Differential diagnostic value of 18F-FDG PET/CT multi-phase imaging with pioglitazone intervention in solitary pulmonary nodules
Objective To evaluate the differential diagnostic value of 18F-FDG PET/CT multi-phase imaging after treated with pioglitazone(PIO)in the diagnosis of solitary pulmonary nodules(SPN).Methods Eighty-six SPN patients in the Department of Nuclear Medicine of Dongguan Tungwah hospital from October 2020 to January 2023 were collected.All patients were performed 18F-FDG PET/CT multi-phase(1 h,2 h,4 h)imaging,and 42 cases of imaging after PIO treatment were in the experimental group(PIO group),while 44 cases of conventional imaging were in the control group(Non-PIO group).The maximum standardized uptake values(SUVmax1,SUVmax2,SUVmax4)of each SPN was measured separately,and the retention index(RI2,RI4)of 2 h and 4 h delayed imaging was calculated.Finally,based on pathology and follow-up,whether the experimental group has improved the diagnostic efficacy in distinguishing between benign and malignant SPN was analyzed.The data was analyzed by using Mann-Whitney U test and ROC curve.Results There were statistically significant differences between SUVmax2 and SUVmax4 in each group compared to SUVmax1(P<0.001).The SUVmax1,SUVmax2,SUVmax4 and RI4 of malignant SPN in the PIO group were significantly higher than those of benign SPN(P<0.05),while there was no statistical significance between RI2(P=0.214).There was no statistically significant difference in SPN values between malignant and benign SPN within the Non-PIO group(P>0.05).There was a statistically significant difference in RI4 between the two groups of malignant lesions(P=0.034),while there was no statistically significant difference in the other values(P>0.05).There was no statistically significant difference between the above values of benign lesions between the two groups(P>0.05).Using RI>10%as the diagnostic criterion for malignant lesions,the accuracy,sensitivity,specificity,positive predictive value,and negative predictive value of diagnosing malignant SPN in the PIO group were higher than those in the Non-PIO group,and all indicators in the 4 h were higher than those in the 2 h.ROC curves showed that the area under the curve of the PIO group RI4 in diagnosing malignant SPN was 0.732,significantly higher than other groups.Conclusion After PIO treatment,the 4 h 18F-FDG PET/CT delayed imaging of SPN can improve the diagnostic efficacy of malignant pulmonary nodules to a certain extent.
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