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Study of SUVm Cut-off Value for the Distinction of Pancreatic Cancer In PET/CT Exam

PET/CT 검사에서 췌장암 판별을 위한 SUVm 경계값 연구

  • Chang, Boseok ;
  • Kim, Jae Ho ;
  • Liu, Guoxu ;
  • Jang, Eun Sung
  • 장보석 (부산대학교 영상정보공학과) ;
  • 김재호 (부산대학교 전자공학과) ;
  • 류궈쉬 (부산대학교 전자공학과) ;
  • 장은성 (고신대학병원 종양학과)
  • Received : 2017.06.01
  • Accepted : 2017.07.05
  • Published : 2017.10.28

Abstract

In this study, when diagnosis pancreatic cancer by dual time point PET/CT, we propose SUVm 2.52 as the threshold value for performing the dual time point PET/CT exam. The hypothesis of normal distribution was adopted through data conversion of 60 pancreatic diseases. The proposed SUVm2.52 boundary value showed a significance level that could be applied to both 120 and 180 minutes of delay time scan for pancreatic cancer determination (p<0.05). C-value variation shows that delay time 2 hour test is more useful than delay time 3 hour test. When the SUVm 2.52 is set to the boundary value and the double-time point PET/CT exam is performed, the probability of distinguishing cancer from inflammation in the delayed image is 95%. When the delayed test is performed with the proposed boundary value SUVm 2.52, Compared with general PET / CT scans, it is thought that it may be helpful to distinguish pancreatic cancer.

본 연구는 PET/CT 장비로 $^{18}F--FDG$ 방사성 의약품 주입 후 60분에서 검출된 췌장질환자 60명의 SUVm 데이터 분포를 정규분포 화 시키는 가설을 설정하여 PET/CT 이중시간 검사에서 지연 검사 시행을 결정할 수 있는 기준으로 제시하였다. 비정규분포를 나타내는 SUVm 데이터를 BOX-COX 변환과 Johnson 변환을 통해 정규분포 화 하였다. 정규 분포 95% 신뢰구간 하단에서 지연검사를 결정할 수 있는 경계값 SUVm 2.52를 제시하였다. 통계적 검증을 통해 제안된 경계값은 췌장암 구별을 위한 지연시간 검사에서 (120분, 180분)두 실험군 모두 적용할 수 있는 유의한 상관관계를 보였으며, 통계적으로 유의하다(p<0.05). C-Value는 췌장암 군과 췌장염 군을 감별에서는 췌장암 판별에 통계적으로 유의하다 (p<0.01). C-Value graph를 이용해서 지연시간 120분 검사가 지연시간 180분 검사보다 유용성이 있음을 확인하였다. 경계값 SUVm 2.52를 기준으로 이중시간 검사를 결정했을 때, 현재 대다수의 핵의학과 개설병원에서 시행하고 있는 단일 시간 PET/CT 검사보다, 췌장암 조기 발견과 감별에 도움을 줄 수 있을 것으로 사료된다.

Keywords

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