肿瘤/肝脏比值在~(18)F-FDG符合线路SPECT/CT显像在肺癌诊断中的价值

目的:探讨18F-FDG符合线路SPECT/CT显像在肺癌病灶的检测能力以及肿瘤/肝脏比值对肺部良恶性病灶及胸部小病灶诊断的临床价值。方法:回顾性分析2011年6月至2013年4月期间于西安交通大学第一附属医院行18F-FDG符合线路SPECT/CT显像的肺癌疑诊患者41例CT测量肺部原发病灶最大直径4.16±2.81厘米(最小直径1.3厘米,最大直径16厘米),以病理结果作为判断标准,通过t检验及接受者操作特征曲线(receiver operating characteristic,ROC)研究18F-FDG符合线路SPECT/CT显像对肺部病灶、肺及纵膈小病灶的诊断价值。结果:18F-FDG符合线路SPECT/CT显像肺部良恶性病灶的肿瘤/肌肉(T/N)、肿瘤/肝脏(T/L)比值差异均具有显著统计学意义(P0.01),T/L比值在肺部良恶性病灶和肺及纵膈最大横径小于3 cm的病灶ROC曲线的曲线下面积分别为0.857、0.810,均大于T/N比值相应的ROC曲线下面积(分别为0.825、0.760)。T/N=3.5为界值时,诊断肺部病灶的灵敏度为90%,特异度为71.4%,准确度为0.614;诊断最大横径小于3 cm病灶的灵敏度为70%,特异度为80%,准确度为0.50。T/L=2.3时诊断肺部病灶的灵敏度为80%,特异度为85.7%,准确度为0.657。T/L=1.6时诊断最大横径小于3 cm病灶的灵敏度为90%,特异度为80%,准确度为0.70。结论:T/N=3.5为界值时,对于肺部病灶及肺及最大横径小于3 cm病灶良恶性的鉴别能力较好。T/L比值对于肺部良恶性病灶和肺及纵膈最大横径小于3 cm的病灶诊断价值均高于传统常用的T/N比值,具有较高的准确性,可以良好的应用于18F-FDG符合线路SPECT/CT显像对肺癌的诊断中。

The Diagnosis Value of Tumor/liver Ratio of 18F-FDG SPECT/CT with Coincidence Detector Imaging in Lung Cancer

Objective:To investigate the ability of 18F-FDG SPECT/CT with coincidence detector imaging in the detection of lung cancer lesions and the diagnosis value of tumor/liver ratios in lung lesions and the thoracic small nodules.Methods:18F-FDG SPECT/CT with coincidence detector imaging data of 41 patients with suspected lung lesions were analyzed fromJune 2011 to April 2013 at the First Affiliated Hospital of Xi''an Jiaotong University, CT measurement of pulmonary primary tumor maximum diameter 4.16± 2.81 cm (the minimum 1.3 cm and largest 16 cm in diameter). Diagnoses of the subjects were confirmed by pathology. To investigate the ability of 18F-FDG SPECT/CT with coincidence detector imaging in the detection of lung cancer lesions and the diagnosis value of tumor/liver ratios in lung lesions by t-test and receiver operating characteristic(ROC) curve.Results:There was a significantly statistical difference of T/N and T/L between benign and malignant lesion (P <0.01). The AUC on ROC curve of T/L ratio was 0.857 in the lung lesions while the T/N was 0.810. And the area under curve (AUC) on ROC curve of T/L ratio was 0.825 while the T/N was 0.760 in thoracic lesions which maximum diameter are less than 3 cm. The sensitivity, specificity and the accuracy were 90%, 71.4%, 0.614 respectively with the T/L cutoff of 3.5 in the lung lesions while in the thoracic lesions which maximum diameter less than 3 cm were 70%, 80%, 0.50 respectively. The sensitivity, specificity and the accuracy were 80%, 85.7%, 0.657 respectively with the T/L cutoff of 2.3 in the lung lesions. The sensitivity, specificity and the accuracy were 90%, 80%, 0.70 respectively with the T/L cutoff of 1.6 in the thoracic lesions which maximum diameter are less than 3 cm.Conclusion:T/L ratio is valuable in the diagnosis and differential diagnosis of lung cancer. It can be well applied in the diagnosis of lung cancer with 18F-FDG SPECT/CT with coincidence detector imaging.