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目的初步探讨~(18)氟-脱氧葡萄糖(~(18)F-FDG)双探头符合线路(DHC)单光子计算机断层显像术(SPECT)显像与CT同机图像融合对非小细胞肺癌(NSCLC)淋巴结转移分期的诊断价值。方法44例确诊为NSCLC患者1个月内均行~(18)F-FDG DHC-SPECT/CT显像及胸部增强螺旋CT检查,2周内完成外科手术和病理学检查。~(18)F-FDG DHC-SPECT/CT显像经过全能量X线衰减校正,并采用有序子集最大期望值法(COSEM)迭代重建后,将同机CT图像与符合线路图像(正电子发射断层显像术,PET)进行图像融合,获得横断面、矢状面、冠状面三维断层图像。再采用视觉分析法和利用感兴趣区(ROI)技术的半定量分析计算病变淋巴结(L)与周围纵隔组织(N)的摄取比值R(L/N)。将~(18)F-FDG DHC-SPECT/CT显像及胸部增强螺旋CT检查对肺癌淋巴结转移分期的诊断结果均与病理结果进行比较。结果以摄取比值R≥1．5为判断标准,诊断肺癌淋巴结转移的灵敏度为75．0%(15/20例)、特异度为91．7%(22/24例)、准确率为84．1%(37/44例)、阳性和阴性预测值分别为88．2%(15/17例)和81．5%(22/27例)。15例~(18)F-FDG显像为阳性的转移淋巴结的ROI分析最大摄取比值为9．4,最小为1．6。结论~(18)F-FDG DHC-SPECT/CT显像对肺癌的纵隔淋巴结、锁骨上淋巴结转移分期诊断具有较高的灵敏度、特异度和准确率,可为临床制定治疗方案、观察疗效和疾病分期提供重要的临床依据。
Objective To investigate the clinical value of ~ (18) Fluoro-deoxyglucose (~ (18) F-FDG double probe coincidence line (DHC) single photon computed tomography (SPECT) (NSCLC) lymph node metastasis staging diagnostic value. Methods Forty-four patients diagnosed as NSCLC underwent ~ (18) F-FDG DHC-SPECT / CT imaging and thoracic enhanced spiral computed tomography (CT) within one month. All patients underwent surgical and pathological examination within 2 weeks. After 18-F-FDG DHC-SPECT / CT imaging was corrected by X-ray attenuation of all-energy system and was iteratively reconstructed by using COSEM, Emission tomography, PET) image fusion, cross-sectional, sagittal, coronal three-dimensional tomographic images. The R (L / N) ratio of the lesion lymph nodes (L) to the surrounding mediastinal tissue (N) was calculated by semi-quantitative analysis using visual analysis and ROI techniques. The diagnostic results of ~ (18) F-FDG DHC-SPECT / CT imaging and chest enhanced helical CT in lymph node metastasis of lung cancer were compared with the pathological results. Results The diagnostic sensitivity was 75.0% (15/20 cases) and 91.7% (22/24 cases), respectively. The accuracy was 84%. 1% (37/44 cases), the positive and negative predictive values were 88.2% (15/17 cases) and 81.5% (22/27 cases) respectively. In 15 patients with ~ 18 F-FDG imaging positive lymph nodes, the maximum uptake ratio of ROI was 9.4 and the minimum was 1.6. Conclusions ~ (18) F-FDG DHC-SPECT / CT imaging has high sensitivity, specificity and accuracy for the diagnosis of mediastinal lymph nodes and supraclavicular lymph node metastasis in lung cancer. It can be used as a clinical treatment plan to observe the curative effect and disease Staging provides an important clinical basis.