The value of net influx constant based on FDG PET/CT dynamic imaging in the differential diagnosis of metastatic from non-metastatic lymph nodes in lung cancer

IF 2.5 4区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Xieraili Wumener, Yarong Zhang, Zihan Zang, Xiaoxing Ye, Jiuhui Zhao, Jun Zhao, Ying Liang
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引用次数: 0

Abstract

Objectives

This study aims to evaluate the value of the dynamic and static quantitative metabolic parameters derived from 18F-fluorodeoxyglucose (FDG)–positron emission tomography/CT (PET/CT) in the differential diagnosis of metastatic from non-metastatic lymph nodes (LNs) in lung cancer and to validate them based on the results of a previous study.

Methods

One hundred and twenty-one patients with lung nodules or masses detected on chest CT scan underwent 18F-FDG PET/CT dynamic + static imaging with informed consent. A retrospective collection of 126 LNs in 37 patients with lung cancer was pathologically confirmed. Static image analysis parameters include LN-SUVmax and LN-SUVmax/primary tumor SUVmax (LN-SUVmax/PT-SUVmax). Dynamic metabolic parameters including the net influx rate (Ki) and the surrogate of perfusion (K1) and of each LN were obtained by applying the irreversible two-tissue compartment model using in-house Matlab software. Ki/K1 was then calculated as a separate marker. Based on the pathological findings, we divided into a metastatic group and a non-metastatic group. The χ2 test was used to evaluate the agreement of the individual and combined diagnosis of each metabolic parameter with the gold standard. The receiver-operating characteristic (ROC) analysis was performed for each parameter to determine the diagnostic efficacy in differentiating non-metastatic from metastatic LNs with high FDG-avid. P < 0.05 was considered statistically significant.

Results

Among the 126 FDG-avid LNs confirmed by pathology, 70 LNs were metastatic, and 56 LNs were non-metastatic. For ROC analysis, in separate assays, the dynamic metabolic parameter Ki [sensitivity (SEN) of 84.30%, specificity (SPE) of 94.60%, accuracy of 88.89%, and AUC of 0.895] had a better diagnostic value than the static metabolic parameter SUVmax (SEN of 82.90%, SPE of 62.50%, accuracy of 74.60%, and AUC of 0.727) in differentiating between metastatic from non-metastatic LNs groups, respectively. In the combined diagnosis group, the combined SUVmax + Ki diagnosis had a better diagnostic value in the differential diagnosis of metastatic from non-metastatic LNs, with SEN, SPE, accuracy, and AUC of 84.3%, 94.6%, 88.89%, and 0.907, respectively.

Conclusions

When the cutoff value of Ki was 0.022 ml/g/min, it had a high diagnostic value in the differential diagnosis between metastasis and non-metastasis in FDG-avid LNs of lung cancer, especially in improving the specificity. The combination of SUVmax and Ki is expected to be a reliable metabolic parameter for N-staging of lung cancer.

Abstract Image

基于 FDG PET/CT 动态成像的净流入常数在肺癌转移性与非转移性淋巴结鉴别诊断中的价值。
研究目的本研究旨在评估18F-氟脱氧葡萄糖(FDG)-正电子发射计算机断层扫描/CT(PET/CT)得出的动态和静态定量代谢参数在肺癌转移性和非转移性淋巴结(LN)鉴别诊断中的价值,并根据之前的研究结果对其进行验证:121名胸部CT扫描发现肺部结节或肿块的患者在知情同意的情况下接受了18F-FDG PET/CT动态+静态成像检查。回顾性收集了 37 名肺癌患者的 126 个 LN,并经病理证实。静态图像分析参数包括LN-SUVmax和LN-SUVmax/原发肿瘤SUVmax(LN-SUVmax/PT-SUVmax)。动态代谢参数包括每个 LN 的净流入率(Ki)和代用灌注率(K1),这些参数是通过使用内部 Matlab 软件应用不可逆双组织分区模型获得的。然后计算 Ki/K1 作为单独的标记。根据病理结果,我们将其分为转移组和非转移组。我们使用χ2检验来评估各代谢参数的单独诊断和综合诊断与金标准的一致性。对每个参数进行接收器-操作特征(ROC)分析,以确定其在区分非转移性和转移性高 FDG-avid淋巴结方面的诊断效果。P 结果:经病理证实的126个FDG-avid LN中,70个为转移性LN,56个为非转移性LN。ROC分析显示,在单独检测中,动态代谢参数Ki[灵敏度(SEN)为84.30%,特异度(SPE)为94.60%,准确度为88.89%,AUC为0.895]分别比静态代谢参数SUVmax(SEN为82.90%,SPE为62.50%,准确度为74.60%,AUC为0.727)在区分转移性和非转移性LN组方面具有更好的诊断价值。在联合诊断组中,SUVmax + Ki 联合诊断在鉴别诊断转移性与非转移性 LN 方面具有更好的诊断价值,SEN、SPE、准确率和 AUC 分别为 84.3%、94.6%、88.89% 和 0.907:当Ki的临界值为0.022 ml/g/min时,它在肺癌FDGavid LN的转移与非转移鉴别诊断中具有很高的诊断价值,尤其是在提高特异性方面。SUVmax和Ki的组合有望成为肺癌N分期的可靠代谢参数。
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来源期刊
Annals of Nuclear Medicine
Annals of Nuclear Medicine 医学-核医学
CiteScore
4.90
自引率
7.70%
发文量
111
审稿时长
4-8 weeks
期刊介绍: Annals of Nuclear Medicine is an official journal of the Japanese Society of Nuclear Medicine. It develops the appropriate application of radioactive substances and stable nuclides in the field of medicine. The journal promotes the exchange of ideas and information and research in nuclear medicine and includes the medical application of radionuclides and related subjects. It presents original articles, short communications, reviews and letters to the editor.
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