[1]王俊起,高硕,李彦生.18F-氟化钠PET和PET-CT诊断肺癌骨转移的对比研究[J].国际放射医学核医学杂志,2009,33(2):68-72.[doi:10.3760/cma.j.issn.1673-4114.2009.02.002]
　WANG Jun-qi,GAO Shuo,LI Yan-sheng.Comparison between 18F-NaF PET and PET-CT to detect bone metastases in patients with lung cancer[J].International Journal of Radiation Medicine and Nuclear Medicine,2009,33(2):68-72.[doi:10.3760/cma.j.issn.1673-4114.2009.02.002]
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18F-氟化钠PET和PET-CT诊断肺癌骨转移的对比研究(/HTML)
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《国际放射医学核医学杂志》[ISSN:1673-4114/CN:12-1381/R]

卷:
33
期数:
2009年第2期
页码:
68-72
栏目:
临床核医学
出版日期:
1900-01-01

文章信息/Info

Title:
Comparison between 18F-NaF PET and PET-CT to detect bone metastases in patients with lung cancer
作者:
王俊起1;  高硕2;  李彦生2
1. 天津市第一中心医院核医学科, 天津 300192;
2. 天津医科大学总医院PET-CT中心, 天津 300052
Author(s):
WANG Jun-qi1;  GAO Shuo2;  LI Yan-sheng2
1. Department of Nuclear Medicine, Tianjin First Central Hospital, Tianjin 300192, China;
2. PET-CT Centre, General Hospital of Tianjin Medical University, Tianjin 300052, China
关键词:
肺肿瘤; 肿瘤转移; 正电子发射断层显像术; 体层摄影术; X线计算机; 18F-氟化钠
Keywords:
Lung neoplasm; Neoplasm metastasis; Positron-emission tomography; Tomography;  X-ray computed; Sodium fluoride F18
DOI:
10.3760/cma.j.issn.1673-4114.2009.02.002
摘要:
目的 对比研究18F-氟化钠(18F-NaF) PET和PET-CT对肺癌骨转移诊断的准确性.方法 34例初始诊断为肺癌的患者接受18F-NaF PET-CT检查,对PET和PET-CT图像分别进行解释,发现的病变分为恶性、良性和不确定三种.骨转移的综合评价方法包括MRI (34例)、18F-氟脱氧葡糖糖PET-CT (4例)、组织学活检(2例)和临床随访(6例).结果 按患者水平分析时,34例患者中的11例(32%)发生骨转移,其中,18F-NaF PET-CT准确诊断所有患者的骨转移,无假阳性和假阴性,而18F-NaF PET诊断真阳性8例、3例不能确定,18F-NaF PET确诊的8例骨转移患者中的4例PET没有显示全部转移病变(假阴性和不确定病变);按病变水平分析时,118个病变获得最终诊断,其中转移病变47个、良性病变71个,其中,18F-NaF PET诊断真阳性27个、真阴性64个、不确定病变24个、假阴性1个、假阳性2个,而18F-NaF PET-CT诊断真阳性46个、假阴性1个、真阴性71个.按患者水平分析,将不确定病变归为恶性时,18F-NaF PET-CT的特异性高于18F-NaF PET (100% vs 78%,χ2=10.78,P<0.05),二者的灵敏度均为100%;将不确定病变归为良性时,18F-NaF PET-CT诊断骨转移的灵敏度显著高于18F-NaF PET (100% vs 73%,χ2=6.41,P<0.01),二者特异度差异无显著性(100% vs 96%,χ2=2.03,P>0.05);按病变水平分析时,得到与患者水平分析相似结果.结论 18F-NaF PET-CT诊断肺癌骨转移的准确性优于18F-NaF PET,PET-CT中的低剂量CT可进一步提高良、恶性病变的鉴别能力.
Abstract:
Objective To evaluate the effect of 18F-sodium fluoride(18F-NaF)PET-CT in the detection of bone metastases in patients with lung cancer.Methods Thirty-four patients with newly diagnosed lung cancer were performed with 18F-NaF PET-CT.18F-NaF PET and 18F-NaF PET-CT were interpreted separately.Lesions were categorized as malignant,benign or inconclusive.A panel of reference methods was used,including MRI(34 patients),18F-fluorodeoxyglucose PET-CT(4 patients),histopathology(2 patients),or clinical follow-up of at least 6 months(6 patients).Results In patient-based analysis,11 of 34 patients had bone metastases.18F-NaF PET-CT correctly diagnosed all 11 patients with bone metastases,18F-NaF PET only correctly detected 8 of them.18F-NaF PET-CT had no false and inconclusive diagnosis.In lesion-based analysis,118 lesions were assessed which had final diagnosis(47 metastases,71 benign lesions).18F-NaF PET-CT was correct in 46 metastatic lesions and 71 benign lesions,but false-negative in lesion.18F-NaF PET was correct in 27 metastatic lesions and 64 benign lesions,but wrong in 3 lesions(2 benign lesions,1 metastatic lesions),and equivocal in 24 lesions.Based on the corresponding appearance on low-dose CT,46 of 47 lesions were categorized metastases(31 presented as sites of increased uptake with corresponding lytic or sclerotic changes,and other 15 metastases show normal or non-specific appearing bone),only 1 sclerotic metastasis was judged benign. All 71 benign lesions have a benign appearance on low-dose CT. In patient-based analysis, categorizing equivocal and malignant interpretation as suggestive for malignancy, the 18F-NaF PET-CT was more specific than 18F-NaF PET(100% vs 78%, χ2=10.78, P<0.05), the sensitivity was 100% for each other. Categorizing equivocal and benign as benignity, the 18F PET-CT was more sensitive than 18F-NaF PET (100% vs 73%, χ2=6.41, P<0.001), the specificity between them was not significantly (100% vs 96%,χ2=2.03, P>0.05). In lesion-based analysis, the similar results were obtained as patient-based analysis.Conclusion 18F-NaF PET-CT was both sensitive and specific for detection of bone metastases in patients with newly diagnosed lung cancer. With the diagnosis information of low-dose CT, its ability of differentiation between malignant and benign lesions is improved.

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备注/Memo

备注/Memo:
收稿日期:2008-11-20。
通讯作者:高硕(E-mail:dr_shuogao@yahoo.com)
更新日期/Last Update: 1900-01-01