Objective To explore the value of dual phase 18F-FDG PET in differential diagnosis of benign and malignant pulmonary lesions. Methods Dual phase 18F-FDG PET was performed in patients with pulmonary focal lesions at 1 h and 2 h after 18F-FDG injection. Forty patients with pathological or clinical following confirmed lesions were enrolled in the study. Maximal SUV (SUVmax) of early and delay phase of all lesions were measured, and the change rates of SUVmax, (ASUVmax) between early and delayed phases were calculated. Differences of SUV,,,,, at early and delayed phase and ASUVmax, between benign and malignant lesions were analyzed. Results Of the 40 patients, 10 patients had benign lesions and 30 patients had malignant lesions. SUVmax, of malignant lesions at early and delayed phase was 6. 78±3. 98 and 8. 19± 4. 46, respectively, both higher than SUVmax,, of benign lesions at early and delayed phase (2. 46±1. 62 and 3. 04±2. 20). The differences were statistically significant (P=0. 006, 0. 004). ASUVmax, between early and delayed phases of benign and malignant lesion was 0. 19±0. 22 and 0. 26±0. 28, which showed no statistical significance (P=0. 888). Using the cutoff SUVmax of 2. 5, the sensitivity, specificity and accuracy rate of early phase in distinguishing malignant pulmonary lesions from benign lesions was 76. 67%, 60. 00% and 72. 50% , of delayed phase was 83. 33%, 60. 00% and 77. 50% , respectively. There was no statistical significance between early phase and delayed phase between benign and malignant pulmonary lesions (P=0. 125). Conclusion Dual-phase 18F-FDG PET can not improve the accuracy of PET/CT in differential diagnosis of benign and malignant pulmonary lesions.%目的 探讨双时相PET对肺内良恶性病变的鉴别诊断价值.方法 对肺内占位性病变患者在注射18F-FDG后1h和2h行双时相PET/CT显像,其中40例病变性质经病理和临床随访证实者入选本研究.测量病变早期和延迟显像最大标准摄取值(SUVmax),计算早期及延迟显像SUVmx变化率(△SUVmax).比较早期和延迟显像SUVmax和△SUVmax对良恶性病变诊断价值.结果 40例患者中,良性病变10例,恶性病变30例.恶性病变的早期和延迟期SUVmax分别为6.78±3.98和8.19±4.46,高于良性病变的2.46±1.62和3.04±2.20,差异有统计学意义(P=0.006、0.004).良恶性病变早期及延迟相的△SUVmax分别为0.19±0.22和0.26±0.28,差异无统计学意义(P=0.888).以SUVmax≥2.5为恶性病变诊断标准,早期显像的灵敏度、特异度和准确率分别为76.67％、60.00％和72.50％,延迟期显像分别为83.33％、60.00％和77.50％.早期和延迟期显像对肺内恶性病变诊断的差异无统计学意义(P=0.125).结论 延迟显像不能提高PET/CT对良恶性病变的鉴别诊断价值.
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