喉癌18F-FDG PET/CT显像的临床应用价值

目的探讨18F-脱氧葡萄糖(FDG)PET/CT显像相对于单独的18F-FDG PET显像在喉癌诊断中的临床价值以及评价平均标准化摄取值(SUVmean)在喉癌和喉生理性显像鉴别中的作用。方法疑似喉癌患者23例。男19例,女4例,年龄30～70岁。空腹6H以上,静脉注射7.4MBq/kg 18F-FDG后40min后仰卧位行头颈部或全身扫描。分别评价18F-FDG PET和18F-FDG PET/CT显像对病灶诊断的灵敏度和特异性。19例病理为鳞癌的喉癌患者与15例喉生理性显像患者作为对照,测定显像部位的SUVmean,试用受试者工作曲线特征(Receivrer Operation Characteristic,ROC)及阳性似然比(positive likelihood ratio,+LR)确定SUVmean阈值。结果 23例喉癌患者,108处病灶。18 F-FDGPET显像和18F-FDG PET/CT显像对病灶诊断的灵敏度分别为85.1%(40/47)和89.4%(42/47),差异无统计学意义(P>0.05),特异性分别为和72.1%(44/61)和91.8%(56/61),差异有统计学意义(P<0.05)。19例病理为鳞癌的喉癌患者SUVmean均数为7.3±2.9,15例喉生理性显像SUVmean均数为4.9±1.1,差异有统计学意义(P<0.05)。SU-Vmean阈值选定为6.1,18 F-FDG PET/CT显像喉癌诊断的灵敏性为63.2%,特异性为86.7%。结论 18 F-FDG PET/CT显像明显改善18F-FDG PET显像的特异性。SUVmean阈值选定为6.1,有利于喉癌和喉生理性显像的鉴别。

Application of PET/CT imaging in the diagnosis of cancer of the larynx

Objective Cancer of the larynx is the most common malignant tumor in the head and neck region. The pur- pose of the present study was to evaluate the clinic value of 18 F-FDG PET/CT imaging in the diagnosis of cancer of the lar- ynx compare with 18 F-FDG PET imaging alone and to assess if median standardized uptake values （ SUVmean ） can differentiate physiological uptake from malignant tumor. Methods Study was conducted in 23 patients with clinical suspicion of cancer of the larynx. There were 19 men, four women, aged 30 to 70 years. 18 F-FDG PET/CT imaging was performed 40 rain after injection of tracer 18F-FDG, 7.4 MBq/kg after 6 hours fasting period in supine position, covering head and neck or the whole body. Assess sensitivity and specificity of laF_FDG PET/CT imaging in diagnosis of lesions compared with ^18F-FDG PET imaging alone. There were two groups in our study.. （1） 19 cases with squamous cell carcinoma of the larynx and （2）15 cases with physiological focal uptake in the region of larynx. SUVmean of uptake in the region of larynx was measured. Cutoff for the SUVmean was established by the analysis of ROC curve of SUVmean and positive likelihood ratio. Results The study analysis showed that 18 F-FDG PET/CT imaging had a sensitivity of 89.4%, specificity of 91.8O/oo as compared with 85.1%, 72.1% for 18 F-FDG PET imaging alone. SUVmean mean of 19 cases with squamous cell carcino- ma of the larynx was 7.3±2.9,SUVmean of 15 cases with physiological focal uptake in the region of larynx was 4.9± 1.1 ,these two groups were differ （ P 〈0.05）. In the absence of an established cutoff for the SUVmean, the value of 6.1 was seemed to represent the best discriminate cutoff, 18 F-FDG PET/CT imaging had a sensitivity of 63.2 %, specificity of 86.7%. Conclusion 18F-FDG PET/CT imaging improved the specificity of 18F-FDG PET imaging alone. It was good for discrimination between physiological uptake and malignant tumor, when cutoff for the SUVmean was 6. 1.