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桑林汪静王喆马小伟王妮李文献 《现代生物医学进展》2014,14(5):885-887
目的:探讨PET/CT和超声弹性成像(UE)在乳腺癌诊断中的价值。方法:回顾性分析2011年1月至2012年5月在我院确诊的173例乳腺患者的临床资料,所有患者均行PET/CT和UE检查。依据病理组织活检和临床随访分别评价PET/CT和UE对乳腺癌诊断的灵敏性、特异性、准确性,并比较两者的结果。结果:PET/CT和UE诊断乳腺癌的灵敏性分别为98.8%和81.3%;特异性分别为84.3%和97.2%;准确性分别为90.7%和90.2%;两种方法联合检测诊断乳腺癌的灵敏性、特异性、准确性分别为98.8%、98.1%、98.4%,UE检测乳腺癌的敏感性明显低于PET/CT及PET/CT+UE,PET/CT检测乳腺癌的特异性明显低于UE及PET/CT+UE,PET/CT+UE诊断乳腺癌的准确性显著提高(P0.05)。结论:PET/CT和超声弹性成像在乳腺癌诊断中均有较高的应用价值,各有优缺点,二者联合检测可提高乳腺癌诊断的准确率。 相似文献
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目的:探讨氟代脱氧葡萄糖(~(18)F-FDG)正电子发射断层显像/X线计算机体层成像仪(PET/CT)检查在局灶早期宫颈癌中的临床应用价值。方法:53例病理确诊为早期宫颈癌的患者行全身~(18)F-FDG PET/CT检查,并在检查结束10日内行广泛性全子宫切除术+双附件切除术+盆腔淋巴结清扫术,计算~(18)F-FDG PET/CT诊断宫颈原发部位肿瘤及盆腔淋巴结转移的敏感度,特异度与准确度。结果:~(18)F-FDG PET/CT检查诊断的宫颈原发部位肿瘤的敏感度为79.25%,特异度为86.79%,准确度为84.9%;以病人为单位诊断盆腔淋巴结转移的准确度为85.71%,特异度为97.87%;以淋巴结为单位诊断盆腔淋巴结转移的准确度为84.61%,特异度为99.00%。结论:PET/CT显像对宫颈癌诊断,分期诊断及盆腔淋巴结转移的检出具有重要临床意义。 相似文献
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PurposeWe aimed to evaluate the Equivalent Doses (HTs) to highly exposed organs as well as the Effective Dose (ED) for 18F-fluorocholine PET/CT scan in the follow-up of prostate cancer patients.MethodsFifty patients were administered with 18F-fluorocholine. The activities in organs with the highest uptake were derived by region-of-interest (ROI) analysis. OLINDA/EXM1.0 and Impact software were used to assess ED for the administered 18F-fluorocholine and CT scan, respectively, and the 18F-fluorocholine and CT-scan EDs summed to yield the total ED for the PET/CT procedure.ResultsThe calculated 18F-fluorocholine and CT scans EDs based on ICRP Publication 103 were 5.2 mSv/300 MBq and 6.7 mSv, respectively. The 18F-fluorocholine HTs to the liver, kidneys, spleen and pancreas were about threefold higher than those from the CT, which contributed a greater proportion of the total ED than the 18F-fluorocholine did.ConclusionsFor 18F-fluorocholine PET/CT procedures, about 40% of the ED is contributed by administered 18F-fluorocholine and 60% by the CT scan. The kidneys and liver were the highly exposed organs. Considering the large number of diagnostic procedures oncology patients undergo, radiation dosimetry is important in relation to the stochastic risk of such procedures. 相似文献
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《Médecine Nucléaire》2022,46(1):34-38
The primary lymphoma of prostate is rare, representing 0.2–0.8% of extranodal lymphomas and 0.1% of all prostate neoplasias. 相似文献
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目的:探讨18氟-氟代脱氧葡萄糖(18F-FDG)PET/CT对淋巴瘤诊断、分期和疗效的评价价值。方法:入选我院2008年1月至2013年1月收治的52例经手术病理证实为淋巴瘤的患者,均进行18F-FDG PET/CT检查,并与病理结果进行比较,评价诊断价值,治疗前后对比分期改变,评价疗效和改变治疗方案。结果:PET/CT诊断发现异常高代谢情况51例(98.1%),其对淋巴瘤检查的灵敏度为98.1%(51/52),诊断率与病理结果比较相当,差异无统计学意义(P0.05),治疗后,11例(21.2%)完全恢复,PET/CT未见高代谢或肿大情况,3例(5.8%)临床分期上调,15例(28.8%)分期下调,其中15例(28.8%)改变治疗方案。结论:18F-FDG PET/CT对淋巴瘤诊断准确性高,在分期和疗效评价中具有重要意义,有助于准确分期并鉴别残余病变性质。 相似文献
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目的：通过PET/CT检查观察脂肪肝患者肝脏及其他组织对18F脱氧葡萄糖（18F-FDG）摄入变化,探讨脂肪肝与糖脂代谢的相关性。方法：36例做PET/CT的健康和2型糖尿病男性患者,分为对照组（n=18例）;脂肪肝组（n=9例）;糖尿病脂肪肝组（n=9例）。常规测血糖、血脂及肝肾功能。PET/CT测肝脏CT值和肝脏、肾皮质,骨骼肌组织18F-FDG的最大标准摄入值（SUVmax）及平均标准摄入值（SUVmean）。结果：1.糖尿病脂肪肝组的TG显著高于单纯脂肪肝组和正常对照组,P=0.0003,0.0000。单纯脂肪肝组的TG亦显著高于正常对照组,P=0.028。2.糖尿病脂肪肝组的肝脏18F-FDG的SUVmean和SUVmax显著高于正常对照组的SUVmean和SUVmax,P=0.0054,0.0133。单纯脂肪肝组的肝脏SUVmean和SUVmax亦高于正常对照组,但比较无统计学差异。脑皮质、肾皮质和骨骼肌组织的18F-FDG的SUVmean和SUVmax三组间比较无显著性差异。3.Spearman相关性分析发现FBG与TG显著正相关（r=0.59919,P=0.0004）;FBG和TG与肝脏的CT值显著负相关（r=-0．55625,P=0．0004;r=-0．45739,P=0．0097）。结论：脂肪肝与空腹血糖和甘油三酯升高显著相关。脂肪肝及2型糖尿病脂肪肝患者肝脏对葡萄糖摄取增高。 相似文献
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~(18)F-FDG PET/CT常规代谢成像反应肿瘤的葡萄糖代谢及乏氧情况,而~(18)F-FDG PET/CT早期动态成像能反映PET/CT成像早期肿瘤的灌注情况。由于肿瘤的异质性,在早期动态~(18)F-FDG PET/CT成像,即~(18)F-FDG PET/CT灌注成像中,存在独立于常规60 min~(18)F-FDG PET/CT代谢成像的SUVmax(最大标准摄取值)高摄取区。因此,在临床工作中应用~(18)F-FDG PET/CT早期动态成像,能够进一步对实体肿瘤的活性区域进行评估,能够更好评价患者预后、完善治疗方案。当前~(18)F-FDG早期动态成像已经应用在肝癌、肾癌以及膀胱癌等实体肿瘤诊断中。早期动态~(18)F-FDG PET/CT成像结合常规标准~(18)F-FDG PET/CT代谢成像,对实体肿块进行一站式成像方法,能够更好的对肿瘤进行评估。 相似文献
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分化型甲状腺癌（Differentiated thyroid carcinoma,DTC）在其病程演变过程中,分化程度较低的复发或转移灶摄^131I能力降低而对^18F-脱氧葡萄糖（Fluoredeoxyglucose,FDG）摄取增多。因此,依赖于^131I和FDG显像的两种不同机制,正电子发射型断层成像（Positron Emission Tomography,PET）探测非功能性DTC复发或转移灶兼具定位诊断、敏感性及特异性都高的优点。因此。DTE患者随访期间,对甲状腺球蛋白阳性（Thyroglobulin positive,TG＋）（在促甲状腺激素刺激作用下TG〉10μg／L或在促甲状腺激素被抑制作用下TG〉2μg／L）或TG阴性（TG negative,TG-）但TsAb〉200U／mL,且131I-诊断剂量全身显像阴性（Diagnostic whole—body scanning negative,dWBS-）的高危患者（Ⅲ期或Ⅳ期患者）是进行^18F—FDG PET显像的指征。同机融合显像设备PET／CT、PET／MRI具有更高的敏感性和分辨率,为病灶的定性和定位,提供更准确的信息。 相似文献
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《Médecine Nucléaire》2022,46(4):198-200
Benign ovarian tumors like fibroma rarely shows mild or moderate F-18 FDG uptake. FDG-avid adnexial lesions in postmenopausal women should be as considered primarily malignant. A 69 years old female who had diagnosis with both colon adenocarcinoma and lung carcinoma, was referred to F-18 FDG PET/CT imaging for follow up. A mass lesion showing moderate F-18 FDG uptake at right adnexial region was detected. She was operated after gynaecological evaluation. Her histopathology examination was reported as ovarian fibroma. 相似文献
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为评价18F-FDG PET/CT参数对不同表皮生长因子受体(epithelial growth factor receptor, EGFR)基因状态晚期肺腺癌患者同步放化疗的疗效预测价值,本研究选择2016年1月至2018年2月我院初诊的100例晚期肺腺癌患者,比较不同EGFR基因状态下晚期肺腺癌患者同步放化疗治疗的临床疗效,并对18F-FDG PET/CT显像中原发病灶的各项代谢参数,代谢肿瘤体积(MTV)、最大标准摄取值(SUVmax)、平均标准摄取值(SUVmean)和总肿瘤糖酵解(TLG)值,以预测不同EGFR基因状态晚期肺腺癌患者同步放化疗效果的受试者工作特征曲线(receiveroperatingcharacteristiccurve,ROC曲线),并进行分析。结果显示,SUVmax预测不考虑EGFR基因状态的晚期肺腺癌患者放化疗疗效的截断值为9.50 (AUC=0.715,敏感度=79.7%,特异性=61%,p=0.031),SUVmax预测EGFR野生型的晚期肺腺癌患者放化疗疗效的截断值为9.50 (敏感度=82.4%,特异性=64.3%, p=0.014)。MTV预测EGFR 19号及21号外显子突变的晚期肺腺癌患者放化疗疗效的截断值分别为93.50(敏感度=63.6%,特异性=92.3%, p=0.021),77.00 (敏感度=83.3%,特异性=69.2%, p=0.041)。综上所述,对于EGFR基因状态不明的肺腺癌患者,SUVmax值可较好的预测放化疗效果,尤其是对于EGFR野生型患者;当EGFR19号及21号外显子突变时,MTV值预测结果优于SUVmax值。 相似文献
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J. Zhang-Yin 《Médecine Nucléaire》2018,42(4):285-292
18F-NAF PET/CT is a relatively uncommon imaging procedure in France, for which indications are similar to those for bone scan and that shows substantial advantages when compared to it. In this review article, we propose to introduce this poorly known radiotracer, its validated indications, performances and some tips for interpretation that will be illustrated by 6 case reports. 相似文献
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PurposeThe aim of this study was to measure the occupational exposure using active personal dosimeters (APD) in the PET/CT department at different stages of the operation chain i.e. radiopharmaceutical arrival, activity preparation, dispensing, injection, patient positioning, discharge and compare the radiation exposure doses received using two automatic injection/infusion systems. This paper also reflects optimization processes that were performed to reduce occupational exposure.MethodsMeasured APD data were analysed for medical physicists, radiology technologists and administrative staff from 2014 till 2018. For dispensing and injecting 18F-FDG, the automatic infusion/injection system IRIDE (Comecer, Italy) or the automatic fractionator ALTHEA (Comecer, Italy) with wireless injection system WIS (Comecer, Italy) were used. Radiation exposure optimization methods were applied during the data collection period (installation of the transport port, patient management, APD alarm threshold and etc.).ResultsRadiology technologists who perform injection procedures, regardless of the automatic infusion system, received the highest radiation exposure dose. The average doses to the radiology technologists per one study were 1.72 ± 0.33 μSv and 1.16 ± 0.11 μSv with ALTHEA/WIS and IRIDE system, respectively. The average dose for accompanying the patient to the PET/CT scanner and scan procedure was 0.52 ± 0.07 μSv. For the medical physicists, the average dose was 0.29 ± 0.09 µSv. The measured dose for administrative staff was 0.30 ± 0.15 μSv.ConclusionsOccupational exposure can be effectively optimized by different means including staff monitoring with APD, implementation of radiation safety culture and the usage of automatic infusion systems. 相似文献
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孤立性肺结节的鉴别诊断一直是胸部影像学的研究热点。早期且准确地鉴别肺内小结节的良恶性,对于患者治疗方案的确定以及随访情况的评估均具有重要的临床意义。~(18)F-FDG PET/CT在鉴别诊断恶性肿瘤方面具有明显优于其他传统检查的高特异性和高敏感性,其公认的恶性肿瘤的诊断阈值是最大化标准摄取值(maximum standard uptake value, SUVmax)为2.5,然而部分临床数据显示一些直径小于1 cm的恶性肺结节的SUVmax数值小于2.5。因此在早期研究中,~(18)F-FDG PET/CT在诊断直径较小的肺结节的其临床价值仍存在争议。为了尽量降低SUVmax的测量误差,提高~(18)F-FDG PET/CT诊断的准确率,衍生出了许多SUVmax辅助诊断方法以及优化的重建算法、放射性显像剂的联合应用等手段。本文将对~(18)F-FDG PET/CT鉴别诊断直径小于1 cm孤立性肺结节的研究进展进行综述。 相似文献
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Histerosalpingography (HSG) remains the dominant diagnostic tool for investigation of infertility in women. Conversion factors used to estimate effective (E) and organ doses (HT) from air Kerma area product (KAP) are needed to estimate patient doses in HSG, performed with state-of-the-art fluoroscopic X-ray systems with digital detectors.In this study, estimates of E and HT for six critical organs/tissues, were derived on an individual basis in 120 HSG procedures and in 1410 irradiation events, performed on two X-ray systems from information available through the radiation dose structured report using Monte Carlo methods.Mean values of E and Hovaries were1.0 ± 0.9 mSv and 5.6 ± 5.4 mGy. E/KAP conversion factors of 0.13; 0.18; 0.28 and 0.35 mSv Gy−1cm−2 were established for irradiation events with a Cu filtration of 0.0; 0.1; 0.4 and 0.9 mm. A high agreement was obtained between E estimated through Monte Carlo methods and E/KAP conversion factors accounting separately for the different modes of fluoroscopy and the radiography component of HSG, with a systematic error of 0 mSv and lower/upper limits of agreement of −0.6 and 0.5 mSv. On the contrary, the use of a single coefficient of conversion did not provide accurate estimates of E, showing a bias of −0.4 mSv and lower and upper limits of agreement of −1.9 and 1.2 mSv.An algorithm for the estimation of effective and organ doses from KAP has been established in HSG procedures depending on the Cu filtration in the X-ray irradiation events. 相似文献
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PurposeTo investigate within phantoms the minimum CT dose allowed for accurate attenuation correction of PET data and to quantify the effective dose reduction when a CT for this purpose is incorporated in the clinical setting.MethodsThe NEMA image quality phantom was scanned within a large parallelepiped container. Twenty-one different CT images were acquired to correct attenuation of PET raw data. Radiation dose and image quality were evaluated.Thirty-one patients with proven multiple myeloma who underwent a dual tracer PET/CT scan were retrospectively reviewed. 18F-fluorodeoxyglucose PET/CT included a diagnostic whole-body low dose CT (WBLDCT: 120 kV-80mAs) and 11C-Methionine PET/CT included a whole-body ultra-low dose CT (WBULDCT) for attenuation correction (100 kV-40mAs). Effective dose and image quality were analysed.ResultsOnly the two lowest radiation dose conditions (80 kV-20mAs and 80 kV-10mAs) produced artifacts in CT images that degraded corrected PET images. For all the other conditions (CTDIvol ≥ 0.43 mGy), PET contrast recovery coefficients varied less than ± 1.2%.Patients received a median dose of 6.4 mSv from diagnostic CT and 2.1 mSv from the attenuation correction CT. Despite the worse image quality of this CT, 94.8% of bone lesions were identifiable.ConclusionPhantom experiments showed that an ultra-low dose CT can be implemented in PET/CT procedures without any noticeable degradation in the attenuation corrected PET scan. The replacement of the standard CT for this ultra-low dose CT in clinical PET/CT scans involves a significant radiation dose reduction. 相似文献
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Conversion factors used to estimate effective (E) and organ doses (HT) from air Kerma area product (KAP) are required to estimate population doses in percutaneous transhepatic biliary drainage (PTBD) and trans arterial chemoembolization (TACE) interventional procedures.In this study, E and HT for ten critical organs/tissues, were derived in 64 PTBD and 48 TACE procedures and in 14,540 irradiation events from dosimetric, technical and geometrical information included in the radiation dose structured report using the PCXMC Monte Carlo model, and the ICRP 103 organ weighting factors. Conversion factors of: 0.13; 0.19; 0.26 and 0.32 mSv Gy−1 cm−2 were established for irradiation events characterized by a Cu filtration of 0.0; 0.1; 0.4 and 0.9 mm, respectively. While a single coefficient of conversion is not able to provide estimates of E with enough accuracy, a high agreement is obtained between E estimated through Monte Carlo methods and E estimated through E/KAP conversion factors accounting separately for the different modes of fluoroscopy and the fluorography component of the procedures.An algorithm for the estimation of effective and organ doses from KAP has been established in biliary procedures which considers the Cu filtration in the X-ray irradiation events. A similar algorithm could be easily extended to other interventional procedures and incorporated in radiation dose monitoring systems to provide dosimetric estimates automatically with enough accuracy to assess population doses. 相似文献
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PurposeTo compare the organ-dose and effective-dose (E) delivered to the patient during percutaneous vertebroplasty (PVP) of one thoracic or lumbar vertebra performed under CT guidance or using a fixed C-arm.MethodsConsecutive adult patients undergoing PVP of one vertebra under CT-guidance, with optimized protocol and training of physicians, or using a fixed C-arm were retrospectively included from January 2016 to June 2017. Organ-doses were computed on 16 organs using CT Expo 2.4 software for the CT procedures and PCXMC 2.0 for the fixed C-arm procedures. E was also computed with both software. Dosimetric values per anatomic locations for all procedures were compared using the paired Mann-Whitney-Wilcoxon test.ResultsIn total, 73 patients were analysed (27 men and 46 women, mean age 78 ± 10 years) among whom 35 (48%) underwent PVP under CT guidance and 38 (52%) PVP using a fixed C-arm. The median E was 11.31 [6.54; 15.82] mSv for all PVPs performed under CT guidance and 5.58 [3.33; 8.71] mSv for fixed C-arm and the differences was significant (p<0.001). For lumbar PVP, the organ doses of stomach, liver and colon were significantly higher with CT-scan than with the fixed C-arm: 97% (p=0.02); 21% (p=0.099) and 375% (p=0.002), respectively. For thoracic PVP, the lung organ dose was significantly higher with CT-scan than with the fixed C-arm (127%; p<0.001) and the oesophagus organ doses were not significantly different (p = 0.626).ConclusionThis study showed that the E and the organ dose on directly exposed organs were both higher for PVP performed under CT-guidance than with the fixed C-arm. 相似文献
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