本研究的目的是调查使用氟-18(18F)-氟脱氧葡萄糖(FDG)正电子发射断层扫描(PET)/计算机断层扫描(CT)与磁共振成像(MRI)用于诊断和鉴别椎管中的良性和恶性病变。为此,从1月开始对MRI和18F-FDGPET/CT的使用进行了回顾性分析,2017年12月,2020年,通过术后病理检查或组织活检(金标准)获得最终诊断。敏感性,特异性,准确度,计算两种检查技术的阳性预测值和阴性预测值,并进行比较。PET代谢参数,最大标准化摄取值(SUVmax),峰值标准化摄取值(SUVpeak),平均标准化摄取值(SUVmean),计算并比较良、恶性组的代谢性肿瘤体积(MTV)和总病变糖酵解(TLG),并绘制相应的ROC曲线。共纳入58例患者,其中恶性病变30例,良性病变28例。MRI的特异性明显高于PET/CT(P<0.05)。PET/CT的敏感性和阴性预测值均高于MRI,虽然没有显著差异(P>0.05)。PET代谢参数的平均值±标准偏差值,SUVmax,SUVpeak,Suvmean,MTV和TLG,分别为4.27±1.25、3.49±1.07、2.49±0.84、6.58±5.36和17.12±15.50,恶性组8.99±3.75,7.35±3.26,5.43±2.40,12.25±12.18,112.41±85.98,分别。SUVmax,SUVpeak,恶性组的SUVmean和TLG高于良性组。差异均有统计学意义(均P<0.0001)。在区分良性和恶性病变时,SUVmax的ROC曲线下面积(AUC)为0.919,Youden指数为0.762,敏感性为83.3%,特异性为92.9%。SUVpeak的AUC为0.905,SUVmean的AUC为0.899。上述AUC显著高于MTV和TLG(分别为0.609和0.786)(P<0.001)。总的来说,本研究表明,MRI是诊断椎管内病变的可靠成像技术。18F-FDGPET/CT,作为核磁共振成像的一个值得注意的补充,对病变的定性诊断和鉴别具有较高的敏感性和准确性。两种检查技术的协同作用可能有助于更准确的诊断。
The aim of the present
study was to investigate the value of the use of fluorine-18 (18F)-fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) vs. magnetic resonance imaging (MRI) for the diagnosis of and differentiation between benign and malignant lesions in the spinal canal. For this purpose, a retrospective analysis was performed on the use of MRI and 18F-FDG PET/CT from January, 2017 to December, 2020, and the final diagnosis was obtained by performing a post-operative pathological examination or following a tissue biopsy (gold standard). The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of the two examination techniques were calculated and comparisons between them were made. The PET metabolic parameters, maximum standardized uptake value (SUVmax), peak standardized uptake value (SUVpeak), mean standardized uptake value (SUVmean), metabolic tumor volume (MTV) and total lesion glycolysis (TLG) in the benign and malignant groups were calculated and compared, and the corresponding ROC curves were plotted. A total of 58 patients were enrolled, including 30 patients with malignant and 28 with benign lesions. The specificity of MRI was significantly higher than that of PET/CT (P<0.05). The sensitivity and negative predictive value of PET/CT were higher than those of MRI, although with no significant difference (P>0.05). The mean ± tandard deviation values of the PET metabolic parameters, SUVmax, SUVpeak, SUVmean, MTV and TLG, were 4.27±1.25, 3.49±1.07, 2.49±0.84, 6.58±5.36 and 17.12±15.50 in the benign, and 8.99±3.75, 7.35±3.26, 5.43±2.40, 12.25±12.18 and 112.41±85.98 in the malignant groups, respectively. The SUVmax, SUVpeak, SUVmean and TLG in the malignant group were higher than those in the benign group. The differences were all statistically significant (all P<0.0001). In distinguishing benign from malignant lesions, the area under the ROC curve (AUC) for SUVmax was 0.919, which was the largest, and the Youden index was 0.762, indicating 83.3% sensitivity and 92.9% specificity. The AUC for SUVpeak was 0.905 and that for SUVmean was 0.899. The aforementioned AUCs were significantly higher than those for MTV and TLG (0.609 and 0.786, respectively) (P<0.001). On the whole, the present
study demonstrates that MRI is a reliable imaging technique for the diagnosis of intravertebral lesions. 18F-FDG PET/CT, as a noteworthy supplement to MRI, has a high sensitivity and accuracy for the qualitative diagnosis and identification of lesions. The synergistic effect of the two examination techniques may be helpful for a more accurate diagnosis.