Study On ^99mTc-3PRGD₂ SPECT Imaging Of Lung Space Occupying Leisions Compared With Thin Slice Thickness CT

Objective: to study the space-occupying lesions in the lungs of 99mtechnetium-nicot inamide-3-al hydrazine polyethylene glycol-arginine-glycine-aspartic acid cyclic peptide dimer（99mTc-3PRGD2）Single Photon Emission Computed Tomography（CT）imaging（Sin gle-Photon Emission Computed Tomography,SPECT）Tomography SPECT/CT)comb ined with chest functional metabolism and morphological characteristics of thin scan C T.And comparison with the pathological results,evaluation of 99mTc-3PRGD2 SPECT/C T imaging in combination with thin scan CT chest space-occupying lesions of benign and malignant diagnosis value within the lung.To explore T/N value in the differential diagnosis of benign and malignant lung lesions diagnostic performance and its influen cing factors,access to differentiate benign and malignant space-occupying lesions in th e lungs best T/N value.Methods:Choice in July 2015 to December 2016 were admitted in our hospital ge neral thoracic surgery to surgical lung,74 cases of patients with space-occupying lesio ns.Line the chest after conventional thin scan CT imaging of 99mTc-3PRGD2 SPECT/C T planar imaging and CT imaging.^99mTc-3PRGD₂ SPECT/CT planar imaging,CT imagi ng,and thin scan CT chest results with the pathological results were analyzed.Patient s with pathologic results as the gold standard,divided into lung cancer group and ben ign lesions in the two groups.Semi-quantitative analysis of planar imaging is positive with T1/N1≥1.5,tomography is positive with T2/N2≥2.0.Application SPSS17.0 soft ware for statistical analysis:（1）analysis of ^99mTc-3PRGD₂ SPECT/CT,CT imaging,plan ar imaging chest thin scan CT and SPECT/CT tomography + thin scan CT imaging in the diagnosis of chest lung placeholder the diagnosis of benign and malignant lesions efficiency;（2）according to the two groups of patients with the T/N ratio of the participants work curve,planar imaging and ct imaging of the best T/N ratio.（3）analysis of different pathological type,tumor diameter and the correlation between the placehol der lesions T/N value.Results: 1.The general situation of 74 patients with space-occupying lesions in p atients with lung,age 37⁸0 years old,average age（58.41±9.63）,including women 25 cases（33.8%）cases,male 49 cases（66.2%）.Histological will according to the resul t of surgical pathology,other 74 patients were divided into group of 51 cases of pulm onary malignant lesions,benign group of 23 cases.Average age of 51 patients with pul monary malignant lesion group（58.7±9.9）years old,male,33 cases（64.7%）,18 case s（35.3%）of women,men and women ratio of 1.83:1.Squamous carcinoma 21 cases,25 cases of adenocarcinoma and small cell lung cancer in 2 cases,1 gland scale can cer,carcinoid tumor 1 case,non-hodgkin’s lymphoma of nodular sclerosis type 1 case.23 cases of benign lesion group,average age（57.9±9.1）,the male 16 cases（69.9%）,the women 7 cases（30.4%）,the sex ratio of 2.3:1.3 cases of inflammatory pseudotu mor,inflammatory changes in 8 cases,6 cases of TB,necrotic nodules in 2 cases,br onchial cyst 1 case,2 cases of bronchiectasis,hamartoma（3 cases）.Tumor according t o the largest diameter can be divided into 3 groups,51 cases of lung malignancy,incl uding D1 group<2cm 12 cases,2cm≤D2<3cm 12 cases,D3 group ≥3cm 27 case s.Benign placeholder 23 cases,including D1 group<2cm 8 cases,2cm≤D2<3cm 4 cases,D3 group≥3cm 11 cases;2.The semi-quantitative analysis: ^99mTc-3PRGD₂ SPECT/CT planar imaging of malignant lesions and benign lesion group T1/N1 were 1.48±0.39 and 1.31±0.3,the independent sample t-test analysis,t=1.89,P=0.64 value is great er than 0.05,the benign and malignant lesions group there was no statistically signific ant difference T1/N1 value.Diagnosis of pulmonary placeholder benign and malignant l esions sensitivity,specificity,accuracy,positive predictive value,negative predictive val ue were 47.1%,65.2%,52.7%,75%,35.7;^99mTc-3PRGD₂ SPECT/CT tomography mali gnant lesions benign lesions and good group T1/N1 were 3.7±2.5 and 3.7±1.7,the i ndependent sample t-test analysis,t=2.507,P=0.014 value is less than 0.05,both differ ence is statistically significant;the difference was statistically significant;The diagnosis of pulmonary placeholder benign and malignant lesions sensitivity,specificity,accuracy,positive predictive value,negative predictive value were 86.3%,47.8%,74.3%,78.6%,61.1%.3.The thin scan CT in the diagnosis of pulmonary malignant lesion group of true positive 42 cases,9 cases of false negative.12 cases benign lesion group true neg ative and false positive in 11 cases,the diagnosis of benign and malignant lung lesion s,specific degree of sensitivity,the accuracy is 82.4%,52.2%,77.0%;Positive predictiv e value and negative predictive value was 79.2%,79.2% respectively.4.^99mTc-3PRGD₂ SPECT/CT planar imaging,CT imaging in combination with thin scan CT in the diag nosis of space-occupying lesions in the lungs of 50 cases of true positive and false n egative in 1 case.Benign lesions group of true negative 17 cases,6 cases of false posi tive,the sensitivity of the diagnosis of benign and malignant lung lesions,specific deg rees,the accuracy is 98.0%,73.9%,90.5%;Positive predictive value and negative predi ctive value,respectively,89.3%,94.4%.5.According to the ^99mTc-3PRGD₂ SPECT/CT planar imaging subjects work curve,lung space-occupying lesions in planar imaging of benign and malignant T1/N1≥1.265.Area under the ROC curve under the threshold o f 0.635,the area under the curve compared with AZ=0.5,there was no statistical diffe rence（P=0.065>0.05）.According to the ^99mTc-3PRGD₂ SPECT/CT tomography subjects work curve,tomography lung benign and malignancy of T2/N2 of space-occupying les ions in the best diagnostic value of 2.03 or higher.Area under the ROC curve under t he threshold of 0.711,the area under the curve compared with AZ=0.5,statistically si gnificant difference（P=0.04<0.05）;6.The malignant lung placeholder lesions group acc ording to the biggest diameter is divided into three groups.Including D1 group≤2cm,12 cases T2/N2 was 3.0±2.0,D2 group 2cm<D<3cm,12 cases T2/N2 was 4.98±2.69,D3 group≥3cm,27 cases T2/N2 was 3.7±1.24.Using single factor analysis of vari ance of different diameter of three group patients of malignant change compare T2/N2 value,F=8.521,P=0.01<0.05,think different tumor T2/N2 values are not all the same size.The two comparative analysis found that D1 and D2 group T2/N2 ratio difference has no statistical significance（P=0.101）.D1,D2 and D3 group,group and D3 group T2 / N2 ratio difference statistically significant（P value were 0.04 and 0.04）;7.Malignant lung space-occupying lesions in primary focal T2/N2 value correlation with the si ze of lesions and pathological type（P values were 0.011,0.011）.and other types of cancer and benign nodules,inflammatory changes and other types of benign lesion s compared T/N value（P=0.850,P=0.850,P=0.117）.3.Malignant lung space-occupying lesions in primary focal T/N value correlation with the size of lesions and pathologic al type（P values were 0.011,0.011）.Conclusion: 1、in lung benign and malignancy in the differential diagnosis of space-occupying lesions of ^99mTc-3PRGD₂ SPECT/CT tomography sensitivity,accuracy higher than that of planar imaging,but the specificity is lower than the planar imaging.2、^99mTc-3PRGD₂ SPECT/CT + planar imaging tomography + thin scan CT chest significantly increased pulmonary placeholder joint imaging diagnosis of benign and m alignant lesions in efficiency.3、to judge the lungs space-occupying lesions SPECT/CT tomography imaging of benign and malignant T/N ratio of the best diagnostic value of 2.03,can achieve bette r sensitivity and specific degrees(sensitivity 86.2%,specific degree is 56.5%,the area under the curve（0.711）.4、^99mTc-3PRGD₂ SPECT/CT tomography malignant lesion of the T/N increases w ith focal diameter increases,the correlation coefficient is 0.354（P = 0.011）.5、malignant lung space-occupying lesions in primary focal T2/N2 value correlatio n with tumor size,pathologic type.6、 placeholder size,pathological types affect the primary placeholder T2/N2 valu es of independent factors.