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
2015年
5期
374-378
,共5页
何巧%史新冲%张林启%张祥松
何巧%史新遲%張林啟%張祥鬆
하교%사신충%장림계%장상송
神经胶质瘤%体层摄影术,发射型计算机%体层摄影术,X线计算机%氮放射性同位素%NH3%脱氧葡萄糖
神經膠質瘤%體層攝影術,髮射型計算機%體層攝影術,X線計算機%氮放射性同位素%NH3%脫氧葡萄糖
신경효질류%체층섭영술,발사형계산궤%체층섭영술,X선계산궤%담방사성동위소%NH3%탈양포도당
Glioma%Tomography,emission-computed%Tomography,X-ray computed%Nitrogen radioisotopes%NH3%Deoxyglucose
目的 探讨13N-NH3 PET/CT显像在脑胶质瘤分级评估中的价值,并与18F-FDG比较.方法 回顾性分析2009年8月至2012年5月于中山大学附属第一医院行13N-NH3及18F-FDG PET/CT显像的45例脑胶质瘤患者资料,其中男29例,女16例,年龄14 ～ 75(47.47± 15.64)岁,所有患者均经手术病理、穿刺活组织检查或随访证实.以肿瘤/脑灰质(T/G)比值为半定量分析指标,采用ROC曲线分析2种显像方法T/G比值鉴别高级别胶质瘤与低级别胶质瘤的最佳临界值.采用单因素方差分析比较13N-NH3及18F-FDG T/G比值在不同级别胶质瘤中的差异.结果 45例患者中共发现48个病灶(3例为多发),其中16个为WHOⅡ级,12个为WHOⅢ级,20个为WHOⅣ级.13N-NH3PET/CT与18F-FDG PET/CT诊断高级别胶质瘤的灵敏度分别为91％(29/32)、66％ (21/32).ROC曲线分析显示,13N-NH3与18F-FDG T/G比值的AUC分别为0.943和0.910,其鉴别高级别胶质瘤与低级别胶质瘤的最佳临界值分别为0.86和0.64.以上述临界值为诊断标准,13N-NH3PET/CT与18F-FDG PET/CT诊断高级别胶质瘤的灵敏度分别为94％ (30/32)、84％ (27/32),阳性预测值分别为94％ (30/32)、93％(27/29).结论 13N-NH3PET/CT对高级别胶质瘤与低级别胶质瘤的鉴别诊断效果优于18F-FDG PET/CT,且在显示高级别胶质瘤时其肿瘤与正常脑组织的对比度好.
目的 探討13N-NH3 PET/CT顯像在腦膠質瘤分級評估中的價值,併與18F-FDG比較.方法 迴顧性分析2009年8月至2012年5月于中山大學附屬第一醫院行13N-NH3及18F-FDG PET/CT顯像的45例腦膠質瘤患者資料,其中男29例,女16例,年齡14 ～ 75(47.47± 15.64)歲,所有患者均經手術病理、穿刺活組織檢查或隨訪證實.以腫瘤/腦灰質(T/G)比值為半定量分析指標,採用ROC麯線分析2種顯像方法T/G比值鑒彆高級彆膠質瘤與低級彆膠質瘤的最佳臨界值.採用單因素方差分析比較13N-NH3及18F-FDG T/G比值在不同級彆膠質瘤中的差異.結果 45例患者中共髮現48箇病竈(3例為多髮),其中16箇為WHOⅡ級,12箇為WHOⅢ級,20箇為WHOⅣ級.13N-NH3PET/CT與18F-FDG PET/CT診斷高級彆膠質瘤的靈敏度分彆為91％(29/32)、66％ (21/32).ROC麯線分析顯示,13N-NH3與18F-FDG T/G比值的AUC分彆為0.943和0.910,其鑒彆高級彆膠質瘤與低級彆膠質瘤的最佳臨界值分彆為0.86和0.64.以上述臨界值為診斷標準,13N-NH3PET/CT與18F-FDG PET/CT診斷高級彆膠質瘤的靈敏度分彆為94％ (30/32)、84％ (27/32),暘性預測值分彆為94％ (30/32)、93％(27/29).結論 13N-NH3PET/CT對高級彆膠質瘤與低級彆膠質瘤的鑒彆診斷效果優于18F-FDG PET/CT,且在顯示高級彆膠質瘤時其腫瘤與正常腦組織的對比度好.
목적 탐토13N-NH3 PET/CT현상재뇌효질류분급평고중적개치,병여18F-FDG비교.방법 회고성분석2009년8월지2012년5월우중산대학부속제일의원행13N-NH3급18F-FDG PET/CT현상적45례뇌효질류환자자료,기중남29례,녀16례,년령14 ～ 75(47.47± 15.64)세,소유환자균경수술병리、천자활조직검사혹수방증실.이종류/뇌회질(T/G)비치위반정량분석지표,채용ROC곡선분석2충현상방법T/G비치감별고급별효질류여저급별효질류적최가림계치.채용단인소방차분석비교13N-NH3급18F-FDG T/G비치재불동급별효질류중적차이.결과 45례환자중공발현48개병조(3례위다발),기중16개위WHOⅡ급,12개위WHOⅢ급,20개위WHOⅣ급.13N-NH3PET/CT여18F-FDG PET/CT진단고급별효질류적령민도분별위91％(29/32)、66％ (21/32).ROC곡선분석현시,13N-NH3여18F-FDG T/G비치적AUC분별위0.943화0.910,기감별고급별효질류여저급별효질류적최가림계치분별위0.86화0.64.이상술림계치위진단표준,13N-NH3PET/CT여18F-FDG PET/CT진단고급별효질류적령민도분별위94％ (30/32)、84％ (27/32),양성예측치분별위94％ (30/32)、93％(27/29).결론 13N-NH3PET/CT대고급별효질류여저급별효질류적감별진단효과우우18F-FDG PET/CT,차재현시고급별효질류시기종류여정상뇌조직적대비도호.
Objective To investigate the diagnostic efficacy of 13N-NH3 and 18F-FDG PET/CT in the evaluation of untreated gliomas.Methods A total of 45 consecutive patients (29 males,16 females;age range 14-75 years,average age (47.47± 15.64) years) with final diagnosis of glioma from August 2009 to May 2012 were retrospectively analyzed.PET/CT imaging was performed with both 18F-FDG and 13N-NH3.Imaging results were analyzed by tumor-to-gray matter (T/G) ratios.ROC curve analysis was conducted to determine the optimal T/G cutoff values between low-grade and high-grade gliomas.One-way analysis of variance was applied to assess the differential efficacy of the two tracers in different grade of glioma.Results Forty-eight separate lesions were identified (WHO grade Ⅱ,n=16;grade Ⅲ,n=12;and grade Ⅳ,n=20).The sensitivities of 13N-NH3 PET/CT and 18F-FDG PET/CT on predicting high-grade gliomas were 91％(29/32) and 66％ (21/32),respectively.The optimal T/G cutoff values for 18F-FDG and 13N-NH3 were 0.64 and 0.86 with the AUC of 0.910 and 0.943,respectively.The sensitivity and positive predictive value of predicting high-grade gliomas with optimal cutoff values were 84％ (27/32) and 93％ (27/29)for 18F-FDG PET/CT,those for 13N-NH3 PET/CT were 94％ (30/32) and 94％ (30/32),respectively.Conclusion 13N-NH3 PET/CT is superior to 18F-FDG PET/CT not only in separating low-grade gliomas from high-grade ones,but also in the detection of high-grade gliomas for better tumor to normal gray matter contrast.
