王 运,李林法,庞伟强.18F-FDG PET/CT半定量参数在肾上腺病灶鉴别诊断中的价值[J].肿瘤学杂志,2019,25(6):547-551.
18F-FDG PET/CT半定量参数在肾上腺病灶鉴别诊断中的价值
The Value of Semi-quantitative Parameters of 18F-FDG PET/CT in the Differential Diagnosis of Adrenal Lesions
投稿时间:2018-09-26  
DOI:10.11735/j.issn.1671-170X.2019.06.B011
中文关键词:  肾上腺病灶  标准化摄取值  18F-FDG  正电子发射型体层摄影术
英文关键词:adrenal lesion  SUV  18F-FDG  positron-emission tomography
基金项目:国家卫生计生委科学研究基金?鄄浙江省医药卫生重大科技计划(WKJ-ZJ-1814)
作者单位
王 运 浙江省肿瘤医院 
李林法 浙江省肿瘤医院 
庞伟强 浙江省肿瘤医院 
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中文摘要:
      摘 要:[目的] 探讨18F-FDG PET/CT半定量参数在鉴别肾上腺病灶中的价值。[方法] 对90例疑有肾上腺疾病患者的18F-FDG PET/CT检查结果进行分析。利用半定量分析法,测量所有病灶的T/L SUVmax、SUVmax、肿瘤直径和平均CT值,与最终病理结果比较。[结果] 共检出110个病灶,其中恶性肾上腺病灶51例、良性肾上腺病灶39例。恶性肾上腺病灶的平均T/L SUVmax(2.9±1.6)、SUVmax(8.3±5.1)、肿瘤直径(3.1cm±1.6cm)和平均CT值(31.9±7.0Hu)较良性病灶的平均T/L SUVmax(0.9±0.5)、SUVmax(2.7±1.4)、肿瘤直径(2.1cm±1.7cm)和平均CT值(12.1±17.5Hu)显著升高(P均<0.001)。假阳性3例、假阴性2例。ROC曲线分析显示,T/L SUVmax>1.15、SUVmax>3.86、CT值>23.5Hu和肿瘤直径>2.35cm可作为鉴别良恶性肾上腺病灶的最佳截断值。此最佳截断值的ROC曲线下的面积分别为0.95、0.95、0.84和0.76。多变量Logistic回归分析表明T/L SUVmax、SUVmax可作为恶性肾上腺病灶的独立诊断因素(P<0.001)。 [结论] 当T/L SUVmax>1.15、SUVmax>3.86时,18F-FDG PET/CT在鉴别肾上腺病灶性质中具有较高价值。T/L SUVmax、SUVmax均可作为预测恶性病灶的独立因素,且T/L SUVmax更为客观。
英文摘要:
      Abstract:[Objective] To evaluate the value of semi-quantitative parameters of 18F-FDG PET/CT for the differentiation of malignant from benign adrenal lesions. [Methods] Included 90 patients (58 men and 32women,age 60.1±11.6 year) who had undergone 18F-FDG PET/CT for evaluation of 110 adrenal lesions. For semi-quantitative analysis,adrenal to liver(T/L) SUVmax ratio,the maximum standardized uptake value(SUVmax),tumor diameter and mean CT attenuation value were measured in all lesions and compared with the pathological findings. [Results] A total of 110 lesions were detected,including 51 malignant and 39 benign. Malignant adrenal masses had a significantly higher T/L SUVmax ratio (2.9±1.6 vs. 0.9±0.5),a higher mean SUVmax (8.3±5.1 vs. 2.7±1.4),a greater tumor diameter (3.1±1.6cm vs. 2.1±1.7cm) and a higher mean CT attenuation value (31.9±7.0Hu vs. 12.1±17.5Hu) than benign lesions(P<0.001). There were three false positives and two false negatives. Based on ROC curve analysis,a T/L SUVmax ratio >1.15,an adrenal SUVmax>3.86,an attenuation value >23.5 Hu and a tumor diameter >2.35 cm were chosen as the optimal cut-off values for differentiating malignant from benign adrenal masses. The areas under the ROC curves for the selected cut-off values were 0.95,0.95,0.84 and 0.76,respectively. A multivariate logistic regression model revealed that the T/L SUVmax and SUVmax were an independent prognostic factor for malignancy(P<0.001);a CT attenuation value of >23.5 Hu and a tumor diameter >2.35 cm had no additional individual importance in the diagnosis of malignancy. [Conclusion] Using a T/L SUVmax ratio >1.15 and an adrenal SUVmax >3.86 in 18F-FDG PET/CT led to high diagnostic sensitivity,accuracy and positive predictive value for characterizing adrenal lesions. T/L SUVmax and SUVmax could be used as independent predictors of malignancy,however,the T/L SUVmax is more objective.
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