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目的对于黑色素瘤病人,确定PET对于不同大小肺转移的敏感性,以及哪些病人还需要进一步检查来确定分期。方法 2008年1月—2011年6月共183例黑色素瘤病人为明确分期或随访而进行18F-FDGPET/CT检查,回顾性分析其中38例[女18例,男20例;平均年龄(62.0±14.7)岁]CT影像中存在一处或多处肺转移的病例。将每个肺转移瘤的PET结果分为阳性和阴性,在CT影像上评价病灶大小(最大横径)。根据病灶大小差距2mm对体积进行分组,评价PET的敏感性。结果共分析181个肺内转移灶。PET对于4～5mm、6～7mm、8～9mm、10～11mm、12～14mm和≥15mm病灶的敏感度分别为7.9%、33.3%、56.8%、63.6%、100%和100%。不同病灶大小组间的敏感度差异具有统计学意义(P<0.001)。结论在目前的PET/CT技术条件下,对于胸部CT存在一处或多处直径<12mm、PET为阴性结节的黑色素瘤病人,还需要进一步检查来明确分期。
Objective To determine the sensitivity of PET to different sizes of lung metastases in patients with melanoma, and which patients still need further examination to determine the stage. Methods From January 2008 to June 2011, a total of 183 patients with melanoma underwent 18F-FDG PET/CT for definite staging or follow-up. 38 patients were retrospectively analyzed (18 women, 20 males; mean age (62.0±) 14.7) The presence of one or more lung metastases in CT images. The PET results of each lung metastasis were scored as positive and negative, and lesion size (maximum transverse diameter) was evaluated on CT images. According to the lesion size difference of 2mm to group the volume, evaluate the sensitivity of PET. Results A total of 181 intrapulmonary metastases were analyzed. The sensitivity of PET to lesions of 4 to 5 mm, 6 to 7 mm, 8 to 9 mm, 10 to 11 mm, 12 to 14 mm, and ≥ 15 mm were 7.9%, 33.3%, 56.8%, 63.6%, 100%, and 100%, respectively. There was a statistically significant difference in sensitivity between different lesion size groups (P<0.001). Conclusion Under the current PET/CT technique, there is one or more melanoma patients with a diameter of <12 mm and PET negative nodules on the chest CT. Further examination is needed to determine the staging.