摘要
目的 研究在原发性肝癌患者 18F-FDG PET-CT检查中不同血糖水平对正常器官摄取FDG的影响,以找到相较于肝脏更为稳定的组织作为背景标准摄取值.方法 本研究为回顾性研究.搜集2022年1-6月经病理确诊为原发性肝癌,并接受 18F-FDG PET-CT检查的175例患者的临床及影像资料.根据注射 18F-FDG前空腹血糖水平分成4组,4.0～6.3 mmol/L为血糖正常组(63例)、6.4～8.9 mmol/L为血糖稍高组(53例)、9.0～11.1 mmol/L为血糖较高组(48例)、＞11.1 mmol/L为血糖极高组(11例).比较4组患者的大脑皮质、肺脏、肝脏、脾脏、胰腺、脂肪组织及纵隔血池的最大标准摄取值(SUVmax),分析不同血糖水平对正常器官摄取 18F-FDG的影响.组间符合正态分布的计量资料比较采用方差分析、以(x)±s表示、两两比较采用t检验.结果 血糖稍高组、较高组和极高组的大脑皮质SUVmax值均明显低于血糖正常组,肝脏SUVmax值均明显高于血糖正常组,差异均有统计学意义(P均＜0.05).血糖稍高组的肺脏SUVmax值与血糖正常组比较,差异无统计学意义(P＞0.05),血糖较高组与血糖极高组的肺脏SUVmax值均明显高于血糖正常组,差异均有统计学意义(P均＜0.05).血糖正常组、稍高组和较高组的胰腺SUVmax值比较,差异均无统计学意义(P均＞0.05),血糖极高组明显高于血糖正常组,差异有统计学意义(P＜0.05).4组脾脏、脂肪组织及纵隔血池的SUVmax值差异无统计学意义(P均＞0.05),表明与血糖水平无显著相关性.其中,纵隔血池SUVmax值最为稳定.结论 原发性肝癌患者的血糖水平,对大脑皮质、肝脏摄取 18F-FDG影响较大,对肺脏、胰腺的影响较小;对纵隔血池的影响最小,可作为肝脏的替代组织用于背景SUVmax的测量.
Abstract
Objective To investigate the impact of different blood glucose levels on FDG uptake in normal organs during 18F-FDG PET-CT examination in patients with primary hepatic carcinoma,aiming to find tissues more stable than the liver as background standardized uptake value references.Methods This was a retrospective study.Clinical and imaging data of 175 patients diagnosed with primary hepatic carcinoma and undergoing 18F-FDG PET-CT examination from January 2022 to June 2023 were collected.Patients were divided into four groups based on fasting blood glucose levels before 18F-FDG injection:normal glucose group(63 cases,4.0-6.3 mmol/L),slightly elevated glucose group(53 cases,6.4-8.9 mmol/L),moderately elevated glucose group(48 cases,9.0-11.1 mmol/L),and extremely high glucose group(11 cases,＞11.1 mmol/L).Maximum standardized uptake values(SUVmax)of the cerebral cortex,lungs,liver,spleen,pancreas,adipose tissue,and mediastinal blood pool were compared among the four groups to analyze the impact of different blood glucose levels on 18F-FDG uptake in normal organs.Normally distributed continuous variables were compared using analysis of variance,expressed as (x)±s,and pairwise comparisons were made using t-tests.Results SUVmax values of the cerebral cortex in the slightly elevated glucose group,moderately elevated glucose group,and extremely high glucose group were significantly lower than those in the normal glucose group,while SUVmax values of the liver were significantly higher than those in the normal glucose group,with all differences being statistically significant(all P＜0.05).There was no statistically significant difference in SUVmax values of the lungs between the slightly elevated glucose group and the normal glucose group(P＞0.05),but SUVmax values of the lungs in the moderately elevated glucose group and extremely high glucose group were significantly higher than those in the normal glucose group(all P＜0.05).There was no statistically significant difference in SUVmax values of the pancreas among the normal glucose group,slightly elevated glucose group,and moderately elevated glucose group(all P＞0.05),but SUVmax values in the extremely high glucose group were significantly higher than those in the normal glucose group(P＜0.05).There were no statistically significant differences in SUVmax values of the spleen,adipose tissue,and mediastinal blood pool among the four groups(all P＞0.05),indicating no significant correlation with blood glucose.Among them,the SUVmax value of the mediastinal blood pool was the most stable.Conclusion Blood glucose levels of patients with primary hepatic carcinoma have a significant impact on 18F-FDG uptake in the cerebral cortex and liver,less impact on the lungs and pancreas,and minimal impact on the mediastinal blood pool.The mediastinal blood pool can be used as an alternative tissue to the liver for measuring background SUVmax.
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