ABSTRACT
<p><b>OBJECTIVE</b>To evaluate the performance of 18F-FDG three-head tomography with coincidence imaging and serum tumor marker assays in identifying lung lesions in 104 patients with abnormal findings on chest X-ray or computer tomography.</p><p><b>METHODS</b>A prospective evaluation of 18F-FDG coincidence imaging and the measurement of 3 serum markers for lung cancer ( carcinoembryonic antigen, CYFRA21-1 and neuron specific enolase) were performed within one week in 104 inpatients with suspected lung malignancy. All images were analyzed visually. It was considered positive for malignancy if the 18F-FDG uptake was increased relative to that in the adjacent lung tissue, and was focal. The serum tumor marker test was considered positive for malignancy if the serum level of at least one marker was elevated.</p><p><b>RESULTS</b>66 patients were proven to have lung cancer by pathology, and 38 patients had benign lung diseases. The sensitivity, specificity, accuracy of 18F-FDG coincidence imaging and serum tumor markers in assessing lung cancers were 80. 0% , 77. 2% , 77. 9% and 56. 0% , 60. 9%, 64. 4% , respectively. 18F-FDG coincidence images in assessing lung lesions showed significantly higher sensitivity, specificity and accuracy than serum tumor markers. Four patients with lung cancer had negative findings on 18F-FDG coincidence images but showed positive serum markers.</p><p><b>CONCLUSION</b>18F-FDG coincidence imaging is a powerful tool for evaluating patients with lung lesions suggestive of malignancy. Although the determination of serum marker levels is less accurate than 18F-FDG coincidence imaging, the combination of a positive 18F-FDG coincidence result and positive tumor markers may be helpful in improving the diagnosis of lung cancers.</p>
Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Antigens, Neoplasm , Blood , Biomarkers, Tumor , Blood , Carcinoembryonic Antigen , Blood , Carcinoma, Small Cell , Blood , Diagnosis , Diagnostic Imaging , Carcinoma, Squamous Cell , Blood , Diagnosis , Diagnostic Imaging , Fluorodeoxyglucose F18 , Keratin-19 , Keratins , Blood , Lung Neoplasms , Blood , Diagnosis , Diagnostic Imaging , Phosphopyruvate Hydratase , Blood , Plasma Cell Granuloma, Pulmonary , Blood , Diagnosis , Diagnostic Imaging , Positron-Emission Tomography , Prospective Studies , Radiopharmaceuticals , Sensitivity and Specificity , Tuberculosis, Pulmonary , Blood , Diagnosis , Diagnostic ImagingABSTRACT
Objective To evaluate the clinical value of 6 h 99mTc-diethyl iminodiacetic acid (99mTc-EHIDA) planar hepatobiliary scintigraphy (HBS),6 h tomographic HBS and 24 h planar HBS in diagnosis on biliary atresia(BA).Methods Seventy cases(32 male,38 female) with continuous jaundice received planar and tomographic HBS in Beijing Friendship Hospital from Jan.2005 to Dec.2007.The mean age was 48.7 d (29 d-4 months).According to final diagnosis,all cases were divided into BA group (45 cases) and non-BA group (25 cases).All cases fasted at least 4 hours before HBS.The equipment was 3 head IRIX from Philips company with low energy high resolution collimator.The tracer was 99mTc-EHIDA and the radiochemistry purity was more than 95 percent.The dosage was 7.4 MBq/kg.All diagnosis demonstrated by operation pathology and clinical follow-up.All cases received HBS at 5,10,15,20,30 min and 1,6 h after tracer injection.HBS would ended if radioactivity appeared in gallbladder or intestine.These cases would received tomographic HBS and 24 h HBS if radioactivity did not appear in gallbladder or intestine at 6 h post injection.All these images were analyzed by 2 or more nuclear medicine physicians.Results There were not radioactivity appearing in gallbladder and intestine on planar and tomographic HBS of 27 cases,which suggested the BA.There were radioactivity appearing in gallbladder and intestine on planar and tomographic HBS of 30 cases,which suggested the non-BA.Positive rate of 6 h tomographic HBS was significantly higher than that of 6 h planar HBS and there was significantly difference between the 2 methods.Positive rate of 6 h tomographic HBS was significantly higher than that of 24 h planar HBS and there was significant difference between the 2 methods.Conclusions 99mTc-EHIDA HBS is a noninvasive,safety,valuable examing method and has definitely clinical value in the diagnosis on BA.The clinical value of 6 h tomographic HBS is significantly higher than that of 6 h planar HBS and 24 h planar HBS.
ABSTRACT
<p><b>OBJECTIVE</b>To evaluate the accuracy of [18F] fluorodeoxyglucose (FDG) triple-head coincidence imaging in the setting of suspected lung cancer.</p><p><b>METHODS</b>109 patients with suspected lung cancer were enrolled in the present study. According to the diameter of the lesion (> 1.5 cm, </= 1.5 cm), patients were divided into two groups. The sensitivity, specificity and accuracy of the results were calculated and the results were compared with pathological results.</p><p><b>RESULTS</b>Of the total of 109 patients, 86 cases were confirmed as lung cancer whereas 23 cases were benign by pathological study. The sensitivity, specificity and accuracy of FDG imaging were 95% (82/86), 74% (17/23) and 91% (99/109), respectively. For the group of lesion diameter > 1.5 cm, the sensitivity, specificity and accuracy were 98% (81/83)), 63% (10/16) and 92% (91/99), respectively. While for the group of lesion diameter </= 1.5 cm, the results were 1/3, 7/7, and 8/10, respectively. The difference between the two groups was significant (P = 0.005).</p><p><b>CONCLUSIONS</b>The technique of [18F] FDG imaging is an useful method for routine evaluation of patients with suspected lung cancer. The sensitivity of detection is related to lesion size, if lesions </= 1.5 cm in diameter the results of FDG imaging should be carefully analyzed.</p>