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Phát hiện các khối u đại trực tràng liên quan bằng PET/CT: độ chính xác hứa hẹn với liều CT tối thiểu và mức cắt chuẩn hóa của PET
Tóm tắt
Mục tiêu của nghiên cứu là xác định hiệu suất của FDG-PET/CT trong việc phát hiện các khối u đại trực tràng liên quan (adenoma ≥10 mm, có loạn sản mức độ cao, ung thư) liên quan đến liều CT và việc sử dụng thuốc cản quang, đồng thời tìm ra mức cắt PET. Trong nghiên cứu hồi cứu này, 84 bệnh nhân đã được thực hiện PET/CT và nội soi đại tràng (n = 79)/nội soi trực tràng (n = 5) cho các đoạn ruột kết đã được đưa vào nghiên cứu. Độ chính xác của PET/CT liều thấp trong việc phát hiện các đoạn dương tính với khối u được đánh giá bằng phân tích ROC bởi hai người đánh giá độc lập và mù. Căn cứ vào từng tổn thương, các giá trị PET đặc trưng được kiểm tra như là mức cắt. PET/CT liều thấp và PET/CT có thuốc cản quang cung cấp độ chính xác tương tự (diện tích dưới đường cong cho các đánh giá ROC trung bình 0.925 so với 0.929, tương ứng). PET đã phát hiện tất cả các carcinoma (n = 23) và 83% (30/36) adenoma liên quan. Trong tất cả các carcinoma và adenoma có loạn sản mức độ cao (n = 10), SUVmax là ≥5. Mức cắt này cho kết quả độ nhạy và giá trị dự đoán âm (NPV) cho từng đoạn tốt hơn so với các đánh giá PET/CT trung bình (độ nhạy: 89% so với 82%; NPV: 99% so với 98%). Tất cả các mức cắt khác được kiểm tra đều kém hơn so với SUVmax. FDG-PET/CT cung cấp độ chính xác hứa hẹn cho việc phát hiện khối u đại trực tràng. Liều thấp và việc thiếu thuốc cản quang i-ốt trong thành phần CT không ảnh hưởng đến độ chính xác. Mức cắt PET SUVmax ≥ 5 cải thiện độ chính xác.
Từ khóa
#FDG-PET/CT #khối u đại trực tràng #độ chính xác #thuốc cản quang #loạn sản mức độ caoTài liệu tham khảo
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