摘要
目的评价吡格列酮(PIO)介入后,18F-FDG PET/CT多时相显像对孤立性肺结节(SPN)的鉴别诊断价值。方法收集东莞东华医院核医学科2020年10月~2023年1月共86例SPN患者,对其行18F-FDG PET/CT多时相(1 h、2 h、4 h)显像,PIO介入后显像的42例为实验组(PIO组),常规显像的44例为对照组(非PIO组),分别测量各结节最大标准化摄取值(SUV_(max1)、SUV_(max2)、SUV_(max4)),计算2 h、4 h延迟显像滞留指数(RI2、RI4),结合病理及随访,分析实验组是否提高对SPN良恶性鉴别诊断效能,采用Mann-Whitney U检验及ROC曲线分析数据。结果各组SUV_(max2)、SUV_(max4)分别与SUV_(max1)比较,差异均有统计学意义(P<0.001)。PIO组内恶性SPN的SUV_(max1)、SUV_(max2)、SUV_(max4)、RI4均高于良性SPN,差异有统计学意义(P<0.05),RI2间的差异无统计学意义(P=0.214)。非PIO组内恶性与良性SPN各值差异均无统计学意义(P>0.05)。两组恶性病变的RI4差异有统计学意义(P=0.034),其余各值差异均无统计学意义(P>0.05)。两组良性病变以上各值的差异均无统计学意义(P>0.05)。以RI>10%为恶性病变的诊断标准,PIO组诊断SPN为恶性病变的准确性、灵敏度、特异度、阳性预测值、阴性预测值均高于非PIO组,4 h各指标均高于2 h。ROC曲线显示,PIO组RI4诊断恶性SPN的曲线下面积为0.732,明显高于其他各组。结论SPN经PIO作用后,4 h 18F-FDG PET/CT延迟显像可一定程度提高恶性肺结节的诊断效能。
Objective To evaluate the differential diagnostic value of 18F-FDG PET/CT multi-phase imaging after treated with pioglitazone(PIO)in the diagnosis of solitary pulmonary nodules(SPN).Methods Eighty-six SPN patients in the Department of Nuclear Medicine of Dongguan Tungwah hospital from October 2020 to January 2023 were collected.All patients were performed 18F-FDG PET/CT multi-phase(1 h,2 h,4 h)imaging,and 42 cases of imaging after PIO treatment were in the experimental group(PIO group),while 44 cases of conventional imaging were in the control group(Non-PIO group).The maximum standardized uptake values(SUV_(max1),SUV_(max2),SUVmax4)of each SPN was measured separately,and the retention index(RI2,RI4)of 2 h and 4 h delayed imaging was calculated.Finally,based on pathology and follow-up,whether the experimental group has improved the diagnostic efficacy in distinguishing between benign and malignant SPN was analyzed.The data was analyzed by using Mann-Whitney U test and ROC curve.Results There were statistically significant differences between SUV_(max2) and SUVmax4 in each group compared to SUV_(max1)(P<0.001).The SUV_(max1),SUV_(max2),SUVmax4 and RI4 of malignant SPN in the PIO group were significantly higher than those of benign SPN(P<0.05),while there was no statistical significance between RI2(P=0.214).There was no statistically significant difference in SPN values between malignant and benign SPN within the Non-PIO group(P>0.05).There was a statistically significant difference in RI4 between the two groups of malignant lesions(P=0.034),while there was no statistically significant difference in the other values(P>0.05).There was no statistically significant difference between the above values of benign lesions between the two groups(P>0.05).Using RI>10%as the diagnostic criterion for malignant lesions,the accuracy,sensitivity,specificity,positive predictive value,and negative predictive value of diagnosing malignant SPN in the PIO group were higher than those in the Non-PIO group,and all indicators in the 4 h were higher than those in the 2 h.ROC curves showed that the area under the curve of the PIO group RI4 in diagnosing malignant SPN was 0.732,significantly higher than other groups.Conclusion After PIO treatment,the 4 h 18FFDG PET/CT delayed imaging of SPN can improve the diagnostic efficacy of malignant pulmonary nodules to a certain extent.
作者
贾志斌
高中山
曾祥高
吴竟雄
李扬彬
苏晓燕
魏帮建
黄威
陈昌伟
JIA Zhibin;GAO Zhongshan;ZENG Xianggao;WU Jingxiong;LI Yangbin;SU Xiaoyan;WEI Bangjian;HUANG Wei;CHEN Changwei(Department of Nuclear Medicine,Dongguan Tungwah Hospital,Dongguan 523110,China;Pulmonary and Critical Care Medicine,Dongguan Tungwah Hospital,Dongguan 523110,China;Department of Radiology,Dongguan Tungwah Hospital,Dongguan 523110,China;Department of Nephrology,Dongguan Tungwah Hospital,Dongguan 523110,China;Department of Pathology,Dongguan Tungwah Hospital,Dongguan 523110,China)
出处
《分子影像学杂志》
2024年第8期861-865,共5页
Journal of Molecular Imaging
基金
东莞市社会发展科技(一般)项目(20211800901252)。
关键词
吡格列酮
正电子发射断层显像
孤立性肺结节
多时相
氟代脱氧葡萄糖
pioglitazone
positron emission tomography imaging
solitary pulmonary nodule
multi-phase imaging
fluorodeoxyglucose
