Application of Dynamic [¹⁸F]FDG PET/CT Multiparametric Imaging Leads to an Improved Differentiation of Benign and Malignant Lung Lesions.

IF 3 4区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Molecular Imaging and Biology Pub Date : 2024-10-01 Epub Date: 2024-08-22 DOI:10.1007/s11307-024-01942-w

Yihan Zhao, Tao Lv, Yue Xu, Jiankang Yin, Xin Wang, Yangyang Xue, Gan Zhu, Wenjing Yu, Hui Wang, Xiaohu Li

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Abstract

Purpose: To evaluate the potential of whole-body dynamic (WBD) 2-deoxy-2-[¹⁸F]fluoro-D-glucose positron emission tomography/computed tomography ([¹⁸F]FDG PET/CT) multiparametric imaging in the differential diagnosis between benign and malignant lung lesions.

Procedures: We retrospectively analyzed WBD PET/CT scans from patients with lung lesions performed between April 2020 and March 2023. Multiparametric images including standardized uptake value (SUV), metabolic rate (MR_FDG) and distribution volume (DV_FDG) were visually interpreted and compared. We adopted SUV_max, metabolic tumor volume (MTV) and total lesion glycolysis (TLG) for semi-quantitative analysis, MR_max and DV_max values for quantitative analysis. We also collected the patients' clinical characteristics. The variables above with P-value < 0.05 in the univariate analysis were entered into a multivariate logistic regression. The statistically significant metrics were plotted on receiver-operating characteristic (ROC) curves.

Results: A total of 60 patients were included for data evaluation. We found that most malignant lesions showed high uptake on MR_FDG and SUV images, and low or absent uptake on DV_FDG images, while benign lesions showed low uptake on MR_FDG images and high uptake on DV_FDG images. Most malignant lesions showed a characteristic pattern of gradually increasing FDG uptake, whereas benign lesions presented an initial rise with rapid fall, then kept stable at a low level. The AUC values of MR_max and SUV_max are 0.874 (95% CI: 0.763-0.946) and 0.792 (95% CI: 0.667-0.886), respectively. DeLong's test showed the difference between the areas is statistically significant (P < 0.001).

Conclusions: Our study demonstrated that dynamic [¹⁸F]FDG PET/CT imaging based on the Patlak analysis was a more accurate method of distinguishing malignancies from benign lesions than conventional static PET/CT scans.

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应用动态[18F]FDG PET/CT 多参数成像改进良性和恶性肺部病变的鉴别。

目的：评估全身动态（WBD）2-脱氧-2-[18F]氟-D-葡萄糖正电子发射断层扫描/计算机断层扫描（[18F]FDG PET/CT）多参数成像在肺部良性和恶性病变鉴别诊断中的潜力：我们对2020年4月至2023年3月期间肺部病变患者的WBD PET/CT扫描进行了回顾性分析。对包括标准化摄取值（SUV）、代谢率（MRFDG）和分布容积（DVFDG）在内的多参数图像进行了视觉解读和比较。我们采用 SUVmax、代谢肿瘤体积（MTV）和总病变糖酵解（TLG）进行半定量分析，采用 MRmax 和 DVmax 值进行定量分析。我们还收集了患者的临床特征。上述变量的 P 值结果：共纳入 60 名患者进行数据评估。我们发现，大多数恶性病变在 MRFDG 和 SUV 图像上显示高摄取，而在 DVFDG 图像上显示低摄取或无摄取；良性病变在 MRFDG 图像上显示低摄取，而在 DVFDG 图像上显示高摄取。大多数恶性病变表现出 FDG 摄取量逐渐升高的特征，而良性病变则表现为最初升高后迅速下降，然后稳定在较低水平。MRmax 和 SUVmax 的 AUC 值分别为 0.874（95% CI：0.763-0.946）和 0.792（95% CI：0.667-0.886）。DeLong检验表明，两个区域之间的差异具有统计学意义（P 结论：我们的研究表明，动态[18FS]瘤细胞的钙化率为0.5%：我们的研究表明，与传统的静态 PET/CT 扫描相比，基于 Patlak 分析的动态[18F]FDG PET/CT 成像是一种更准确的区分恶性肿瘤和良性病变的方法。

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来源期刊

Molecular Imaging and Biology 医学-核医学

CiteScore

6.90

自引率

3.20%

发文量

审稿时长

3 months

期刊介绍： Molecular Imaging and Biology (MIB) invites original contributions (research articles, review articles, commentaries, etc.) on the utilization of molecular imaging (i.e., nuclear imaging, optical imaging, autoradiography and pathology, MRI, MPI, ultrasound imaging, radiomics/genomics etc.) to investigate questions related to biology and health. The objective of MIB is to provide a forum to the discovery of molecular mechanisms of disease through the use of imaging techniques. We aim to investigate the biological nature of disease in patients and establish new molecular imaging diagnostic and therapy procedures. Some areas that are covered are: Preclinical and clinical imaging of macromolecular targets (e.g., genes, receptors, enzymes) involved in significant biological processes. The design, characterization, and study of new molecular imaging probes and contrast agents for the functional interrogation of macromolecular targets. Development and evaluation of imaging systems including instrumentation, image reconstruction algorithms, image analysis, and display. Development of molecular assay approaches leading to quantification of the biological information obtained in molecular imaging. Study of in vivo animal models of disease for the development of new molecular diagnostics and therapeutics. Extension of in vitro and in vivo discoveries using disease models, into well designed clinical research investigations. Clinical molecular imaging involving clinical investigations, clinical trials and medical management or cost-effectiveness studies.