、SUVmax≥2.5（2分）、ΔSUVmax≥1.0（2分）、滞留指数≥15%（2分）、分叶征（3分）、毛刺征（3分）、胸膜牵拉征（3分）、空泡征（3分）。根据各项指标建立评分系统，随着评分增加，恶性率逐渐增高，通过ROC曲线得出12分为区分良、恶性病变的最佳临界点，灵敏度为92.6%，特异度为81.8%。结论 基于PET/CT、HRCT影像学特征的量化分级系统有助于鉴别孤立性肺部良恶性病变。
Abstract:
Objective To explore a quantitative scoring system based on PET/CT and high-resolution computed tomography(HRCT) characteristics for differentiating benign and malignant solitary pulmonary lesions. Methods A total of 112 patients with solitary pulmonary lesions detected by 18F-FDG PET/CT were enrolled and reviewed retrospectively. Of these cases, 44 were benign lesions and 68 were malignant. PET/CT and HRCT imaging features were recorded and evaluated. A quantitative scoring system was established. The best cut-off score was calculated by analysis of receiver operating characteristics(ROC) in differentiating benign and malignant lesions. Results The indicators of malignant solitary pulmonary lesions by PET/CT and HRCT included age≥60 years(2 points), diameter of the lesion≥1 cm(2 points), heterogeneous density(2 points), clear boundary(1 point), SUVmax≥2.5(2 points), ΔSUVmax≥1.0(2 points), retention index(RI)≥15%(2 points), lobular sign(3 points), spiculation sign(3 points), pleural traction sign(3 points), and vacuole sign(3 points). A quantitative scoring system was established according to risk factors. Moreover, score 12 was the best cut-off by ROC analysis in differentiating benign and malignant lesions. The sensitivity and specificity rates were 92.6% and 81.8%, respectively. Conclusion The quantitative scoring system based on PET/CT and HRCT features exhibited a good capacity for differentiating malignant lesions from benign solitary pulmonary lesions.

参考文献/References:

[1] Soubani AO.The evaluation and management of the solitary pulmonary nodule[J].Postgrad Med J, 2008, 84(995):459-466.DOI:10.1136/pgmj.2007.063545.
[2] 姚稚明, 屈婉莹, 刘甫庚, 等.18F-FDG PET/CT双时相显像对孤立性肺结节的诊断价值[J].中华核医学杂志, 2007, 27(1):5-7.DOI:10.3760/cma.j.issn.2095-2848.2007.01.002.Yao ZM, Qu WY, Liu FG, et al.The clinical value of dual time point 18F-FDG PET/CT in diagnosis of solitary pulmonary nodule[J].Chin J Nucl Med, 2007, 27(1):5-7.
[3] 耿贯一.流行病学[M].2版.北京:人民卫生出版社, 1997:221.Geng GY.Epidemiolog[M].2nd ed.Beijing:People’s Medical Publishing House, 1997:221.
[4] 陈聪霞, 李旭, 姚稚明.18F-FDG PET/CT诊断孤立性肺结节良恶性的研究进展[J].国际放射医学核医学杂志, 2012, 36(6):344-347.DOI:10.3760/ema.j.issn.1673-4114.2012.06.006.Chen CX, Li X, Yao ZM.The development of 18F-FDG PET-CT in the diagnosis of benign and malignant solitary pulmonary nodules[J].Int J Radiat Med Nucl Med, 2012, 36(6):344-347.
[5] Gould MK, Maclean CC, Kuschner WG, et al.Accuracy of positron emission tomography for diagnosis of pulmonary nodules and mass lesions:a meta-analysis[J].JAMA, 2001, 285(7):914-924.
[6] Kim SK, Allen-Auerbach M, Goldin J, et al.Accuracy of PET/CT in characterization of solitary pulmonary lesions[J].J Nucl Med, 2007, 48(2):214-220.
[7] Zhang X, Yan HH, Lin JT, et al.Comparison of three mathematical prediction models in patients with a solitary pulmonary nodule[J].Chin J Cancer Res, 2014, 26(6):647-652.DOI:10.3978/j.issn.1000-9604.2014.11.02.
[8] Truong MT, Sabloff BS, Ko JP.Multidetector CT of solitary pulmonary nodules[J].Radiologic Clinics North America, 2010, 48(1):141-155.DOI:10.1016/j.rcl.2009.09.005.
[9] Li Y, Wang J.A mathematical model for predicting malignancy of solitary pulmonary nodules[J].World J Surg, 2012, 36(4):830-835.DOI:10.1007/s00268-012-1449-8.
[10] 周莹, 刘士远, 李琼, 等.临床IA期周围型肺腺癌病理性脉管浸润与其薄层CT征象的相关性研究[J].中华放射学杂志, 2015, 49(4):259-263.DOI:10.3760/cma.j.issn.1005-1201.2015.04.006.Zhou Y, Liu SY, Li Q, et al.Correlation of thin-section CT morphologic features and pathological vascular invasion in the clinical stage IA peripheral lung adenocarcinoma[J].China Radiol, 2015, 49(4):259-263.
[11] Martins Rde C, Almeida SA, Siciliano AA, et al.Value of[18F]-FDG-PET/CT as a predictor of cancer in solitary pulmonary nodule[J].J Bras Pneumol, 2008, 34(7):473-480.
[12] Alkhawaldeh K, Bural G, Kumar R, et al.Impact of dual-time-point(18)F-FDG PET imaging and partial volume correction in the assessment of solitary pulmonary nodules[J].Eur J Nucl Med Mol Imaging, 2008, 35(2):246-252.DOI:10.1007/s00259-007-0584-1.
[13] Suga K, Kawakami Y, Hiyama A, et al.Dual-time point 18F-FDG PET/CT scan for differentiation between 18F-FDG-avid non-small cell lung cancer and benign lesions[J].Ann Nucl Med, 2009, 23(5):427-435.DOI:10.1007/s12149-009-0260-6.
[14] Chen HH, Lee BF, Su WC, et al.The increment in standardized uptake value determined using dual-phase 18F-FDG PET is a promising prognostic factor in non-small-cell lung cancer[J].Eur J Nucl Med Mol Imaging, 2013, 40(10):1478-1485.DOI:10.1007/s00259-013-2452-5.
[15] van Gómez López O, García Vicente AM, Honguero Martínez AF, et al.18F-FDG PET/CT in the assessment of pulmonary solitary nodules:comparison of different analysis methods and risk variables in the prediction of malignancy[J].Transl Lung Cancer Res, 2015, 4(3):228-235.DOI:10.3978/j.issn.2218-6751.2015.05.07.
[16] 李兰涛, 林红雨, 王海燕, 等.HRCT与PET/CT联合诊断孤立性肺结节[J].中国医学影像技术, 2013, 29(3):425-428.Li LT, Lin HY, Wang HY, et al.HRCT combining with PET/CT in diagnosis of solitary pulmonary nodules[J].Chin J Med Imaging Technol, 2013, 29(3):425-428.
[17] Al-Ameri A, Malhotra P, Thygesen H, et al.Risk of malignancy in pulmonary nodules:A validation study of four prediction models[J].Lung Cancer, 2015, 89(1):27-30.DOI:10.1016/j.lungcan.2015.03.018.

相似文献/References:

[1]何燕,苏晋,郑晓霞,等.P-糖蛋白抑制剂在PET显像中的应用研究[J].国际放射医学核医学杂志,2016,40(1):1.[doi:10.3760/cma.j.issn.1673-4114.2016.01.001]
　He Yan,Su Jin,ZhengXiaoxia,et al.Developing P-glycoprotein inhibitor marked by PET[J].International Journal of Radiation Medicine and Nuclear Medicine,2016,40(1):1.[doi:10.3760/cma.j.issn.1673-4114.2016.01.001]
[2]许飞,刘建军,黄钢,等.PET乏氧显像在预测肿瘤乏氧及指导临床治疗中的应用进展[J].国际放射医学核医学杂志,2016,40(1):35.[doi:10.3760/cma.j.issn.1673-4114.2016.01.008]
　Xu Fei,Liu Jianjun,Huang Gang,et al.The application of hypoxia imaging with PET in predicting tumor hypoxia and guiding clinical therapy[J].International Journal of Radiation Medicine and Nuclear Medicine,2016,40(1):35.[doi:10.3760/cma.j.issn.1673-4114.2016.01.008]
[3]胡伟,赵军.小胶质细胞在AD炎性机制中的作用及其常见PET显像剂的应用进展[J].国际放射医学核医学杂志,2016,40(1):44.[doi:10.3760/cma.j.issn.1673-4114.2016.01.009]
　Hu Wei,Zhao Jun.Microglia’s Alzheimer disease inflammatory mechanisms and progress of its common application in PET imaging agents[J].International Journal of Radiation Medicine and Nuclear Medicine,2016,40(1):44.[doi:10.3760/cma.j.issn.1673-4114.2016.01.009]
[4]张莹莹,王振光,孔艳.PET/CT显像在肺间质纤维化中的应用进展[J].国际放射医学核医学杂志,2016,40(1):55.[doi:10.3760/cma.j.issn.1673-4114.2016.01.011]
　Zhang Yingying,Wang Zhenguang,Kong Yan.Application advancement on PET/CT in pulmonary interstitial fibrosis[J].International Journal of Radiation Medicine and Nuclear Medicine,2016,40(1):55.[doi:10.3760/cma.j.issn.1673-4114.2016.01.011]
[5]李海峰,张晓军,李云钢,等.国产模块LOOP环改良法合成11C-蛋氨酸[J].国际放射医学核医学杂志,2016,40(2):106.[doi:10.3760/cma.j.issn.1673-4114.2016.02.004]
　Li Haifeng,Zhang Xiaojun,Li Yungang,et al.Synthesis of 11C-methionine on home-made module by the improved LOOP method[J].International Journal of Radiation Medicine and Nuclear Medicine,2016,40(1):106.[doi:10.3760/cma.j.issn.1673-4114.2016.02.004]
[6]史文杰,孟召伟,谭建.基于Deauville标准探讨18F-FDG PET/CT在霍奇金淋巴瘤复发诊断中的应用价值[J].国际放射医学核医学杂志,2016,40(2):120.[doi:10.3760/cma.j.issn.1673-4114.2016.02.007]
　Shi Wenjie,Meng Zhaowei,Tan Jian.Value of 18F-FDG PET/CT on diagnosis of Hodgkin lymphoma recurrence using Deauville criterion[J].International Journal of Radiation Medicine and Nuclear Medicine,2016,40(1):120.[doi:10.3760/cma.j.issn.1673-4114.2016.02.007]
[7]李海峰,张晓军,张锦明.多巴胺转运蛋白显像剂11C-β-CFT在帕金森病中的应用研究[J].国际放射医学核医学杂志,2016,40(3):218.[doi:10.3760/cma.j.issn.1673-4114.2016.03.011]
　Li Haifeng,Zhang Xiaojun,Zhang Jinming.Review of the use of dopamine transporter imaging agent 11C-β-CFT for diagnosing Parkinson disease[J].International Journal of Radiation Medicine and Nuclear Medicine,2016,40(1):218.[doi:10.3760/cma.j.issn.1673-4114.2016.03.011]
[8]尤阳,轩昂,张杰,等.淋巴瘤患者大脑静息葡萄糖代谢改变[J].国际放射医学核医学杂志,2016,40(4):255.[doi:10.3760/cma.j.issn.1673-4114.2016.04.003]
　You Yang,Xuan Ang,Zhang Jie,et al.Changes in resting-state brain glucose metabolism in patients with lymphoma[J].International Journal of Radiation Medicine and Nuclear Medicine,2016,40(1):255.[doi:10.3760/cma.j.issn.1673-4114.2016.04.003]
[9]王朋,崔邦平,代文莉,等.18F-FDG PET/CT在前列腺癌中的应用进展[J].国际放射医学核医学杂志,2016,40(4):277.[doi:10.3760/cma.j.issn.1673-4114.2016.04.008]
　Wang Peng,Cui Bangping,Dai Wenli,et al.Progress in the application of 18F-FDG PET/CT in prostate cancer[J].International Journal of Radiation Medicine and Nuclear Medicine,2016,40(1):277.[doi:10.3760/cma.j.issn.1673-4114.2016.04.008]
[10]李菲,黄俊星,张俊.18F-FDG PET/CT在食管癌中的临床应用[J].国际放射医学核医学杂志,2016,40(4):282.[doi:10.3760/cma.j.issn.1673-4114.2016.04.009]
　Li Fei,Huang Junxing,Zhang Jun.The clinical application of 18F-FDG PET/CT in esophageal cancer[J].International Journal of Radiation Medicine and Nuclear Medicine,2016,40(1):282.[doi:10.3760/cma.j.issn.1673-4114.2016.04.009]

备注/Memo

备注/Memo:
收稿日期:2016-10-13。
通讯作者:陈相猛,Email:xmchen0908@163.com
更新日期/Last Update: 1900-01-01