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目的:为探讨其他示踪剂补充18F-FDGPET/CT显像的不足、提供国内多中心临床研究数据,组织国内6家医院进行18F-FDG/18F-FLT肺结节的研究。材料和方法:用规范化操作、随机、前瞻方式,收集55例临床诊断困难的肺结节病例的18F-FDG和18F-FLTPET/CT显像结果,通过盲法集中阅片方式,以病理组织学或确定临床证据为真实标准,分析双示踪剂PET/CT方式与单一示踪剂/显像方式的诊断效率,通过检查前后临床问卷方式,分析对临床决策的影响。结果:与18F-FDG、18F-FLT单显像比较,双示踪剂PET/CT使诊断特异性从58.97%-76.92%提高到89.74%,准确率从67.27%-74.45%提高到92.73%。以FLT/FDGSUV比值0.4-0.9为阈,可以最大程度区分肿瘤(16例)、结核(16例)和其他良性结节(23例)。双示踪剂PET/CT改变和部分改变了33%和14%病例的临床决策,除3例外,这些改变最终证实是正确的。结论:通过显示病变的不同生物学特征,18F-FDG/18F-FLT双示踪剂显像可以明显改善肺结节PET/CT的诊断效率,并可以对临床决策产生积极影响。
OBJECTIVE: To investigate the inadequacies of 18F-FDG PET / CT imaging with other tracers and to provide domestic multi-center clinical research data and to organize the study of 18F-FDG / 18F-FLT pulmonary nodules in 6 hospitals in China. MATERIALS AND METHODS: The results of 18F-FDG and 18F-FLTPET / CT imaging of 55 cases of pulmonary nodules with clinical diagnosis were collected by standardized operation, randomized and prospective methods. The results of pathological histology Or to determine the clinical evidence as a true standard, to analyze the diagnostic efficiency of dual tracer PET / CT and single tracer / imaging modalities, and analyze the impact on clinical decision-making by examining the clinical questionnaire before and after. Results: Compared with 18F-FDG and 18F-FLT, the diagnostic accuracy of double tracer PET / CT increased from 58.97% -76.92% to 89.74%, and the accuracy increased from 67.27% -74.45% to 92.73%. Tumors (16 cases), tuberculosis (16 cases) and other benign nodules (23 cases) can be distinguished to the maximum with FLT / FDGSUV ratio of 0.4-0.9. The dual tracer PET / CT changed and partially changed the clinical decision-making in 33% and 14% of the cases, with the exception of three that ultimately proved to be correct. CONCLUSIONS: The 18F-FDG / 18F-FLT dual tracer imaging can significantly improve the diagnostic efficiency of PET / CT in lung nodules by displaying different biological characteristics of the lesion and may have a positive impact on clinical decision-making.