The Diagnostic Role of Fluoro-deoxy-D-glucose- Positron Emission Tomography (FDG-PET) for Pulmonary Nodules: Preliminary Experience from A Single Center

氟化去氧葡萄糖正子掃描在診斷胸腔結節病灶之應用：單一醫學中心之初步經驗

鄭自剛(Chee-Kong Chang) ； 廖健發(Chien-Fa Liao) ； 林嘉謨(Chia-Mo Lin) ； 江俊松(Jiunn-Song Jiang) ； 高尚志(Shang-Jyh Kao)

《胸腔醫學》 18卷1期 (2003/02) Pp. 37-43

摘要

近年來正子掃描（PET）已成為一種具有潛力而重要的胸腔結節診斷工具。利用氟化去氧葡萄糖（FDG）為放射顯影劑，正子掃描可以將胸腔內各種病灶之葡萄糖代謝加以顯影及分析；進而分辨出良性或惡性之病灶。在十個月期間我們蒐集二十個因胸腔內疑似惡性病灶的病患進行正子掃描。根據初步所得結果正子掃描用於分辨良性及惡性病灶之敏感度為75%，特異性為100%；其陽性預測值為100%，陰性預測值為50%。我們發現正子掃描仍然不能完全取代侵入性之檢查。我們仍須在台灣地區做更大型之研究以確定正子掃描的準度及效度。

關鍵字

正子掃描 ； 氟化去氧葡萄糖 ； 胸部結節 ； 肺腫瘤

並列摘要

Positron emission tomography (PET) has emerged as a significant and promising imaging modality in pulmonary medicine over the past few years. Using D-glucose analogue 2-fluoro(fluorine-18)-2-deoxy-D-glucose (FDG) as an uptake contrast, the glucose metabolism of different lesions in the lung can be visualized and analyzed. Such imaging is of great value in differentiating benign and malignant pulmonary lesions. We conducted a prospective study to evaluate the efficacy of FDG-PET in our center. We enrolled 20 patients over a period of ten months. PET was performed on all of these patients for suspected malignant lung lesions. Our experience showed that PET performed well in differentiating a lesion, with an overall sensitivity of 75% and specificity of 100%, using pathology obtained by biopsy or surgery as the gold standard. The positive predictive value and negative predictive value were 100% and 50%, respectively. It is our conclusion that PET cannot fully replace invasive procedures for tumor detection, based on the low negative predictive value seen in our analysis. However, large-scale studies may still be needed to further evaluate the accuracy and efficacy of PET in the diagnosis of pulmonary nodules in Taiwan.

並列關鍵字

positron emission tomography ； PET ； fluorodeoxyglucose ； FDG ； pulmonary nodules ； lung tumor