- 期刊
Effectiveness of FDG-PET Scans in the Evaluation of Patients with Single Pulmonary Nodules in Taiwan
氟－18去氧葡萄糖正子造影在評估臺灣病患肺部單一結節的價值
摘要
背景：肺癌是常見的癌症，也常導致死亡。在西方國家，氟－18去氧葡萄糖正子檢查(以下簡稱正子檢查)已被證實對評估肺部單一結節十分有效。然而在台灣，因為一些傳染病和肺結核的發生率仍然相當高，在此情況下，正子檢查在台灣，對肺部單一結節的臨席評估是否也能像在西方國家一樣有效。仍有疑問。本研究中，我們針對15位懷疑有肺腫癌之台灣患者進行正子檢查以評估其效果。 方法：本研究包括15位懷疑有肺部腫癌之患者。所有患者在開刀或切片之前均接受電腦層和正子檢查。所有病人之最後診斷均依據開刀，切片或支氣管沖刷後之病理報告為準。 結果：15位病患中，共有11位肺癌和4個良性病灶。若以標準值攝取值2.5為診斷閾值，本研究中，正子檢查的敏感度、專一度和準確度分別為81.8%、25%和66.7%。但若改以3.0為診斷閾值，則其敏感度、專一度和準確度則分別為81.8%、50%和73.3%。 結論：與文獻結果相較，我們是先期研究顯示本院正子檢查對肺癌診斷之敏感性尚不錯，但專一性明顯不理想。台灣較高的肺部感染疾病發生率或許是造成此低專一性的一個原因，此時若能將標準攝取值的診斷閾值提高，或許可有效地提高診斷專一性。
並列摘要
Background: Lung cancer is one of the most frequent malignancies and a major cause of mortality. FDG-PET scan has been proven to be very useful in the evaluation of single pulmonary nodules in western countries. However, its clinical value for Taiwanese who have a high incidence of infectious disease such as tuberculosis is still not clear. In this study, 15 Taiwanese patients were diagnosed with single pulmonary nodule by CT scans. All these patients were further evaluated with FDG-PET scans for differentiating benign lesion from malignancy. Methods: Fifteen patients with suspected primary pulmonary neoplasm were enrolled in this study. All patients received a thoracic CT scan and a whole body FDG-PET scan before surgery or biopsy. All patients were given a final diagnosis in a histopathologic report from thoracic surgery, CT-guide biopsy or bronchoalveolar brushing. Results: There were 11 lung cancers and four benign lesions in our study. The sensitivity, specificity and accuracy for FDG-PET were 81.8%, 25% and 66.7%, respectively, using a SUV of 2.5 as a cut-off value. Using a SUV of 3 as a cut-off value, the sensitivity, specificity and accuracy were 81.8%, 50% and 73.3%, respectively. Conclusion: Our preliminary study showed that the sensitivity of FDG-PET in the detection of lung malignancy is high, but the specificity is suboptimal when compared to the results in the literature. High incidence of pulmonary infection rate may play a role in low specificity. Based on our preliminary study, a higher SUV as a cut-off value may be useful in improving the specificity in Taiwan.