Clinical Investigation
Incremental value of chest thin layer CT over 99Tcm-3PRGD2 SPECT/CT imaging in the diagnosis of solitary pulmonary space occupying
Li Yanmei, He Chengxiang, He Wei, Li Juan, Yang Jiqin
Published 2020-11-25
Cite as Chin J Nucl Med Mol Imaging, 2020, 40(11): 647-651. DOI: 10.3760/cma.j.cn321828-20191129-00280
Abstract
ObjectiveTo evaluate the additional value of chest thin layer CT over 99Tcm-hydrazinonicotinyl-(polyethylene glycol)4-E[(polyethylene glycol)4-c(RGDfK)]2(HYNIC-PEG4-E[PEG4-c(RGDfK)]2; 3PRGD2) SPECT/CT in detecting isolated pulmonary space.
MethodsThis was a prospective study conducted in General Hospital of Ningxia Medical University. There were 87 patients with solitary pulmonary space occupying between July 2015 and December 2016, and 74 of those patients (49 males, 25 females, age range: 37-80 (58.4±9.6) years) who had pathological results were enrolled. 99Tcm-3PRGD2 SPECT/CT imaging was performed routinely, and then the chest thin layer CT images were acquired. The maximum radioactive counts ratio of tumor to non-tumor (T/N)≥1.5 was the standard for positive planer 99Tcm-3PRGD2 imaging, and that ≥2.0 was the standard for positive SPECT/CT imaging. According to the pathological results as gold standard, the diagnostic efficiencies of 99Tcm-3PRGD2 planer and SPECT/CT imaging, chest thin layer CT and chest thin layer CT+ 99Tcm-3PRGD2 SPECT/CT imaging for malignant pulmonary lesions were calculated. Kappa test was used to compare the consistency of the imaging methods and pathological results.
ResultsThe post-surgery histopathology confirmed that 51 patients were with malignancy and 23 had benign lesions. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of 99Tcm-3PRGD2 planer imaging, SPECT/CT imaging and chest thin layer CT in the diagnosis of malignant pulmonary lesions were 47.1%(24/51), 65.2%(15/23), 52.7%(39/74), 75.0%(24/32), 35.7%(15/42); 86.3%(44/51), 47.8%(11/23), 74.3%(55/74), 78.6%(44/56), 11/18 and 84.3%(43/51), 52.2%(12/23), 74.3%(55/74), 79.6%(43/54), 12/20, respectively. Those of the chest thin layer CT+ SPECT/CT were 98.0%(50/51), 73.9%(17/23), 90.5%(67/74), 89.3%(50/56) and 17/18 respectively. The Kappa values between the imaging methods (99Tcm-3PRGD2 planer imaging, SPECT/CT imaging, chest thin layer CT and the chest thin layer CT+ SPECT/CT) and pathological examination were 0.100, 0.250, 0.354 and 0.765 (all P<0.001).
ConclusionChest thin layer CT has an incremental value over 99Tcm-3PRGD2 SPECT/CT imaging in the differential diagnosis of benign and malignant pulmonary lesions.
Key words:
Lung neoplasms; Technetium; Arginine-glycine-aspartic acid; Tomography, emission-computed, single-photon; Tomography, X-ray computed
Contributor Information
Li Yanmei
Department of Nuclear Medicine, General Hospital of Ningxia Medical University, Yinchuan 750004, China
He Chengxiang
Department of Nuclear Medicine, General Hospital of Ningxia Medical University, Yinchuan 750004, China
He Wei
Department of Nuclear Medicine, General Hospital of Ningxia Medical University, Yinchuan 750004, China
Li Juan
Department of Nuclear Medicine, General Hospital of Ningxia Medical University, Yinchuan 750004, China
Yang Jiqin
Department of Nuclear Medicine, General Hospital of Ningxia Medical University, Yinchuan 750004, China
