3D量化单光子发射计算机断层扫描/计算机断层扫描:与肺 perfusion 扫描相比,对预期的管理的影响,对肺切除的边缘候选人
Makhmudbek Mallaev1, Alin-Florin Chirindel2, Didier Lardinois1
1Clinic of Thoracic Surgery, University Hospital Basel, Basel, Switzerland.
Clinical lung cancer
|August 6, 2023
概括
三维定量SPECT/CT改善了肺切除候选人的肺 perfusion 评估. 这种先进的成像改变了3.3%的患者的可操作性,特别是那些上叶病变患者,突出了其改善风险分层的潜力.
科学领域:
- 核医学是一种核医学.
- 肺部医学 肺部医学
- 放射学 放射学是一门学科.
背景情况:
- 单光子发射计算机断层扫描/计算机断层扫描 (SPECT/CT) 提供了优越的准确性和可重复性比平面光束扫描用于叶膜 perfusion 评估.
- 3D定量SPECT/CT对经过肺切除的边界肺功能患者的管理决策的临床影响尚不清楚.
研究的目的:
- 评估3D定量SPECT/CT对功能边缘肺切除候选人的管理的影响.
- 为了比较3D定量SPECT/CT与传统平面光学扫描在估计叶膜 perfusion 的准确性.
主要方法:
- 在120名肺切除候选人身上进行了术前肺 perfusion 成像,使用平面光学和3D量化 SPECT/CT (CT Pulmo3D 和 xSPECT-Quant).
- 计算了腹腔 perfusion 的贡献,并分析了它们对预测术后 (ppo) 肺功能,手术程度和可操作性的影响的差异.
- 评估了住院治疗的结果.
主要成果:
- 与平面方法相比,3D定量SPECT/CT低估了上叶输液的中位数为5%,高估了下叶输液的4-6% (P < .0001).
- 根据3D定量SPECT/CT,4名患有上叶病变的患者 (3.3%) 被认为是无法手术的,这与平面光束扫描评估的变化不同.
- 这4名患者的术后死亡率不成比例.
结论:
- 3D定量SPECT/CT可以改变治疗策略,在某些患上上叶病变的患者中,可操作性从符合条件变为不可操作性.
- 该技术在功能边缘肺切除候选人的术前风险分层增强方面显示出前景.
- 建议对3D定量SPECT/CT进行进一步评估,以优化患者选择和改善结果.
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