Clinical Application Of Cross-modality Fusion Images Of¹⁸F-FDG SPECT/CT And 64 Row CT

The accuracy of PET/CT is higher than that of routine imaging examination for diagnosis of malignant tumors and TNM staging[1].However,most of the primary hospitals are not equipped with PET/CT.The co-modality fusion 18F-FDG SPECT/CT has dual-head and CT imaging system,accompanied with SPECT function and some PET function.But the thickness of its image layer is thick,the space and time resolution are low,the image motion artifacts are large[2].This study mainly discusses the value of cross-modality fusion 18F-FDG SPECT/CT in diagnosis of solitary pulmonary nodule(SPN);comparing of image quality scores of colorectal cancer(CRC)between Group T,Group N and Group M of CRC;studying on the value of cross-fusion 18F-FDG SPECT/CT in predicting recurrence of patients.The results are as follows:First PartObjective:To analyze the value of cross-modality fusion 18F-FDG SPECT/CT in diagnosis of benign and malignant SPN.Methods:The cross-modality fusion and co--modality-fusion 18F-FDG SPECT/CT images of 80 SPN patients who were admitted to Sanmenxia Central Hospital during the period from February 2014 to June 2018 were collected.Taking pathological diagnosis results as golden standard,diagnostic efficiency of co--modality fusion and cross-modality fusion 18F-FDG SPECT/CT in diagnosis of benign and malignant SPN was analyzed.The relationship between clinical information,image features and benign and malignant nodules of patients was studied.Results:There were significant differences in age,proportion of smoking history,nodule diameter and T/N value between malignant nodule group and benign nodule group(P<0.05),while there was no significant difference in gender,tumor history,lesions located at superior lobe and the CT value of nodule in plain scan between the two groups(P>0.05).The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of cross-modality fusion 18F-FDG SPECT/CT for diagnosis of malignant SPN were 95.37%,88.89%,98.55%,72.73%and 95.00%,respectively,which were higher than those of co--modality fusion 18F-FDG SPECT/CT(85.92%,66.67%,95.31%,37.50%,83.75%)(P<0.05).The detection rates of cross-modality fusion 18F-FDG SPECT/CT were higher than those of of co--modality fusion 18F-FDG SPECT/CT for lobulation,spiculation,vocule sign,spiculate protuberance,pleural indentation sign,bronchial aeration sign and bronchial vascular convergence sign(P<0.05).Conclusions:1.Age,lesion size,proportion of smoking history and T/N value are related with malignant nodules,while gender,tumor history,lesions located at superior lobe and the CT value of nodule in plain scan are not related malignant nodules.2.The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of cross-modality fusion 18F-FDG SPECT/CT are higher than those of co--modality fusion 18F-FDG SPECT/CT for diagnosis of SPN.In the primary hospitals without PET/CT,diagnostic accuracy of SPN can be improved.Second PartObjective:To score the images of CRC patients' lesions in T group,N group and M group,which was processed by co-modality fusion and cross-modality fusion 18F-FDG SPECT/CT.To analyze the risk factors of recurrence in patients with CRC.Methods:The case data of 47 CRC patients who were diagnosed and treated in Sanmenxia Central Hospital during the period from February 2014 to June 2018 were collected.The image quality scores of cross-modality fusion and co-modality fusion in T group,N group and M group were analyzed.Taking presence or absence of recurrence as prognostic evaluation criteria,clinical data of patients with recurrence and without recurrence were compared.The single factors and independent risk factors influencing prognosis were analyzed.Results:Among the 47 patients,there were 47 primary lesions.There were 42 cases confirmed by surgery,5 cases confirmed by colonoscopy biopsy.There were 21 lymph nodes.The distant metastases lesions included 6 lung metastases lesions and 7 liver metastases lesions,confirmed by ultrasound or CT guided biopsy.The image quality scores in T,N and M group of cross-modality fusion images were higher than those of co-modality fusion images(P<0.05).Univariate analysis results showed that there was no significant difference in age,gender,tumor location,mucinous carcinoma,number of lymph node specimens,histological differentiation degree or tumor markers(CEA,CA125,CA199)between recurrence and non-recurrence patients(P>0.05).The tumor size,tumor liver ratio(TLR),lymphovascular/neural invasion rate in recurrence patients were higher than those in non-recurrence patients(P<0.05).Multivariate Logistic regression analysis showed that tumor size,TLR,lymphovascular/neural invasion were independent risk factors for recurrence of CRC patients(P<0.05).Conclusions:1.The image quality of cross-modality fusion 18F-FDG SPECT/CT is superior to that of co-modality fusion 18F-FDG SPECT/CT in CRC patients' lesions in T group,N group and M group.2.In metabolic parameters of 18F-FDG SPECT/CT,TLR is of high predictive value for recurrence of CRC patients.