臺灣博碩士論文加值系統

研究背景和目標： 在這項研究中，依據斷層造影表現為實質或毛玻璃樣結節與手術結果分析、比較短時距雙相正子斷層造影應用於鑑別肺癌與良性病變的準確性。
材料和方法： 共有 94 名病人參加這項回顧性研究。肺部斷層造影的結果被歸類為實質(solid)或毛玻璃樣結節(ground-glass nodules , GGNs)兩類。正子造影檢查的結果包括初期和延遲期的最高的攝取值(SUVmax)以及殘留指數(RI)。
結果： 在75例實質結節中，53例為惡性，22例為良性。在19例GGNs中，15例為惡性而4例是良性。在實質結節病例中，初期 SUVmax值在惡性病例組明顯高於良性病變組 (5.78±3.66 與 3.41±4.13，p = 0.002）；殘留指數(RI)在惡性病例組裡也是高於良性病例組（17.51±18.08 與 11.45±19.48，p = 0.181）。
在實質結節病例組中，惡性組的延遲期SUVmax值明顯地高於良性組 (6.75±4.27 與 3.79±4.46，p = 0.001)。在GGNs病例組中，惡性組的初期SUVmax值低於良性組 (1.89±0.85 與 2.86±2.36，p = 0.549）。此外，GGNs組中，惡性組的延遲期SUVmax值低於良性組（2.20±1.10與3.45±2.80； p = 0.424）；殘留指數(RI)也呈現相同的傾向 (惡性 15.65±12.72與良性21.98±6.23; p = 0.230)。
結論：使用外科術後病理結果作為參考標準，在斷層造影的結果為實質樣結節(solid nodules)者，其PET檢查SUVmax值與其是否為惡性腫瘤有明顯的正相關。在斷層造影的結果為毛玻璃樣結節(ground-glass nodules , GGNs)者，其SUVmax值和是否為惡性腫瘤沒有顯著關係。

Rational and Objectives: In this study, we compare the accuracy of shorter-time dual-phase 18F-FDG PET/CT in evaluating different types of lung nodules classified as solid or ground-glass nodules (GGNs).
Materials and Methods: A total of 94 patients were enrolled in this retrospective study. The diagnostic chest CT images were classified as solid or GGNs. The early and delayed maximum standardized uptake value (SUVmax) as well as retention index (RI) of each nodule were determined.
Results: Of the 75 solid nodules, 53 were malignant and 22 were benign. Of the 19 GGNs, 15 were malignant and 4 were benign. In solid nodules, the early SUVmax was significantly higher in malignant than benign lesions (5.78±3.66 vs. 3.41±4.13, p = 0.002); the RI in malignant was higher than in benign (17.51±18.08 vs. 11.45±19.48, p = 0.181). In the solid group, the delayed SUVmax was significantly higher in malignant than benign (6.75±4.27 vs. 3.79±4.46, p = 0.001). In GGNs, the early SUVmax was lower in the malignant than benign (1.89±0.85 vs. 2.86±2.36, p = 0.549). In the GGN group, the delayed SUVmax was lower in the malignant than benign (2.20±1.10 vs. 3.45±2.80; p = 0.424); the same was true for RI (malignant 15.65±12.72 vs. benign 21.98±6.23; p = 0.230).
Conclusion: Using surgical pathology as reference standard, there is significant positive correlation between SUVmax on FDG PET and malignancy in solid nodules. No significant relationship between SUVmax and malignancy was found in GGNs.

Abstract …………………………V
致謝 ……………………………VII
Contents …………………………IX
List of Figures …………………X
Introduction ……………………1
Material and Methods …………3
Results …………………………6
Discussion ………………………8
Conclusion ………………………12
References ………………………13
Figures and Figure Legends …16

1. Imdahl A, Jenkner S, Brink I, Nitzsche E, Stoelben E, Moser E, Hasse J (2001) Validation of FDG positron emission tomography for differentiation of unknown pulmonary lesions . Eur J Cardiothorac Surg 20:324-329.
2. Gould MK, Maclean CC, Kuschner WG, Rydzak CE, Owens DK (2001) Accuracy of positron emission tomography for diagnosis of pulmonary nodules and mass lesions: a meta-analysis . JAMA 285:914-924.
3. Kim SK, Allen-Auerbach M, Goldin J, Fueger BJ, Dahlbom M, Brown M, Czernin J, Schiepers C (2007) Accuracy of PET/CT in characterization of solitary pulmonary lesions . J Nucl Med 48:214-220.
4. Kubota K (2001) Changing pattern of lung cancer and its imaging: (201)Tl SPECT versus [(18)F]FDG PET . J Nucl Med 42:1497-1498.
5. Goudarzi B, Jacene HA, Wahl RL (2008) Diagnosis and Differentiation of Bronchioloalveolar Carcinoma from Adenocarcinoma with Bronchioloalveolar Components with Metabolic and Anatomic Characteristics Using PET/CT. J Nucl Med 49:1585-1592.
6. Conrad GR, Sinha P (2003) Narrow time-window dual-point 18F-FDG PET for the diagnosis of thoracic malignancy. Nucl Med Commun 24:1129-1137.
7. Zhuang H, Pourdehnad M, Lambright ES, Yamamoto AJ, Lanuti M, Li P, Mozley PD, Rossman MD, Albelda SM, Alavi A (2001) Dual Time Point 18F-FDG PET Imaging for Differentiating Malignant from Inflammatory Processes. J Nucl Med 42:1412-1417.
8. Xiu Y, Bhutani C, Dhurairaj T, Yu JQ, Dadparvar S, Reddy S, Kumar R, Yang H, Alavi A, Zhuang H (2007) Dual-time point FDG PET imaging in the evaluation of pulmonary nodules with minimally increased metabolic activity . Clin Nucl Med 32:101-105.
9. Schillaci O, Travascio L, Bolacchi F, Calabria F, Bruni C, Ciccio C, Guazzaroni M, Orlacchio A, Simonetti G (2009) Accuracy of early and delayed FDG PET-CT and of contrast-enhanced CT in the evaluation of lung nodules: a preliminary study on 30 patients . Radiol Med 114:890-906.
10. Chen YM, Huang G, Sun XG, Liu JJ, Chen T, Shi YP, Wan LR (2008) Optimizing delayed scan time for FDG PET: comparison of the early and late delayed scan . Nucl Med Commun 29:425-430.
11. Acton PD, Zhuang H, Alavi A (2004) Quantification in PET. Radiol Clin North Am 42:1055.
12. Goethals I, Smeets P, De Winter O, Noens L (2006) Focally Enhanced F-18 Fluorodeoxyglucose (FDG) Uptake in Incidentally Detected Pulmonary Embolism on PET/CT Scanning. Clin Nucl Med 31:497-498.
13. Goerres GW, Forster A, Uebelhart D, Seifert B, Treyer V, Michel B, von Schulthess GK, Kaim AH (2006) F-18 FDG whole-body PET for the assessment of disease activity in patients with rheumatoid arthritis . Clin Nucl Med 31:386-390.
14. Houseni M, Chamroonrat W, Zhuang H, Alavi A (2006) Facet joint arthropathy demonstrated on FDG-PET . Clin Nucl Med 31:418-419.
15. Demura Y, Tsuchida T, Ishizaki T, Mizuno S, Totani Y, Ameshima S, Miyamori I, Sasaki M, Yonekura Y (2003) 18F-FDG Accumulation with PET for Differentiation Between Benign and Malignant Lesions in the Thorax. J Nucl Med 44:540-548.
16. Chun EJ, Lee HJ, Kang WJ, Kim KG, Goo JM, Park CM, Lee CH (2009) Differentiation between malignancy and inflammation in pulmonary ground-glass nodules: The feasibility of integrated 18F-FDG PET/CT. Lung Cancer 65:180-186.