中华核医学与分子影像杂志
中華覈醫學與分子影像雜誌
중화핵의학여분자영상잡지
Chinese Journal of Nuclear Medicine and Molecular Imaging
2013年
3期
161-166
,共6页
吴湖炳%王全师%韩彦江%周文兰%李洪生
吳湖炳%王全師%韓彥江%週文蘭%李洪生
오호병%왕전사%한언강%주문란%리홍생
鼻咽肿瘤%肝细胞瘤%体层摄影术,发射型计算机%体层摄影术,X线计算机%胆碱%脱氧葡萄糖
鼻嚥腫瘤%肝細胞瘤%體層攝影術,髮射型計算機%體層攝影術,X線計算機%膽堿%脫氧葡萄糖
비인종류%간세포류%체층섭영술,발사형계산궤%체층섭영술,X선계산궤%담감%탈양포도당
Nasopharyngeal neoplasms%Hepatoma%Tomography,emission-computed%Tomography,X-ray computed%Choline%Deoxyglucose
目的 探讨11C-胆碱(CHO) PET/CT对18F-FDG PET/CT显像诊断鼻咽癌(NPC)和HCC的补充价值.方法 将明确诊断的NPC和HCC患者纳入该研究.该研究经医院伦理委员会通过,患者均签署知情同意书.2007年12月至2010年1月,15例局部进展型NPC和76例HCC患者均行18 F-FDG PET/CT显像,其中43例(15例NPC和28例HCC)同时行局部11C-CHO PET/CT显像.病灶处出现18 F-FDG或11C-CHO高摄取者为阳性.半定量分析采用SUVmax、肿瘤/脑(T/B)比值和肿瘤/肝(T/L)比值等指标.统计学分析采用两样本t检验、x2检验、Fisher确切概率法和直线相关分析.结果 (1)在15例局部进展型NPC患者中,病灶处18F-FDG SUVmax明显高于11 C-CHO SUVmax (12.81 ±5.00与6.84±2.76;t =6.416,P＜0.01),但11C-CHO PET/CT显像T/B比值明显高于18F-FDG PET/CT显像(18.62±7.95与1.38±0.59；t=8.801,P＜0.01).2种显像剂在病灶处的摄取结果明显相关(r =0.712,P＜0.01).与18F-FDG PET/CT显像比较,11C-CHO显像改进了50.0％(12/12与6/12;x2=8.000,P＜0.05)患者颅内侵犯病灶、4/14患者颅底侵犯病灶和3/3患者眼眶侵犯病灶的显示.(2)在76例HCC患者中,63.1％ (48/76)的患者18F-FDG PET/CT显像阳性.在28例18 F-FDG PET/CT显像阴性者中,71.4％ (20/28)的患者11C-CHO PET/CT显像阳性.18F-FDG联合11C-CHO使PET/CT诊断HCC的灵敏度从63.1％(48/76)提高到89.5％ (68/76；x2=14.559,P＜0.01).与18F-FDG PET/CT显像比较,11C-CHO PET/CT显像倾向易于检出高分化HCC[6/9与35.7％(5/14)；P =0.214]；在检测中分化HCC方面,两者差异无统计学意义[6/7与72.0％(18/25),P=0.648].11C-CHO PET/CT显像在检测直径＜5.0 cm的HCC方面较18 F-FDG PET/CT显像灵敏[72.7％ (16/22)与42.1％ (16/38)；x2=5.249,P＜0.05],特别是＜2.0 cm病灶[5/7与0/7;P=0.021].结论 11C-CHO与18F-FDG相结合可提高PET/CT对局部进展型NPC T分期诊断的准确性.11C-CHO可弥补18F-FDG显像在高中分化HCC诊断中的不足,从而提高PET/CT的诊断灵敏度.
目的 探討11C-膽堿(CHO) PET/CT對18F-FDG PET/CT顯像診斷鼻嚥癌(NPC)和HCC的補充價值.方法 將明確診斷的NPC和HCC患者納入該研究.該研究經醫院倫理委員會通過,患者均籤署知情同意書.2007年12月至2010年1月,15例跼部進展型NPC和76例HCC患者均行18 F-FDG PET/CT顯像,其中43例(15例NPC和28例HCC)同時行跼部11C-CHO PET/CT顯像.病竈處齣現18 F-FDG或11C-CHO高攝取者為暘性.半定量分析採用SUVmax、腫瘤/腦(T/B)比值和腫瘤/肝(T/L)比值等指標.統計學分析採用兩樣本t檢驗、x2檢驗、Fisher確切概率法和直線相關分析.結果 (1)在15例跼部進展型NPC患者中,病竈處18F-FDG SUVmax明顯高于11 C-CHO SUVmax (12.81 ±5.00與6.84±2.76;t =6.416,P＜0.01),但11C-CHO PET/CT顯像T/B比值明顯高于18F-FDG PET/CT顯像(18.62±7.95與1.38±0.59；t=8.801,P＜0.01).2種顯像劑在病竈處的攝取結果明顯相關(r =0.712,P＜0.01).與18F-FDG PET/CT顯像比較,11C-CHO顯像改進瞭50.0％(12/12與6/12;x2=8.000,P＜0.05)患者顱內侵犯病竈、4/14患者顱底侵犯病竈和3/3患者眼眶侵犯病竈的顯示.(2)在76例HCC患者中,63.1％ (48/76)的患者18F-FDG PET/CT顯像暘性.在28例18 F-FDG PET/CT顯像陰性者中,71.4％ (20/28)的患者11C-CHO PET/CT顯像暘性.18F-FDG聯閤11C-CHO使PET/CT診斷HCC的靈敏度從63.1％(48/76)提高到89.5％ (68/76；x2=14.559,P＜0.01).與18F-FDG PET/CT顯像比較,11C-CHO PET/CT顯像傾嚮易于檢齣高分化HCC[6/9與35.7％(5/14)；P =0.214]；在檢測中分化HCC方麵,兩者差異無統計學意義[6/7與72.0％(18/25),P=0.648].11C-CHO PET/CT顯像在檢測直徑＜5.0 cm的HCC方麵較18 F-FDG PET/CT顯像靈敏[72.7％ (16/22)與42.1％ (16/38)；x2=5.249,P＜0.05],特彆是＜2.0 cm病竈[5/7與0/7;P=0.021].結論 11C-CHO與18F-FDG相結閤可提高PET/CT對跼部進展型NPC T分期診斷的準確性.11C-CHO可瀰補18F-FDG顯像在高中分化HCC診斷中的不足,從而提高PET/CT的診斷靈敏度.
목적 탐토11C-담감(CHO) PET/CT대18F-FDG PET/CT현상진단비인암(NPC)화HCC적보충개치.방법 장명학진단적NPC화HCC환자납입해연구.해연구경의원윤리위원회통과,환자균첨서지정동의서.2007년12월지2010년1월,15례국부진전형NPC화76례HCC환자균행18 F-FDG PET/CT현상,기중43례(15례NPC화28례HCC)동시행국부11C-CHO PET/CT현상.병조처출현18 F-FDG혹11C-CHO고섭취자위양성.반정량분석채용SUVmax、종류/뇌(T/B)비치화종류/간(T/L)비치등지표.통계학분석채용량양본t검험、x2검험、Fisher학절개솔법화직선상관분석.결과 (1)재15례국부진전형NPC환자중,병조처18F-FDG SUVmax명현고우11 C-CHO SUVmax (12.81 ±5.00여6.84±2.76;t =6.416,P＜0.01),단11C-CHO PET/CT현상T/B비치명현고우18F-FDG PET/CT현상(18.62±7.95여1.38±0.59；t=8.801,P＜0.01).2충현상제재병조처적섭취결과명현상관(r =0.712,P＜0.01).여18F-FDG PET/CT현상비교,11C-CHO현상개진료50.0％(12/12여6/12;x2=8.000,P＜0.05)환자로내침범병조、4/14환자로저침범병조화3/3환자안광침범병조적현시.(2)재76례HCC환자중,63.1％ (48/76)적환자18F-FDG PET/CT현상양성.재28례18 F-FDG PET/CT현상음성자중,71.4％ (20/28)적환자11C-CHO PET/CT현상양성.18F-FDG연합11C-CHO사PET/CT진단HCC적령민도종63.1％(48/76)제고도89.5％ (68/76；x2=14.559,P＜0.01).여18F-FDG PET/CT현상비교,11C-CHO PET/CT현상경향역우검출고분화HCC[6/9여35.7％(5/14)；P =0.214]；재검측중분화HCC방면,량자차이무통계학의의[6/7여72.0％(18/25),P=0.648].11C-CHO PET/CT현상재검측직경＜5.0 cm적HCC방면교18 F-FDG PET/CT현상령민[72.7％ (16/22)여42.1％ (16/38)；x2=5.249,P＜0.05],특별시＜2.0 cm병조[5/7여0/7;P=0.021].결론 11C-CHO여18F-FDG상결합가제고PET/CT대국부진전형NPC T분기진단적준학성.11C-CHO가미보18F-FDG현상재고중분화HCC진단중적불족,종이제고PET/CT적진단령민도.
Objective To evaluate the complementary value of 11C-choline (CHO) PET/CT to 18F-FDG PET/CT in the staging of locally advanced nasopharyngeal carcinoma (NPC) and diagnosis of HCC.Methods From December 2007 to January 2010,15 patients with locally advanced NPC and 76 patients with HCC were prospectively enrolled into this study.The research was approved by the ethics committee,and all patients signed informed consents.Whole body 18 F-FDG PET/CT scans were performed on all patients and regional 11C-CHO PET/CT was conducted in 43 patients (15 with NPC,28 with HCC).A lesion with increased uptake of either 11 C-CHO or 18F-FDG was considered positive.SUVmax,tumor/brain (T/B) ratio and tumor/liver (T/L) ratio were calculated for semi-quantitative analysis.Two-sample t test,x2 test,Fisher exact test and linear correlation analysis were used for statistical analysis.Results (1) The lesion SUVmax of 18 F-FDG was higher compared to 11C-CHO (12.81 ± 5.00 vs 6.84 ± 2.76 ; t =6.416,P ＜0.01) in NPC patients.However,11C-CHO PET/CT had a much higher T/B ratio than 18F-FDG (18.62 ±7.95 vs 1.38 ±0.59 ; t =8.801,P ＜ 0.01).Significant correlation was found between the 2 tracers with regard to NPC lesion uptake (r =0.712,P ＜0.01).Compared with 18F-FDG PET/CT,11C-CHO PET/CT had better delineation of intracranial invasion in 50.0％ of patients (12/12 vs 6/12; x2 =8.000,P ＜0.05),skull base invasion in 4/14 patients and orbital invasion in 3/3 patients.(2) 18F-FDG PET/CT showed positive findings in 63.1％ (48/76) of HCC patients.In 28 HCC patients with negative findings on 18F-FDG PET/CT,11 C-CHO PET/CT was positive in 71.4％ (20/28) of patients.The dual-tracer PET/CT improved the diagnostic sensitivity (89.5％,68/76) of HCC compared with 18F-FDG PET/CT (63.1％,48/76) alone (x2 =14.559,P ＜0.01).11C-CHO PET/CT was more sensitive than 18F-FDG PET/CT for the detection of well differentiated HCC (6/9 vs 35.7％ (5/14) ; P =0.214).For the detection of moderately differentiated HCC,the sensitivity of 11C-CHO and 18F-FDG PET/CT was similar to each other (6/7vs 72.0％ (18/25),P =0.648).11C-CHO PET/CT was more sensitive than 18F-FDG for the detection of HCC lesions ＜5.0 cm (72.7％ (16/22) vs 42.1％ (16/38) ; x2 =5.249,P ＜0.05),especially for lesions ＜ 2.0 cm (5/7 vs 0/7; P =0.021).Conclusions 11 C-CHO PET/CT could improve the accuracy in T staging of NPC.It might also play a complementary role for 18 F-FDG PET/CT in the detection of HCC.
