非小细胞肺癌患者血糖浓度和病灶大小对18F-FDG PET/CT病灶标准摄取值的影响

Effect of blood glucose and lesion size on fluorodeoxyglucose lesions standard uptake value in non-small cell lung cancer patients

摘要:

目的 研究非小细胞肺癌（NSCLC）患者的体重、血糖浓度及病灶大小对氟代脱氧葡萄糖（18F-FDG）病灶标准摄取值（SUV）的影响。方法 70例NSCLC患者，其中纵隔淋巴结转移灶61例。患者均行18F-FDG PET/CT检查，由Advantage Workstation图像处理工作站获取肺癌病灶SUV，并获取经过体型和体重校正的SUV。由图像处理工作站以半自动方法获取肝脏本底的SUV参考值。NSCLC的原发灶及转移灶的诊断标准参照肝脏本底SUV或体型校正SUV×1.5+2×标准差。结果 70例NSCLC患者的血糖浓度与肝脏参考本底SUV呈正相关，与NSCLC原发灶的SUV呈负相关，与纵隔转移灶呈正相关。按照参考诊断标准，70例NSCLC原发灶和61例肺癌纵隔转移灶经血糖浓度、病灶大小进行校正前与校正后，其诊断的准确率分别为91.31%、73.42%、100.00%和96.43%。结论 患者的血糖浓度及病灶大小与NSCLC诊断的准确率有相关性。经过血糖浓度及病灶大小的校正后，NSCLC的诊断准确率提高。因此，行18F-FDG PET/CT诊断NSCLC时，患者的血糖浓度与病灶大小对诊断结果的影响需要得到重视。

Abstract:

Objective To study the effects of blood glucose and lesion size of non-small cell lung cancer on 18F-FDG PET/CT lesions SUV. Methods Totally 70 cases of non-small cell lung cancer, among which 61 patients were identified with mediastinal lymph node metastasis, were involved in this study. According to clinical routine 18F-FDG PET/CT scanning, automatic extraction of lung cancer SUV, weight and size correction SUV were obtained using the GE Advantage Workstation image processing workstation. Liver reference background SUV was obtained using semi-automatic extraction method of extraction. Diagnosis reference standards of non-small cell lung cancer primary tumors and metastatic lesions were obtained with the liver reference background SUV or SUV shape correction 1.5 + 2 standard deviation. Results Blood sugar concentration were positively correlated with liver reference background SUV and lung metastases while negatively correlated with SUV of primary non-small cell lung cancer. Based on criteria, diagnostic sensitivity prior to and post blood sugar and lesion size correction for 70 NSCLC were 91.31% and 73.42%, respectively. Based on criteria, diagnostic sensitivity prior to and post blood sugar and lesion size correction for 66 NSCLC with metastasis were 100% and 96.43%, respectively. Conclusions Blood glucose concentration and lesion size significantly affect the diagnostic accuracy of PET/CT, which needs further consideration when using 18F-FDG PET/CT for diagnosis of non-small cell lung cancer.