摘要
目的探讨^18F-脱氧葡萄糖(FDG)PET/CT显像在恶性胸膜间皮瘤(MPM)诊断中的临床价值及原发肿瘤病灶平均标准摄取值(SUVmean)对患者预后的判断价值。方法回顾性总结17例2002—2008年临床疑诊MPM患者^18F-FDG PET/CT显像资料,测量病灶的SUVmean。将病理检查及临床随访证实的MPM患者按照有无转移分为2组,测定每例患者原发肿瘤病灶的SUVmean,用受试者工作特征(ROC)曲线评价SUVmean对患者转移与否的诊断价值,判断预后。采用SPSS11.0软件进行t检验。结果经病理及随访结果证实MPM12例,良性胸膜病变5例,二者的SUVmean分别为5.78±1.81和2.72±2.51,差异有统计学意义(t=2.8,P〈0.05)。全身^18F-FDG PET/CT显像诊断MPM的灵敏度为100%(12/12),特异性为4/5,准确性为94%(16/17)。^18F-FDG PET/CT显像有7例MPM伴有骨和(或)淋巴结转移。SUVmean ROC曲线分析表明曲线下面积(AUC)为0.80。结论全身^18F-FDG PET/CT显像对于MPM的诊断有重要价值。原发肿瘤病灶SUVmean越高越易发生转移,预后越差。
Objective Malignant pleural mesothelioma (MPM) is an uncommon neoplasm arising from mesothelial cells of the pleura. The prognosis is poor with median survival of 4- 12 months. The aim of this study was to evaluate the clinic value of ^18F-fluorodeoxyglucose (FDG) PET/CT imaging in the diagnosis and to staging of MPM and to determine if the mean standardized uptake value ( SUV ) of primary tumor correlates with staging and prognosis. Methods Study was conducted retrospectively including 17 patients with clinical suspicion of MPM from 2002 to 2008. Twelve cases of MPM and 5 cases benign pleural pathology were proven by histopathology and clinical follow-up. ^18F-FDG PET/CT imaging was performed 1 h after injection of 7.4 MBq/kg ^18F-FDG. Patients with MPM confirmed by histopathology were divided into two groups: with and without metastasis. PET/CT findings were analyzed to determine if SUVmean of primary tumor correlates with staging and prognosis. Receiver operating characteristic ( ROC) curve of SUVmean of primary tumor was evaluated to determine if it was a predictor of metastasis and survival time. Results The difference in SUVmean between MPM and benign plcural were statistical significant (5.78 ± 1.81 vs 2.72 ± 2.51, t = 2. 8, P 〈 0.05 ). The diagnostic sensitivity, specificity and accuracy of ^18F-FDG PET/CT imaging for MPM were 100% ( 12/12), 4/5 and 94% (16/17). All 7 cases of bone and lymph node metastases were detected by ^18F-FDG PET/CT imaging. Area under the curve (AUC) was 0. 80. Conclusions ^18F-FDG PET/CT imaging is useful in the diagnosis and staging of MPM. High SUVmean in the primary tumor correlates well with prognosis and predication of a greater propensity to have nodal and distant metastasis.
出处
《中华核医学杂志》
CAS
CSCD
北大核心
2009年第3期171-173,共3页
Chinese Journal of Nuclear Medicine