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The Application of Positron Emission Tomography/Computed Tomography Imaging on Differential Diagnosis of Pulmonary Nodules

Author: DuanZhongXiang
Tutor: TianJiaHe
School: PLA Postgraduate Medical School
Course: Medical Imaging and Nuclear Medicine
Keywords: (18) ~ F-FLT Solitary lung nodules SUVmax Differential Diagnosis (18) ~ F-FDG Pulmonary solitary nodules Diagnostic performance Dual- tracer Pulmonary nodules Maximum SUV values Ratio
CLC: R816.4
Type: Master's thesis
Year: 2011
Downloads: 41
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Abstract


The value of the first part: topic 18F-FLT PET / CT imaging in the diagnosis of pulmonary solitary nodules, benign and malignant Objective To evaluate the value of 18F-FLT PET / CT imaging in the differential diagnosis of solitary lung nodules. Materials and methods prepared MINITrace cyclotron and automated synthesis module (Tracerlab FX-FN, American GE company), 52 single lung nodules using the U.S. company GE Discovery ST type PET / CT, 18F-FLT imaging agent line 18F-FLT PET / CT examination patients were retrospectively analyzed, including 40 males and 12 females; ages 35-72 years old, with an average age of 56 years old. Pathology results tracking, 36 cases of lung cancer, tuberculosis: seven cases of inflammation: 9 cases. Get a group of lung cancer, tuberculosis group and pneumonia group average maximum uptake value (SUVmax), and calculate the sensitivity, specificity, and accuracy of the application of 18F-FLT diagnosis of lung cancer, the data processing using the CHISS2004 statistical software for processing and calculation. Results in patients with a final diagnosis of lung cancer in 36 cases, 36 cases of lesions have different levels of 18F-FLT uptake SUVmax0.6 ~ 6.04 ± 1.87 average SUVmax3.61, including 32 cases of the SUVmax ≥ 1.5.16 benign nodules in the. , SUVmax0.18 ~ 2.48, the average SUVmax0.92 ± 0.76,7 cases in patients with tuberculosis ball, have different levels of radioactivity uptake, average SUVmax1.64 ± 0.60,9 inflammatory nodules are the low level of radioactivity uptake , close to the surrounding normal lung tissue. Benign nodules, including three cases of the SUVmax ≥ 1.5 are tuberculosis. Simple application of 18F-FLT diagnosis of lung cancer, the sensitivity, specificity, and accuracy were 88%, 81%, 87%. The conclusion simple application 18F-FLT diagnosis of pulmonary solitary nodules, sensitivity, specificity, and accuracy were 80% more application of 18F-FLT relatively high value in the differential diagnosis of lung nodules, but tuberculosis can also higher 18F-FLT uptake. Part II: topic 18F-FDG and 18F-FLT the two imaging agent in the differential diagnosis of lung nodules in benign and malignant value comparison purposes to compare two imaging agent 18F-FDG and 18F-FLT in lung single Materials and methods of value in the differential diagnosis of nodular U.S. company GE Discovery ST PET / CT, 52 lung single nodules admission examination, two parallel 18F-FLT and 18F-FDG tracer PET / CT check the patients were retrospectively analyzed, including 40 males and 12 females; aged 35-72 years old, the average age of 56 years old. Last pathologically confirmed 36 cases of lung cancer, tuberculosis, pneumonia. After using CHISS2004 statistical software processing and calculation, calculation of the maximum standard uptake value of the mean of the lung cancer group, tuberculous pneumonia group two tracers, two kinds of tracers and calculate the sensitivity, specificity, and accuracy of the diagnosis of lung cancer. Results in 36 patients eventually diagnosed with lung cancer, 33 patients (33/36) of patients with 18F-FDG maximum standardized uptake value (SUVmax-FDG) ≥ 2.5, average SUVmax of from-FDG8.80 ± 4.51; 16 benign nodules average SUVmax2.44 ± 1.19, tuberculosis SUVmax 3.04 ± 1.38, the inflammatory nodules SUVmax1.98 ± 0.81,7 cases of tuberculosis patients in the three cases ((3/7) SUVmax of-FDG gt; 2.5,9 cases inflammatory nodules in 3 cases (3/9) of SUVmax of-FDG ≥ 2.5; 36 patients with lung cancer, 18F-FLT standardized uptake value (SUVmax-FLT) 0.6 to 6.04, an average of the SUVmax-FLT3.61 ± 1.87 the of average SUVmax of-16 cases of benign nodules ± 0.75 FLT0.92, tuberculosis of the SUVmax-FLT 1.62 ± 0.60, inflammation SUVmax-FLT0.37 ± 0.13,7 cases of tuberculosis in 3 cases (3/7) the SUVmax-FLT ≥ 1.5, nine cases of inflammatory nodules, SUVmax-FLT ≤ 1.5; two tracers, SUVmax of lung cancer group, a statistically significant difference (P lt; 0.01). to the SUVmax-FDG gt; 2.5 as standard, 18F-FDG diagnosis of pulmonary malignant tumor sensitivity, specificity, and accuracy were 92%, 63%, 82%; SUVmax-FLT ≥ 1.5 standard, the diagnosis of lung cancer in 18F-FLT sensitivity, specificity, and accuracy were 88% , 81%, 87%. conclusions of the two tracers in the diagnosis of pulmonary solitary nodule, 18F-FLT uptake in lung nodules is lower than 18F-FDG. differential diagnosis of lung cancer, 18F- value Objective To analyze the diagnostic sensitivity of FLT lower than 18F-FDG, specificity and accuracy than 18F-FDG. third part entitled 18F-FLT and 18F-FDG joint application in the differential diagnosis of solitary lung nodules 18F -FDG and 18F-FLT the two tracers joint application in the differential diagnosis of solitary lung nodules diagnosis performance materials and methods using the U.S. company GE Discovery the ST type PET / CT, 52 single lung nodules admission examination, parallel both 18F-FLT and 18F-FDG tracer PET / CT scan patients were retrospectively analyzed, including 40 males and 12 females; aged 35-72 years old, the average age of 56 years old. final pathology confirmed 36 cases of lung cancer, tuberculosis, pneumonia, 9 cases meet the maximum standard uptake value method and the maximum uptake value ratio method, and the two methods, and compare these three methods of diagnostic performance in the differential diagnosis of lung cancer. 1, lesions were nodular or lumpy uptake of radioactive SUVmax of-FDG gt; 2.5 and SUVmax-FLT ≥ 1.5 at the same time meet the diagnostic imaging standard for judging the malignancy, the diagnosis of lung cancer, the sensitivity, specificity, and accuracy were 89%, 88%, 88%, the ratio method, 0.3 ≦ SUVmax-FLT / SUVmax-FDG ≦ 0.95 for diagnostic imaging standard, the sensitivity, specificity, and accuracy of the diagnosis of lung cancer were sensitivity of 78%, 63%, 73% 3, the SUVmax-FDG gt; 2.5 and the SUVmax-FLT ≥ meet 1.5,0.3 ≦ SUVmax-FLT/SUVmax-FDG ≦ 0.95, the diagnosis of pulmonary solitary nodule , specificity, and accuracy were 69%, 94%, 77%. conclusion using the two tracers agent 18F-FLT and 18F-FDG differential diagnosis of pulmonary nodules compared the diagnostic performance of the three methods, In the present study, when the SUVmax-FDG gt; 2.5 and SUVmax-FLT ≥ 1.5 at the same time meet the high specificity and accuracy achieved satisfactory results. less accumulated cases in the study, pending additional The number of patients to compare the value of the three methods.

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CLC: > Medicine, health > Of Medical > Radiation Medicine > Each location and course of disease X - ray diagnosis and therapy > Chest and respiratory system
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