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99mTc-ナノコロイドセンチネルリンパ節イメージングにおける平面、SPECT、SPECT/computed tomographyシステムの比較：ファントムデザインと臨床的検討
Comparison between planar, SPECT and SPECT/computed tomography systems in 99mTc- nanocolloid sentinel lymph node imaging: phantom design and clinical investigations.
PMID: 31290848 DOI: 10.1097/MNM.0000000000001041.
抄録
目的:
乳がんのリンパ節検出における平面、SPECT、SPECT/CTの性能を検討することを目的とした。
PURPOSE: It was aimed to examine the performance of planar, SPECT and SPECT/CT in lymph nodes detection of breast cancer.
材料と方法:
社内で作られたファントムは、水で満たされた容器に浸漬された。バラバラの活動は、乳房腫瘍（1.5 cm）、および隣接するリンパ節（1、0.5および0.25 cm）をエミュレートする球体に注入された。平面、SPECTおよびSPECT/CTスキャンは、1、3、5、7および9 cmの深さで行われた。平面画像での検出性を調べるためにRose Criteriaを採用し，SPECTとSPECT/CT画像ではCNR（Contrast to Noise Ratio）を用いた．今回の研究では20名の患者のSPECTとSPECT/CTを無作為に組み入れた。
MATERIALS AND METHODS: In-house made phantom was immersed in water-filled container. Disparate activities were injected into spheres emulating breast tumour (1.5 cm), and adjacent lymph nodes (1, 0.5 and 0.25 cm). Planar, SPECT and SPECT/CT scans were made at depths of 1, 3, 5, 7 and 9 cm. Rose Criteria was employed to investigate the detectability in planar imaging, and contrast to noise ratios (CNRs) were used in SPECT and SPECT/CT images. SPECT and SPECT/CT of 20 patients were randomly incorporated in the current study.
結果:
模擬結節1,0.5,0.25cmの深さ1cmの平面画像からのCNR値はそれぞれ36,18,17であった．一方，SPECT/CTのCNRは94.5，63.3，20.9であった．SPECTからのCNRはSPECT/CTよりも60.1，41.8，17.1の順に低かった．9cmでは，平面画像からのCNRは1，0.5，0.25cmでそれぞれ14，6，5であった．一方，SPECTからのCNR値はそれぞれ53.6，38.0，14.9と高く，SPECT/CTからのCNR値が最も大きかったのは85.7，55.8，19.1であった．
RESULTS: CNR values from planar images at 1 cm depth for the simulated nodes of 1, 0.5and 0.25 cm were 36, 18 and 17, respectively. Whereas, those from SPECT/CT were 94.5, 63.3 and 20.9, repectively. CNRs from SPECT were lower than SPECT/CT in order of 60.1, 41.8 and 17.1 at the same depth. At 9 cm, CNR values of 1, 0.5 and 0.25 cm from the planar images were 14, 6 and 5, respectively. While CNR values from SPECT were higher as 53.6, 38.0, and 14.9, respectively, and the greatest CNRs were in SPECT/CT as 85.7, 55.8, and 19.1, repectively.
結論:
SPECT/CTのCNR値はSPECTと平面画像に比べて1.5倍、3.5倍と深さ1～9cmで高かった。患者の研究ではSPECT/CTのCNRはSPECTよりも1.6倍も高い値を示した。
CONCLUSION: The CNR values in SPECT/CT were 1.5- and 3.5-folds higher than SPECT and planar imaging at depth range 1-9 cm. The patients study exhibited larger SPECT/CT CNRs over SPECT as great as 1.6-fold.