| 陈晓琳,边艳珠,胡玉敬,张新超,杨双臣,宋国庆,李康.PET/CT多参数评估非小细胞肺癌纵隔淋巴结转移[J].中国医学影像技术,2022,38(6):873~877 |
| PET/CT多参数评估非小细胞肺癌纵隔淋巴结转移 |
| PET/CT multi-parameters for evaluating mediastinal lymph node metastasis from non-small cell lung cancer |
| 投稿时间：2021-10-28 修订日期：2022-03-19 |
| DOI：10.13929/j.issn.1003-3289.2022.06.019 |
| 中文关键词: 癌,非小细胞肺 纵隔 淋巴结转移 体层摄影术,X线计算机 正电子发射断层显像 18F氟脱氧葡萄糖 |
| 英文关键词:carcinoma, non-small-cell lung mediastinum lymphatic metastasis tomography, X-ray computed positron-emission tomography fluorodeoxyglucose F18 |
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| 中文摘要: |
| 目的 观察18F-FDG PET/CT多参数评估非小细胞肺癌（NSCLC）纵隔淋巴结转移的价值。方法 回顾性分析174例肺内占位或纵隔淋巴结肿大患者的18F-FDG PET/CT资料，根据纵隔淋巴结性质将其分为恶性组（83例，淋巴结232枚）和良性组（91例，淋巴结230枚）；比较组间纵隔淋巴结参数差异，并将差异有统计学意义的参数输入神经网络多层感知器（MLP），以标准化重要性>50%的参数建立评估模型。绘制受试者工作特征曲线，评估模型判断纵隔淋巴结性质的效能；以Spearman相关性分析评价恶性组纵隔淋巴结参数与NSCLC原发灶参数的关系。结果 组间纵隔淋巴结短径、纵横比，坏死、脂肪、钙化占比，对称分布比例，最大标准摄取值（SUVmax）、平均标准摄取值（SUVmean）、肿瘤代谢体积（MTV）、糖酵解总量（TLG）及淋巴结SUVmax/纵隔血池SUVmax差异均有统计学意义（P均<0.05）；淋巴结短径、纵横比、SUVmax及MTV标准化重要性>50%，以之鉴别纵隔淋巴结性质的曲线下面积（AUC）分别为0.731、0.657、0.776及0.772，联合应用的AUC为0.831。恶性组纵隔淋巴结SUVmax、TLG与NSCLC原发灶SUVmax均呈正相关（r=0.318、0.151，P均<0.05）；纵隔淋巴结是否位于原发灶同侧与NSCLC原发灶长径及SUVmax均呈负相关（r=－0.139、－0.201，P均<0.05），纵隔淋巴结是否分布对称则与NSCLC原发灶长径及SUVmax均呈正相关（r=0.164、0.161，P均<0.05）。结论 18F-FDG PET/CT参数可用于判断NSCLC纵隔淋巴结转移，以淋巴结短径、纵横比、SUVmax及MTV效能较高。 |
| 英文摘要: |
| Objective To observe the value of multi-parameters of 18F-FDG PET/CT for evaluating mediastinal lymph node metastasis from non-small cell lung cancer (NSCLC). Methods 18F-FDG PET/CT data of 174 patients with lung mass or mediastinal lymphadenopathy were retrospectively analyzed. The patients were divided into malignant group (83 cases, 232 lymph nodes) and benign group (91 cases, 230 lymph nodes). Parameters of mediastinal lymph nodes were compared between groups, those being significant different were incorporated into the neural network multilayered perceptron (MLP) for screening parameters with standardized importance greater than 50% to establish an evaluation model. Receiver operating characteristic curve was drawn, and the value of the model for judging the nature of mediastinal lymph nodes was analyzed. Spearman correlation analysis was used to evaluate the relationship of the parameters of mediastinal lymph nodes in malignant group and the parameters of primary NSCLC lesions. Results There were significant differences of the short diameter of mediastinal lymph node, aspect ratio, also proportion of necrosis, fat and calcification, symmetrical distribution proportion, the maximum standard uptake value (SUVmax), the average standard uptake value (SUVmean), metabolic tumor volume (MTV), total lesion glycolysis (TLG), as well as lymph node SUVmax/mediastinal blood pool SUVmax between groups (all P<0.05). The standardized importance of the short diameter, aspect ratio, SUVmax and MTV of lymph nodes were all more than 50%, with the area under the curve (AUC) for identifying mediastinal lymph nodes was 0.731, 0.657, 0.776 and 0.772, respectively, and AUC of the combination of the above indexes was 0.831. The SUVmax and TLG of mediastinal lymph nodes in malignant group were positively correlated with the SUVmax of primary NSCLC lesions (r=0.318, 0.151, both P<0.05). Mediastinal lymph nodes locating on the same side of primary NSCLC lesion or not was negatively correlated with the length and SUVmax of the latter (r=-0.139, -0.201, both P<0.05), and whether the mediastinal lymph nodes distributed symmetrically or not was positively correlated with the length and SUVmax of primary NSCLC lesion (r=0.164, 0.161, both P<0.05). Conclusion 18F-FDG PET/CT parameters could be used to judge mediastinal lymph node metastasis from NSCLC, and the short diameter, aspect ratio, SUVmax and MTV of lymph nodes had good efficacy. |
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