Application Of ¹¹C-Choline And ¹⁸F-FDG PET/CT Imaging In The Diagnosis Of Pulmonary Masses

Pulmonary carcinoma is one of the major malignant tumors which harm human health. The prognosis of pulmonary carcinoma has a close relationship with earlier diagnosis and earlier treatment. Medical imaging played an important role in diagnosis, treatment planning, therapeutic effectiveness and prognosis evaluation. Compared with morphologic imaging modalities such as X-ray plain film, CT and MRI, PET with the merits of functional and anatomical imaging could display function and metabolism noninvasively, quantitively and qualitively. F-FDG PET and PET/CT imaging had wide application in diagnosis of pulmonary tumors. The SUVmax more than or equal to 2.5 was regarded as positive, but this PET diagnostic criteria of pulmonary malignancies had false positive and false negative results. How to use ¹⁸F-FDG PET to characterize pulmonary masses is the hot topic. ¹¹C-choline acting as a novel PET tracing agent is emphasized in clinical research of the tumors nowadays. Partâ… Application of ¹⁸F-FDG PET/CT imaging in the diagnosis ofpulmonary massesObjective: To investigate the value of ¹⁸F-FDG PET/CT imaging in the diagnosis of benign and malignant pulmonary lesions,to explore the correlation between the F-FDG PET maximum standardized uptake value (SUVmax) and the size of pulmonary lesions and to study the difference of SUVmax between different pathological types.Materials and methods: 122 cases with pulmonary masses were underwent ¹⁸F-FDG PET/CT imaging.Images were obtained 60min after the injection of 296-370MBq ¹⁸F-FDG. PET and PET/CT images were analyzed. The results were compared with pathological results. Statistical analysis was done, including the following issues.(1)Sensitivity, specificity, accuracy, positive predictive value and negative predictive value were computed to evaluate the diagnosis value of ¹⁸F-FDG PET and PET/CT in pulmonary benign and malignant lesions.(2)The difference of SUVmax for ¹⁸F-FDG PET/CT imaging between benign and malignant lesions.(3)The correlation between SUV of ¹⁸F-FDG PET/CT imaging and the size of pulmonary lesions and the difference of SUVmax between different pathological types.Results: (1)82 cases with pulmonary carcinoma and 18 cases with benign pulmonary lesions were correctly diagnosed with 8 false negative results and 14 false positive results for ¹⁸F-FDG PET imaging in 122 cases with pulmonary lesions. The Sensitivity, specificity, accuracy, positive predictive value and negative predictive value of PET imaging were 91.1%, 56.3%, 81.97%, 85.4% and 69.2 % respectively. 84 cases with pulmonary carcinoma and 27 cases with pulmonary benign lesions were correctly diagnosed with 6 false negative results and 5 false positive results for PET/CT imaging. The Sensitivity, specificity, accuracy, positive predictive value and negative predictive value of PET/CT imaging were 93.3%, 84.4%, 91%, 94.4% and 81.8 % respectively. The accuracy of ¹⁸F-FDG PET/CT imaging was higher than that of ¹⁸F-FDG PET imaging (X²=4. 24, P<0. 05 ) . (2)SUVmax of pulmonary carcinoma (9.51±4.80) was significantly higher than the values of benign pulmonary lesions (2.77±1.73) for ¹⁸F-FDG PET/CT imaging.(3)There was a positive correlation between SUVmax of ¹⁸F-FDG PET/CT imaging and the size of pulmonary lesions, and there was no statistical significance for SUVs between adencarcinoma and squamous carcinoma. SUV of bronchioalveolar carcinoma was significantly lower than adencarcinoma and squamous carcinoma.Conclusions: (1) ¹⁸F-FDG PET/CT imaging is an effective and noninvasive method in the diagnosis of benign and malignant pulmonary lesions. The diagnosis efficiency is superior to that of PET imaging.(2)SUVmax of ¹⁸F-FDG PET imaging increases with the enlargement of the lesion.There is no difference for SUVs between adencarcinoma and squamous carcinoma and SUV of bronchioalveolar carcinoma is significantly lower than adencarcinoma and squamous carcinoma. Partâ…¡Comparison of ¹¹C-Choline and ¹⁸F-FDG PET/CT imaging in thediagnosis of primary pulmonary carcinomaObjective: To compare the diagnostic value of ¹¹C-choline and ¹⁸F-FDG PET/CT imaging in the detection of primary pulmonary carcinoma, to explore the relationship of ¹¹C-choline PET/CT imaging and ¹⁸F-FDG PET/CT imaging in primary pulmonary carcinoma.Materials and methods: 20 cases with histologically proven primary pulmonary carcinoma (10 cases with adencarcinoma, 6 cases with squamous carcinoma, 2 cases with small cell carcinoma, 2 case with bronchioalveolar carcinoma) were done with ¹¹C-choline PET/CT imaging and ¹⁸F-FDG PET/CT imaging. Images were analyzed semi-quantitively and SUV of the lesions with the differential imaging agent were calculated. Finally statistical analyses were done, including the following issues. (1) The difference of results for ¹¹C-Choline and ¹⁸F-FDG PET/CT imaging.(2) The difference of SUVs between ¹¹C-choline and ¹⁸F-FDG PET/CT imaging, the relationship of SUVs between ¹¹C-choline and ¹⁸F-FDG PET/CT imaging.(3) The relationship between SUVs of ¹¹C-choline PET/CT imaging and the size of lesions.Results: (1)Both ¹¹C-choline and ¹⁸F-FDG PET/CT imaging showed an increase in tracer uptake in 17 of 20 patients with primary pulmonary carcinoma. However neither ¹¹C-choline nor ¹⁸F-FDG PET/CT imaging showed an increase in tracer uptake in the other three patients.(2)SUVs of the lesions using the ¹¹C-choline PET/CT imaging were lower significantly than the values of ¹⁸F-FDG PET/CT imaging. There was a positive correlation between SUVs of ¹⁸F-FDG and ¹¹C-choline PET/CT imaging in pulmonary carcinoma. (3) SUVs of ¹¹C-choline PET/CT imaging had a positive correlation with the size of the lesions. Conclusions: The sensitivity of ¹¹C-choline PET/CT imaging is similar to that of ¹⁸F-FDG PET/CT imaging in primary pulmonary carcinoma. SUVmax of ¹¹C-choline PET/CT imaging increases with the enlargement of the lesion.¹¹C-choline PET/CT imaging is valuable in differentiating primary pulmonary carcinoma.