Diagnostic value and advantage of 18F-FDG PET/CT imaging in patients with primary gallbladder carcinoma
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摘要:
目的 探讨18F-FDG PET/CT显像在原发性胆囊癌诊断中的价值, 并与增强CT、B超及MRI进行比较。 方法 收集2006年3月至2011年12月期间38例临床疑似胆囊癌而在本院行PET/CT检查的患者, 其中男26例, 女12例; 年龄46~82岁, 中位年龄69岁。患者均行PET/CT、增强CT、B超及MRI检查。全部病例均经手术病理及临床随访证实, 其中35例为原发胆囊癌, 3例为胆囊炎。分别统计4种影像诊断方法的真阳性率、假阳性率、真阴性率、假阴性率及诊断正确率。 结果 PET/CT、增强CT、B超及MRI检查的真阳性率分别为100.0%、74.3%、60.0%、71.4%;假阴性率分别为0、25.7%、40.0%、28.6%;增强CT、B超及MRI检查真阴性率分别为66.7%、33.3%、66.7%;假阳性率分别为33.3%、66.7%、33.3%。诊断正确率分别为92.1%、71.1%、60.5%、68.4%。PET/CT与增强CT、B超及MRI结果比较, P值分别为0.036、0.002、0.019, 均P < 0.05。 结论 在原发性胆囊癌诊断中, PET/CT较其他3种传统影像诊断方法准确率高。如将PET/CT结合增强CT检查, 可使诊断正确率提高2.6%。故18F-FDG PET/CT显像对原发性胆囊癌的诊断具有重要的临床应用价值。 Abstract:Objective This study aimed to investigate the diagnostic value of 18F-FDG PET/CT imaging in primary gallbladder carcinoma cases and compare this diagnostic value with the advantages of enhanced CT, B ultrasound, and MRI scans. Methods Thirty-eight patients(26 males and 12 females; aged 46 to 82 years, median age = 69 years), who were clinically suspected of gallbladder carcinoma, were examined using PET/CT, CT(both plain and contrast-enhanced) scan, B ultrasound, and MRI diagnoses from March 2006 to December 2011.All of the cases were histopathologically confirmed by biopsy(21 cases) and clinical follow-up(17cases).Among these cases, 35 were primary gallbladder carcinoma and 3 were cholecystitis.The true positive rate(TPR), false positive rate(FPR), true negative rate(TNR), false negative rate(FNR), and diagnostic accuracy rate(DAR) of the four imaging modalities were calculated. Results All of the 35 gallbladder carcinoma cases showed an increase in 18F-FDG uptake without FNR.The following results were obtained from PET/CT, contrast-enhanced CT, B ultrasound, and MRI diagnoses, respectively(P < 0.05): TPRs = 100%, 74.3%, 60.0%, and 71.4%;FNRs = 0%, 25.7%, 40.0%, and 28.6%;and DARs = 92.1%, 71.1%, 60.5%, and 68.4%.TNRs were 66.7%, 33.3%, and 66.7% in the contrast-enhanced CT, B ultrasound, and MRI diagnoses, respectively, whereas FPRs were 33.3%, 66.7%, and 33.3% in the diagnostic methods.Statistically significant diagnostic results were obtained from PET/CT, enhanced CT scan, B ultrasound, and MRI(P=0.036, 0.002, and 0.019, respectively; P < 0.05. Conclusion The18F-FDG PET/CT scan is more efficient than the traditional imaging methods, such as contrast-enhanced CT, B ultrasound, and MRI.Thus, this technique can be a useful modality for the diagnosis of gallbladder carcinoma. -
Key words:
- PET/CT /
- gallbladder carcinoma /
- 18F-FDG /
- diagnosis
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图 1 PET/CT与增强CT联合应用诊断胆囊癌
Figure 1. Combined diagnosis with PET/CT and enhanced CT scan ofgallbladder carcinoma
A man, 64 years old, Figure A(unenhanced CT): the bottom of gallbladder slightly thickened; Figure B, E(PET): the bottom of gallbladder abnormal radioactivity concentration; Figure C(unenhanced PET/CT): suspicious gallbladder; Figure D(enhanced CT): the gallbladder bottom irregular significantly enhanced; Figure F(enhanced PET/CT): gallbladder cancer. Surgical pathology was moderately differentiated adenocarcinoma
表 1 PET/CT与增强CT、B超、MRI诊断胆囊癌的最终结果
例 Table 1. Final diagnostic results of PET/CT, enhanced CT scan, B ultrasound, and MRI in gallbladder carcinoma
表 2 比较PET/CT与其他影像学方法对胆囊癌诊断的价值
例(%) Table 2. Comparison of the diagnostic values between PET/CT and the other imaging methods for gallbladder carcinoma
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