Comparative analysis of integrated 99mTc-MIBI-SPECT/localizable CT and integrated 18F-FDG-PET/CT for differential diagnosis of solitary pulmonary nodules
10.3969/j.issn.1673-4254.2015.03.22
- VernacularTitle:99Tcm-MIBI-SPECT与定位CT融合显像和18F-FDG-PET/CT融合显像鉴别孤立性肺结节的对比研究
- Author:
Zhiyong DENG
1
;
Gaofeng LI
;
Xudong XIANG
;
Li JIA
;
Chao LIU
;
Ting CHEN
;
Changjiang LIU
Author Information
1. 昆明医科大学第三附属医院暨云南省肿瘤医院核医学科
- Keywords:
Technetium-99m sestamibi;
single photon emission computed tomography;
18F-FDG;
PET/CT;
X-ray computed tomography;
solitary pulmonary nodule;
lung cancer
- From:
Journal of Southern Medical University
2015;(3):422-426
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the diagnostic value of 9 Tcm-MIBI SPECT/localizable CT and 18FDG-PET/CT in patients with indeterminate solitary pulmonary nodules (SPNs) and assess the feasibility of using 9 Tcm-MIBI SPECT/localizable CT as an alternative when 18FDG-PET/CT is not available. Methods Thirty-nine patients with indeterminate SPNs were examined by 9 Tcm-MIBI SPECT/localizable CT, and another 46 patients by 18FDG-PET/CT. The findings of the two modalities were analyzed qualitatively and semiquantitatively to assess their efficacy for a definitive diagnosis of SNPs. Results Of the 39 patients examined by 9 Tcm-MIBI SPECT/localizable CT, 13 were identified to have malignant SPNs and 26 had benign SPNs; the diagnostic sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) of the examination were 92.31%(12/13), 88.46%(23/26), 89.74%(35/39), 80%(12/15) and 95.83%(23/24), respectively. Of the 46 patients receiving 18FDG-PET/CT examination, 29 malignant cases and 17 benign cases were identified with a diagnostic sensitivity, specificity, accuracy, PPV and NPV of 96.55% (28/29), 76.47% (13/17), 89.13% (41/46), 87.50% (28/32) and 92.86% (13/14), respectively. The two modalities showed no significant differences in the diagnostic sensitivity (χ2=0.356, P=0.55), specificity (χ2=1.084, P=0.298), accuracy (χ2=0.008, P=0.927), PPV (χ2=0.453, P=0.501) or NPV (χ2=0.157, P=0.692). The ROC curve showed that with the early uptake ratio (EUR) of 9 Tcm-MIBI ≥1.474 and ≥1.38 as the cutoff values, the sensitivity of 9 Tcm-MIBI SPECT/localizable CT was both 100%and the specificity both 76.90%;with the maximum standard uptake value (SUVmax) of 18FDG≥2.40 as the cutoff value, the sensitivity of 18FDG-PET/CT was 96.60% and the specificity was 76.50%, showing no significant differences between the two modalities in the diagnostic efficacy. Conclusion 9 Tcm-MIBI-SPECT/localizable CT may be a useful and practical modality for early diagnosis of SNPs for patients with a medium or low income in small and medium-sized cities.
