18F-FDG符合线路显像与异机CT图像融合诊断非小细胞肺癌复发转移的价值

目的 评价18F-脱氧葡萄糖(FDG)符合线路显像与异机CT图像融合诊断非小细胞肺癌(NSCLC)术后放化疗后复发转移的价值.方法 对可疑复发转移的40例NSCLC患者行18F-FDG符合线路显像,并于显像前后1周内行CT扫描.用三维(3D)图像融合软件进行图像融合.结果 在18F-FDG符合线路显像与CT扫描相同的范围内,40例患者共检出病灶58处,其中恶性52处,良性6处.融合图像诊断NSCLC复发转移的灵敏度、特异性、准确性、阳性预测值、阴性预测值、阳性似然比及阴性似然比分别为94.23%(49/52),5/6,93.10%(54/58),98.00%(49/50),5/8,5.65及0.07.图像融合灵敏度、准确性明显高于CT.单纯18F-FDG符合线路显像诊断效能与图像融合无差别,但与CT图像融合可明显提高对病灶的定位诊断(提高44.83%).结论 18F-FDG符合线路与CT图像融合诊断NSCLC术后放化疗后复发转移灵敏度高,定位准确,值得推广应用.

Image fusion diagnostic value of 18F-FDG coincidence image and spiral CT in non-small cell lung cancer recurrence and metastases

Objective The aim of this study was to evaluate the clinical value of software based imaging fusion of 18F-fluorodeoxyglucose (FDG) coincidence study and diagnostic CT in re-staging non small cell lung cancer (NSCLC). Methods Forty NSCLC patients were included for re-staging. All had 18F-FDG coincidence image and diagnostic CT within one week. The software based imaging fusion was done automatically by three-dimension (3D) image fusion software (syngo, Siemens). The gold standard of lesion identification was either histopathology or clinical follow-up. Results With the help from fusion technique, 58 lesions from 40 NSCLC patients were detected. Of the 58 lesions, 52 were malignant and 6 were benign. The sensitivity, specificity, accuracy, positive predictive value, negative predictive value, positive likelihood ratio and negative likelihood ratio of the software based imaging fusion results were 94.23%(49/52),5/6,93.10%(54/58),98.00%(49/50),5/8,5.65 and 0.07, respectively. As compared with the results from diagnostic CT, the sensitivity and accuracy in lesions detection were significantly higher with fusion technique. Though no statistical difference between 18F-FDG coincidence image alone or combined with diagnostic CT (with fusion), the clinical impact of fusion technique was to improve the localization of lesions up to 44.83%. Conclusions With the fusion technique, the localization of lesions at lung can be improved. Therefore, the re-staging at T- and N- status for NSCLC can be further improved.