The clinical application research of positron emission tomographic-CT in lung cancer
- Author:
- No author available
- Journal Title:
- CHINESE JOURNAL OF RADIOLOGY
- Issue:
- 11
- DOI:
- 10.3760/j.issn:1005-1201.2005.11.006
- Key Word:
- 肺肿瘤;体层摄影术,发射型计算机;体层摄影术,X线计算机;诊断
Abstract： 目的探讨18氟-脱氧葡萄糖(18F-FDG)正电子发射计算机体层摄影(PET)-CT对肺癌诊断、分期、治疗及疗效监测的临床应用价值.方法 80例肺癌患者,其中66例为术前诊断分期,14例为治疗后复查患者.均行18F-FDG PET-CT检查,23例行胸部检查,57例行全身检查.所有病例均在PET-CT检查前后加做薄层螺旋CT扫描.最后诊断均经手术病理、纤维支气管镜或穿刺活检病理证实.分析不同病理类型肺癌的18F-FDG摄取能力与病理诊断的符合率.按照美国癌症联合委员会(AJCC)肺癌的TNM分期标准对病变分别行CT、PET-CT分期,并将组织病理结果作为参照标准.结果 (1)所有原发性肺癌均示异常放射性高摄取.不同组织学类型的肺癌对18F-FDG的摄取能力差异较大,以腺鳞癌和低分化鳞癌的摄取能力最强.(2)66例术前诊断分期的患者中,与病理符合的肺癌N分期,PET-CT 61例,CT 48例.PET-CT对肺癌的N分期与CT相比差异有统计学意义(χ2=8.89, P<0.01).对肺癌N分期的敏感性、特异性、阳性预测值、阴性预测值,PET-CT分别为80.09%、97.14%、96.11%、84.70%;CT分别为56.48%、71.02%、63.21%、64.93%.CT发现了11例患者的17处转移,PET-CT发现了16例患者的39处转移.PET-CT与CT相比,改变了18例患者的治疗计划.(3)对14例治疗后复查的患者PET-CT能显示其在早期评价治疗疗效、区别手术瘢痕与复发提供了指导临床治疗等方面的信息.结论 18F-FDG PET-CT对肺癌的诊断、分期有较高的诊断效能,对治疗及预后监测具有积极的意义.
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