18F-FDG PET/CT影像辅助CT引导下经皮穿刺活组织检查术的临床应用

目的 评价一日法18F-脱氧葡萄糖(FIX;)PET/CT全身扫描联合18F-FDG PET/CT影像辅助CT引导下经皮穿刺活组织检查术用于恶性实体肿瘤分期与定性诊断的临床价值.方法 16例实体占位病变患者,全部行一日内全身18F-FDG PET/CT扫描结合18F-FDG PET/CT影像辅助CY引导下经皮穿刺活组织检查术.每例患者的2种检查均在同一台PET/CT扫描仪上完成.共获18份适合病理分析的标本.分别以活组织检查标本结合外科术后病理检查,或临床随访结果为依据,建立最后诊断.采用SPSS 13.0软件,对2种检查结果进行比较(Fisher精确概率法).结果 16例患者中,最后诊断恶性12例,良性4例.有10例18F-FDG;PET/CT影像诊断与穿刺活组织病理检查结果一致.10例18F-FDG PET/CT诊断为恶性病变者中,最终诊断为恶性8例,良性2例.6例18F-FDGPET/CT诊断为良性者中,最终诊断为良性2例,恶性4例.穿刺活组织检查结果与最后手术病理检查和随访诊断结果全部符合.PET/CT影像诊断与穿刺活组织检查结果之间差异无统计学意义(P=0.604).所有最后诊断为恶性实体肿瘤的患者,定性与分期在一日内完成;诊断为良性者则规定门诊长期随访,排除假阴性.穿刺获取组织学标本时间为平均每例15 min.该组病例均无严重并发症发生.结论 全身18F-FDG PET/CT扫描联合18F-FDG PET/CT影像辅助CT引导下经皮穿刺活组织检查术,有助于提高PET/CT诊断效能与穿刺活组织检查的成功率与准确性.当18F-FDG PET/CT影像诊断出现定性困难时,其价值尤为明显.

The combination of 18F-FDG PET/CT imaging and its guided tissue core biopsy in differentiating malignant from benign lesions

Objective It is well known that 18F-fluorodeoxyghicose (FDG) PET/CT might have false-positive and false-negative results in differentiating malignant from benign lesions. This study was to e-valuate the value of combining 18F-FDG PET/CT imaging with PET/CT guided tissue core biopsy on the same day so to improve the overall diagnostic capability. Methods Sixteen consecutive patients with de-tectable lesions underwent CT guided tissue core biopsy assisted by 18F-FDG PET/CT images after whole body PET/CT scan on a same-day protocol. The biopsy procedure took an average of 15 win. A total of 18samples were obtained for subsequent histological examinations. The final diagnosis was established by sur-gical or biopsy pathological findings and clinical follow-up. SPSS 13.0 and Fisher Exact Test were used to analyze the diagnostic ability of PET/CT alone and PET/CT combining with guided biopsy. Results Of these 16 patients, 12 were finally diagnosed as malignant and 4 as benign. Out of the 10 cases that had been considered as malignant based on 18F-FDG PET/CT scans, 8 were finally confirmed as malignant (TP) and 2 as benign (FP). Of the 6 lesions that were judged as benign on 18F-FDG PET/CT images, 2 were proven as benign (TN) and 4 as malignant (FN). Fisher's Exact Test showed that the difference between the re-suits of 18F-FDG PET/CT and tissue core biopsy was not statistically significant (P=0.604). No serious complication in biopsy was found. Conclusion The combination of 18F-FDG PET/CT and its guided tissue core biopsy may improve the diagnostic capability, especially in cases when a definitive diagnosis by PET/CT alone is difficult to make.