China Oncology ›› 2016, Vol. 26 ›› Issue (10): 866-869.doi: 10.19401/j.cnki.1007-3639.2016.10.010

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Dual-phase 18F-FDG coincidence detection SPECT/CT imaging for differential diagnosis of pulmonary lesions

ZHANG Yue, ZHANG Zuncheng, JIAO Yan, DONG Ping, DONG Hua   

  1. Department of Nuclear Medicine, the Second Hospital of Tianjin Medical University, Tianjin 300211, China
  • Online:2016-10-30 Published:2016-11-17
  • Contact: ZHANG Zuncheng E-mail: zhangzuncheng@sina.com

Abstract: Background and purpose: Although FDG tumor imaging has been applied in clinic widely, dual-phase imaging can provide much more information about the FDG uptaking of pulmonary lesions. The purpose of the study was to evaluate the usefulness of dual-phase 18F-FDG coincidence detection SPECT/CT imaging in the differential diagnosis of the pulmonary lesions. Methods: There were 28 patients with pulmonary lesions which were detected by CT. All the patients undertook the SPECT/CT imaging at 2 time-phases respectively: early imaging at 40-60 min and delayed imaging at 2-3 h after the intravenous injection of FDG. Data processing: calculating the radio of T and N in early and delayed imaging respectively; T: The radioactive count of the lesions; N: The radioactive count of the normal tissue; and the change rate: ΔT/N. ROC was used to find out the threshold of T1/N1, T2/N2及ΔT/N in the differential diagnosis between benign and malignant lesions. AUC was used to evaluate the diagnosis value of the dual-phase and single-phase imaging. Results: The threshold of T1/N1 in early imaging was 2.65, whereas AUC was 0.767. The sensitivity, specificity and accuracy were 83.3%, 30% and 64.3%, respectively. The threshold of T2/N2 in delayed imaging was 3.14, whereas AUC was 0.847. The sensitivity, specificity and accuracy were 94.4%, 60.0% and 82.1%, respectively. The threshold of ΔT/N in delayed imaging was 16.9%, whereas AUC is 0.950. The sensitivity, specificity and accuracy were 88.5%, 71.4% and 86.2%, respectively. Conclusion: Dual-phase 18F-FDG coincidence detection SPECT/CT imaging has much higher accuracy and specificity. However it still has false positivity, and should be analyzed with CT and clinical history.

Key words: Dual phase, 18F-FDG, Coincidence Detection, SPECT/CT, Lung cancer, Differential diagnosis