Abstract：Objective: To investigate the differential diagnostic value of 99Tcm-MIBI SPECT/CT fusion imaging for lung lesions, and to establish a cost-effective imaging modal in the detection of malignant lung lesions. Methods: From December 2008 to May 2011, we had prospectively studied 45 consecutive patients with suspicious malignant lung lesions. Ten minutes and 2 hours after 99Tcm-MIBI injection, early and delayed SPECT/CT fusion imaging of the chest were performed respectively. The uptake ratios of malignant and benign lung lesions were compared by independent-samples T test. In addition, the diagnostic efficiency was analyzed with receiver operating characteristic(ROC) curve. Results: There are 30 patients with primary lung cancers and 15 patients with benign lung lesions. The sensitivity, specificity, accuracy, positive predictive value(PPV), and negative predictive value(NPV) of qualitative analysis were 96.7%, 73.3%, 88.9% 87.9% and 91.7% respectively. In patients with malignant lesions, the early mean T/N ratio value±standard deviation 2.80±2.21(95%CI: 1.97, 3.62), whereas in patients with benign lesions was 1.56±0.71(95%CI: 1.17, 1.95). In patients with malignant lesions, the delayed mean T/N ratio value±standard deviation was 2.93±1.86(95%CI: 2.24, 3.63), whereas in patients with benign lesions was 1.64±0.81(95%CI: 1.20, 2.09). The T/N ratio had significant difference between malignant lung lesion and benign lung lesion(t=-2.10, t=-2.56, respectively. P＜0.05). Semiquantitative analysis showed that for an early T/N value≥1.50, the value of sensitivity and specificity was 96.7% and 73.3%, respectively(ROC curve), for a delayed T/N value≥1.459, the value of sensitivity and specificity was 100% and 66.7%, respectively(ROC curve). Conclusion: Our study shows that 99Tcm-MIBI SPECT/CT fusion imaging has highly clinical value in differentiating malignant from benign lung lesions, and is a practical method for medium-to-low income patients with lung lesions in small and medium-sized cities.
2012, Vol. 23 
