目的:基于计算机断层扫描(CT)的肺错构瘤(PH)诊断是一个挑战,尤其是具有不典型影像学特征的患者。本研究旨在总结18F-Fluoro-D-葡萄糖正电子发射断层扫描-计算机断层扫描(18F-FDGPET-CT)在PH诊断中的影像学特征,探讨PET-CT在PH诊断中的应用价值。
方法:回顾性分析文献中诊断为PH并接受PET-CT检查的患者,这些是科克伦图书馆的出版物,PubMed,摘录医学数据库(EMBASE),中国国家知识基础设施(CNKI)和万方数据库,从2008年到2022年6月。收集的其他20例均为我院2008年至2022年6月的患者。患者的症状,胸部CT的影像学特征,PET-CT特征,分析PET-CT的原因及并发症。
结果:在这项回顾性研究中,共有216例患者被诊断为PH,并接受了PET-CT检查。其中20例为我院2008年1月至2022年6月的患者。其他病例是从文献中收集的。大多数PH病变的平均直径为1.7±1.0cm。PH病变的平均最大标准化摄取值(SUVmax)为1.2±1.1。它们的大多数SUVmax低于国际公认的截止值(SUVmax=2.5)。PET-CT对PH的诊断优于CT,但对PH病变的CT诊断与PET-CT诊断之间存在相关性。为了绘制接收器工作特性(ROC),我们选择了29例PH病变SUVmax值明确的患者,收集29例SUVmax值明确的肺癌患者作为对照组。ROC曲线分析显示,SUVmax的曲线下面积(AUC)为0.899,最佳诊断阈值为SUVmax>2.65。PET-CT可以通过在本研究中应用2.65的SUVmax作为截止值,以89.66%的灵敏度区分PH和恶性病变。
结论:PET-CT可能是诊断PH的有用工具,显示出比CT更好的诊断灵敏度。但PET-CT不能作为单一的诊断手段,应结合其他方法和患者病史做出最正确的诊断。
The diagnosis of pulmonary hamartoma (PH) based on computed tomography (CT) is a challenge, especially in patients with atypical imaging characteristics. This study was aimed at summarizing the imaging characteristic of 18F-Fluoro-D-glucose positron emission tomography-computed tomography (18F-FDG PET-CT) in PH and exploring the application value of PET-CT in the diagnosis of PH.
Patients diagnosed with PH who had undergone PET-CT from literature pertaining were retrospectively analyzed, which were cases of publications from the Cochrane Library, PubMed, Excerpta Medica Database (EMBASE), China National Knowledge Infrastructure (CNKI) and Wanfang databases, from 2008 to June 2022. The other 20 cases of the collection were patients from our hospital from 2008 to June 2022. Patients\' symptoms, imaging characteristics of chest CT, PET-CT characteristics, the reason for PET-CT and the complications were analyzed.
In this retrospective study, a total of 216 patients were diagnosed with PH and had been examined by PET-CT. 20 of the cases were patients of our hospital from January 2008 to June 2022. The other cases were collected from the literature. The mean diameter of most PH lesions is 1.7 ± 1.0 cm. The mean maximum standardized uptake value (SUVmax) of the PH lesions was 1.2 ± 1.1. Most of their SUVmax were lower than internationally recognized cut-off value (SUVmax = 2.5). PET-CT was superior to CT in the diagnosis of PH but there was a correlation of between CT diagnosis and PET-CT diagnosis for the PH lesions. In order to draw the Receiver operating characteristic (ROC), we selected 29 patients with a clear SUVmax value of their PH lesion, and 29 lung cancer patients with clear SUVmax value in our hospital were collected as a control group. ROC curve analysis showed that the area under curve (AUC) of SUVmax was 0.899, and the optimal diagnostic threshold was SUVmax > 2.65. PET-CT could distinguish PH from malignant lesions with a sensitivity of 89.66% by applying a SUVmax of 2.65 as a cut-off in this study.
PET-CT might be a useful tool to diagnose PH, which shows a better diagnostic sensitivity than CT. But PET-CT can not be used as a single diagnostic approach, which should be combined with other methods and the patients\' history to make the most correct diagnosis.