LIN Jie,ZHENG Xiangwu,WANG Ling, et al. The value of 18F-FDG PET metabolic spatial heterogeneity quantitative analysis for the diagnosis of nonsmall cell lung cancer[J]. JOURNAL OF WEZHOU MEDICAL UNIVERSITY, 2021, 51(2): 123-127.
Abstract：Objective: To quantitatively analyze the metastatic spatial heterogeneity (MSH) of benign and malignant lung nodules, and evaluate the diagnostic value of MSH for non-small cell lung cancer (NSCLC).Methods: From January 2012 to August 2016, 367 patients with pulmonary nodules from the First Affiliated Hospital of Wenzhou Medical University who underwent 18F-FDG PET/CT imaging were studied retrospectively.The ROIs of different metabolic thresholds of maximum standardized uptake value (SUVmax) were plotted. The ipsilateral hilar angle was taken as the reference point and the maximum distance from the ROI boundary of each metabolic threshold to the ipsilateral hilar angle was measured and calculated. Linear regression analysis was performed on the distance values of different metabolic thresholds, and the corresponding linear slope k value was calculated. The absolute value of k represented the spatial heterogeneity of the lesion. The larger the k value,the higher the spatial heterogeneity. The diagnostic value of SUVmax, retention index (RI), PET/CT and MSH in NSCLC were calculated and compared. Results: Of the 367 pulmonary lesions, 252 were malignant and 115 were benign ones. The mean slope k values of the two groups were 1.40±0.68 and 2.28±1.53, respectively. The difference between the two groups was statistically significant (P<0.001). The diagnostic sensitivity, specificity,accuracy, PPV and NPV of MSH for NSCLC were 72.62%, 64.35%, 70.03%, 81.70% and 51.75%, respectively.The AUC under the ROC curves of MSH was 0.723, which was significantly higher than that of SUVmax (0.474), RI (0.597) and PET/CT (0.623) (all P<0.05). Conclusion: There was significant difference of 18F-FDG metabolic heterogeneity between pulmonary benign and malignant nodules. Compared with conventional PET/CT methods, MSH may improve the value in diagnosis of NSCLC.
