目的:探索可行性,安全,基于18F-FDGPET/CT融合图像的临床应用价值,用于指导腹膜后穿刺活检技术和确定腹膜后肿块的诊断,以诊断恶性肿瘤。
方法:2019年3月至2023年1月,42例患者行18F-FDGPET/CT显像,发现腹膜后病变,需明确诊断;22例男性,20是女性,平均年龄(59.17±13.23)岁。根据融合的18F-FDGPET/CT断层图像,具有最高代谢活性的目标点,最安全的,并选择了预期的最大样本量。用同一台机器获取CT扫描,并与18F-FDGPET融合,引导穿刺活检针接近预期的目标区,能够及时进行活检的病理和免疫组织化学检查。成功率,总考试时间,活检手术时间,并发症,CT辐射剂量,病态,并记录免疫组化结果。
结果:所有42例患者均成功取样,成功率为100%。对42例患者的采样部位准确靶向最高的代谢活性,最安全的,和预期的最大样本量。42例患者均获得明确诊断(恶性肿瘤25例,良性组织17例)。15例患者临床诊断有改变,占所有患者的35.7%,影响后续治疗计划。患者平均总检查时间为(41.3±7.3)分钟,活检手术时间为(29.1±8.7)min。CT引导下整个检查产生的有效辐射剂量为(2.0±0.5)mSv,无严重并发症发生。
结论:基于18F-FDGPET/CT融合图像的实时引导腹膜后穿刺活检是安全的,准确,可行,并能为腹膜后肿块患者提供明确的病理诊断和免疫组化评价。
OBJECTIVE: To explore the feasibility, safety, and clinical application value based on the fusion image of 18 F-FDG PET/CT, for guiding retroperitoneal puncture biopsy technology and to determine the diagnosis of retroperitoneal masses in diagnosing malignant tumors.
METHODS: From March 2019 to January 2023, 42 patients underwent 18 F-FDG PET/CT imaging and were found to have retroperitoneal lesions that required definite diagnosis; 22 were male, 20 were female, and the average age was(59.17 ± 13.23) years. According to the fused 18 F-FDG PET/CT tomographic image, the target point with the highest metabolic activity, the safest, and expected maximum sample size was selected. CT scans were acquired with the same machine and fused with 18 F-FDG PET, guiding the puncture biopsy needle to approach the expected target zone, enabling timely delivery of pathological and immunohistochemical examination of the biopsy. Success rate, total examination time, biopsy operation time, complications, CT radiation dose, pathological, and immunohistochemical results were recorded.
RESULTS: All 42 patients were sampled successfully with the successful rate being 100%. The site of sampling of 42 patients accurately targeted the highest metabolic activity, the safest, and the expected maximum sample size. All 42 patients received clear diagnosis (25 cases of malignant tumors and cases of 17 benign tissues). 15 cases of patients had a change in clinical diagnosis, accounting for 35.7% of all patients, and affecting subsequent treatment plans. The average total examination time for patients was (41.3 ± 7.3) minutes, and the biopsy operation time was (29.1 ± 8.7) minutes. The effective radiation dose generated by the entire examination generated by CT guidance was (2.0 ± 0.5) mSv; no severe complications occurred in the patients.
CONCLUSIONS: Real-time-guided retroperitoneal puncture biopsy based on 18 F-FDG PET/CT fusion image is safe, accurate, and feasible, and can provide patients of retroperitoneal mass with clear pathological diagnosis and immunohistochemical evaluation.