Background and objective: Pleural effusions, a common feature among patients with lung cancer, should be differentiated into benign or malignant pleural effusions. F-18 fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) is one of accurate diagnostic tool for differentiating benign from malignant disease and for mediastinal lymph node staging. We explored the clinical role of PET/CT for differentiating malignant pleural effusion from benign pleural effusion among patients with lung cancer.
Methods: We retrospectively reviewed the data from all patients with lung cancer and pleural effusion who underwent F-18 FDG PET/CT. The PET/CT results were compared with the pathologic diagnosis or clinical follow-up. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of PET/CT for detecting malignant pleural metastases were calculated.
Results: A total of 33 patients were enrolled. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of PET/CT were 81.5%, 83.3%, 95.7%, 50.0%, and 81.8%, respectively, for detecting malignant pleural effusions lung cancer patients.
Conclusions: Our results suggest that F-18 FDG PET/CT can play a significant role in diagnosing lung cancer patients with pleural diffusions, with low false-positive rate. However, negative findings under PET/CT should be confirmed through further tests.
背景与目的: 胸腔积液是肺癌患者常见的临床表现，鉴别胸水的性质有重要意义。正电子发射断层扫描/计算机体层摄影（positron emission tomography/computed tomography, PET/CT）是鉴别肺部良恶性肿瘤和纵隔淋巴结分期的重要诊断方法之一。本研究旨在探讨PET/CT鉴别肺癌中胸腔积液性质的临床价值。
方法: 回顾性分析合并胸腔积液的病理确诊的肺癌病例，以病理或临床随访为最后诊断标准，计算PET/CT诊断肺癌恶性胸腔积液的敏感性、特异性、阴性预测值、阳性预测值和准确率。
结果: 33例肺癌患者符合条件纳入分析。PET/CT诊断肺癌恶性胸腔积液的敏感性、特异性、阳性预测值、阴性预测值和准确率分别为81.5%、83.3%、95.7%、50.0%和81.8%。
结论: PET/CT对鉴别肺癌中胸腔积液的性质具有重要作用，假阳性率低，对PET/CT阴性的胸腔积液，需有创检查确认。