|Table of Contents|

99Tcm-MIBI SPECT/CT two-phase tomography fusion imaging combined with semi-quantitative analysis to distinguish benign and malignant ground-glass nodules of lung

Journal Of Modern Oncology[ISSN:1672-4992/CN:61-1415/R]

Issue:
2023 21
Page:
4015-4019
Research Field:
Publishing date:

Info

Title:
99Tcm-MIBI SPECT/CT two-phase tomography fusion imaging combined with semi-quantitative analysis to distinguish benign and malignant ground-glass nodules of lung
Author(s):
JING Gongwei; WANG Lijun; PU Shenglan; WANG Jiaoya; LI Ya; REN Bingxiu
The First People's Hospital of Zunyi（The Third Affiliated Hospital of Zunyi Medical University)，Guizhou Zunyi 563000，China.
Keywords:
99Tcm-methoxyisobutyl isonitrile; single-photon emission-computed tomography/computed tomography; T/NT semi-quantitative analysis; ground-glass nodule of lung; receiver operating characterstic curve
PACS:
R734.2
DOI:
10.3969/j.issn.1672-4992.2023.21.020
Abstract:
Objective:To explore the diagnostic value of 99Tcm-MIBI SPECT/CT imaging combined with target/non-target（T/NT） semi-quantitative analysis in benign and malignant ground-glass nodules of lung.Methods:A total of 68 patients with ground-glass nodules by plain CT from 2015 to 2022 in our hospital were retrospectively collected.After injection of 99Tcm-MIBI，SPECT/CT was used to collect early（15 min) and delayed（3 h) tomography fusion images，respectively，and calculate early uptake ratio（EUR) and delayed uptake ratio（DUR) were calculated.Then，according to the pathological results，the lesions were divided into benign and malignant groups，and the EUR and DUR of 99Tcm-MIBI SPECT/CT imaging between the two groups were compared.Finally，ROC curve analysis was performed for their diagnostic efficacy.Results:The 99Tcm-MIBI SPECT/CT fusion imaging showed that 55 cases were malignant and 13 cases were benign.The sensitivity，specificity,accuracy,positive predictive value and negative predictive value of the 99Tcm-MIBI SPECT/CT fusion imaging were 98.1%，75.0%，92.6%，92.7% and 92.3% respectively in the differential diagnosis of benign and malignant ground-glass nodules.There were significant differences between EUR（t=-2.841，P=0.006) and DUR（t=-3.525，P=0.001) in the identification of benign and malignant ground-glass nodules.When EUR≥1.315 or DUR≥1.145，it was the best truncation value for the diagnosis of malignant lung lesions，and the corresponding sensitivity and specificity were 54.2%，100.0%，79.2%，83.3%，and the area under the curve were 0.771 and 0.799，respectively.Conclusion:99Tcm-MIBI SPECT/CT imaging combined with T/NT semi-quantitative analysis can provide a certain reference value for early diagnosis of benign and malignant ground-glass nodules of lung.

References:

［1］GAO C，KONG N，ZHANG F，et al.Risk stratification of lung adenocarcinoma using a nomogram combined with ferroptosis-related lncRNAs and subgroup analysis with immune and N6-methyladenosine modification［J］.BMC Med Genomics，2022,15(1):15.
［2］WANG Z，HU F，CHANG R，et al.Development and validation of a prognostic model to predict overall survival for lung adenocarcinoma:A population-based study from the SEER database and the Chinese multicenter lung cancer database［J］.Technol Cancer Res Treat,2022，21:15330338221133222.
［3］陈佳琪,王建卫.持续存在肺磨玻璃结节预后的研究进展［J］.癌症进展,2022,20(13):1297-1302,1306. CHEN JQ，WANG JW.Advances in the study of prognosis of persistent pulmonary ground-glass nodules［J］.Oncology Progress，2022,20(13):1297-1302,1306.
［4］XU F，ZHU W，SHEN Y，et al.Radiomic-based quantitative CT analysis of pure ground-glass nodules to predict the invasiveness of lung adenocarcinoma［J］.Front Oncol,2020,10:872.
［5］王阳.CT表现为肺磨玻璃结节的炎症、浸润前与浸润性腺癌的鉴别诊断研究［D］.大连：大连医科大学，2016. WANG Y.Differential diagnosis study of manifesting ground-glass pulmonary nodular inflammation，pre-invasive and invasive adenocarcinoma on CT［D］.Dalian: Dalian Medical University，2016.
［6］ZHU M，YANG Z，WANG M，et al.A computerized tomography-based radiomic model for assessing the invasiveness of lung adenocarcinoma manifesting as ground-glass opacity nodules［J］.Respir Res，2022,23(1):96.
［7］徐同毅,颜廷权,黎涛,等.高分辨CT对肺良恶性磨玻璃结节的诊断价值［J］.实用癌症杂志,2022,37(7):1170-1173. XU TY，YAN TQ，LI T，et al.Value of high resolution CT in diagnosing benign and malignant ground glass nodules of lung［J］.The Practical Journal of Cancer,2022,37(7):1170-1173.
［8］宋传顺.能谱CT对肺腺癌分化程度的诊断价值［J］.河南医学研究,2022,31(5):900-903. SONG CS.Diagnostic value of spectral CT in the differentiation degree of lung adenocarcinoma［J］.Henan Medical Research,2022,31(5):900-903.
［9］江春亭,张安南,张卫方.18F-FDG PET/CT诊断肺磨玻璃结节应用进展［J］.中国医学影像技术,2020,36(11):1738-1741. JIANG CT，ZHANG AN，ZHANG WF.Application progresses of 18F-FDG PET/CT in diagnosis of lung ground glass nodules［J］.Chin J Med Imaging Technol,2020,36(11):1738-1741.
［10］周淼,马学进,江林,等.增强CT扫描和99Tcm-MIBI-SPECT/CT同机融合显像鉴别孤立性肺结节的临床研究［J］.临床放射学杂志,2021,40(7):1303-1307. ZHOU M，MA XJ，JIANG L，et al．The diagnosis value on solitary pulmonary nodule between enhanced MSCT scan and 99Tcm-MIBI-SPECT/CT fusion imaging［J］.Journal of Clinical Radiology,2021,40(7):1303-1307.
［11］刘长江,肖本波,黄霖,等.99Tcm-甲氧基异丁基异腈单光子发射型计算机断层显像联合诊断级CT融合显像在鉴别良恶性肺部病灶中的应用［J］.广西医学,2020,42(24):3201-3204. LIU CJ，XIAO BB，HUANG L，et al.Application of technetium-99m methoxyisobutylisonitrile single photon emission computed tomography combined with diagnosis-level CT fusion imaging to differentiating benign from malignant lung lesions［J］.Guangxi Medical Journal,2020,42(24):3201-3204.
［12］MINAI OA，RAJA S，MEHTA AC，et al.Role of Tc-99m MIBI in the evaluation of single pulmonary nodules:A preliminary report［J］.Thorax，2000，55(1):60-62.
［13］MENGOLI MC，LONGO FR，FRAGGETTA F，et al.The 2015 World Health Organization classification of lung tumors:New entities since the 2004 classification［J］.Pathologica,2018，110(1):39-67.
［14］张成君.锝-99m标记甲氧基异丁基异腈肿瘤阳性显像的价值［J］.现代诊断与治疗,1999,10(2):30-32. ZHANG CJ.Value of 99Tcm MIBI in tumor imaging［J］.Modern Diagnosis and Treatment,1999,10(2):30-32.
［15］NIKOLETIC K，LUCIC S，PETER A，et al.Lung 99Tcm-MIBI scintigraphy:Impact on diagnosis of solitary pulmonary nodule［J］.Bosn J Basic Med Sci,2011,11(3):174-179.
［16］NIKOLETIC K，MIHAILOVIC J，SRBOVAN D，et al.Lung tumors:Early and delayed ratio of 99Tcm-methoxy-2-isobutylisonitrile accumulation［J］.Vojnosanit Pregl,2014，71(5):438-445.
［17］ZHANG S，LIU Y.Diagnostic performances of 99Tcm-Methoxy isobutyl isonitrile scan in predicting the malignancy of lung lesions:A Meta-analysis［J］.Medicine，2016，95(18):e3571．
［18］刘长江,张旭,张庆,等.99Tcm-MIBI SPECT与定位CT同机融合显像对肺部病灶的鉴别诊断价值［J］.中国临床医学影像杂志,2012,23(7):468-471,483. LIU CJ，ZHANG X，ZHANG Q，et al.DifferentiaI diagnosis of lung masses with integrated 99Tcm-MIBI SPECT/CT［J］.Journal of China Clinic Medical Imaging,2012,23(7):468-471,483.
［19］PARK JW,HONG SP，LEE JH，et al.99Tcm-MIBI uptake as a marker of mitochondrial membrane potential in cancer cells and effects of MDR1 and verapamil［J］.PLoS One，2020，15:e0228848.
［20］ZHANG SX，LIU Y.Diagnostic performances of 99Tcm-methoxy isobutyl isonitrile scan in predicting the malignancy of lung lesions:A Meta-analysis［J］.Medicine（Baltimore)，2016，95(18):e3571.
［21］JIA X,XUE JJ,GAO R，et al.Diagnostic efficacy of 99Tcm-MIBI SPECT/CT and 18F-FDG coincidence SPECT/CT for solitary pulmonary nodules:A comparative study［J］.Journal of Southern Medical University，2016，36(3):386-390.
［22］XU F，ZHU W，SHEN Y，et al.Radiomic-based quantitative CT analysis of pure ground-glass nodules to predict the invasiveness of lung adenocarcinoma［J］.Front Oncol,2020，10:872.
［23］SUN Y，LI C，JIN L，et al.Radiomics for lung adenocarcinoma manifesting as pure ground-glass nodules:Invasive prediction［J］.Eur Radiol,2020，30(7):3650-3659.

Memo

Memo:
贵州省基础研究计划（自然科学类）项目（编号：黔科合基础〔2019〕1325号）；贵州省卫生健康委科学技术基金项目(编号：gzwjkj2020-1-001)
Last Update: 2023-09-28