评价99m锝-三聚乙二醇间隔基-精氨酸-甘氨酸-天冬氨酸（99mTc-3PRGD2）单光子发射计算机断层扫描（SPECT）/计算机断层扫描（CT）成像对原发性肺恶性肿瘤淋巴结转移的诊断价值。我们前瞻性入组26 名原发性恶性肺部肿瘤患者接受了 99mTc-3PRGD2 SPECT/CT 和 18F-氟脱氧葡萄糖 (18F-FDG) 正电子发射断层扫描 (PET)/CT 成像。两种成像方法均以定性（分别对淋巴结和肺肿瘤进行视觉二分和5点分级）和半定量（最大组织背景放射性计数）方式对淋巴结和肺肿瘤进行分析。以组织病理学结果为参考标准，在每个淋巴结站和每个患者水平确定有转移和无转移淋巴结的分化表现。共有42个站有转移淋巴结，136个站有良性淋巴结。 99mTc-3PRGD2 SPECT/CT和~(18)F-FDG PET/CT视觉定性和半定量分析中转移性淋巴结与良性淋巴结的差异均有统计学意义(均P<0.001)。 99mTc-3PRGD2 SPECT/CT半定量分析中受试者工作特征曲线下面积（AUC）为0.908（95%置信区间[CI]，0.851-0.966），敏感性、特异性、阳性预测值，阴性预测值分别为0.86（36/42）、0.88（120/136）、0.69（36/52）和0.95（120/126）。 26例患者（其中2例患者各有两个肺部肿瘤）中，15例经病理证实有淋巴结转移。仅在99mTc-3PRGD2 SPECT/CT半定量分析中，有和无淋巴结转移患者肺部原发灶差异有统计学意义（P = 0.007），AUC为0.807（95% CI，0.641-0.974） ).99mTc-3PRGD2 SPECT/CT 成像尤其可以直接诊断原发性恶性肺肿瘤的淋巴结转移，并通过原发灶的摄取间接预测淋巴结转移的存在。版权所有 © 2023 韩国放射学会。

To evaluate 99mtechnetium-three polyethylene glycol spacers-arginine-glycine-aspartic acid (99mTc-3PRGD2) single-photon emission computed tomography (SPECT)/computed tomography (CT) imaging for diagnosing lymph node metastasis of primary malignant lung neoplasms.We prospectively enrolled 26 patients with primary malignant lung tumors who underwent 99mTc-3PRGD2 SPECT/CT and 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/CT imaging. Both imaging methods were analyzed in qualitative (visual dichotomous and 5-point grades for lymph nodes and lung tumors, respectively) and semi-quantitative (maximum tissue-to-background radioactive count) manners for the lymph nodes and lung tumors. The performance of the differentiation of lymph nodes with and without metastasis was determined at the per-lymph node station and per-patient levels using histopathological results as the reference standard.Total 42 stations had metastatic lymph nodes and 136 stations had benign lymph nodes. The differences between metastatic and benign lymph nodes in the visual qualitative and semiquantitative analyses of 99mTc-3PRGD2 SPECT/CT and 18F-FDG PET/CT were statistically significant (all P < 0.001). The area under the receiver operating characteristic curve (AUC) in the semi-quantitative analysis of 99mTc-3PRGD2 SPECT/CT was 0.908 (95% confidence interval [CI], 0.851-0.966), and the sensitivity, specificity, positive predictive value, and negative predictive value were 0.86 (36/42), 0.88 (120/136), 0.69 (36/52), and 0.95 (120/126), respectively. Among the 26 patients (including two patients each with two lung tumors), 15 had pathologically confirmed lymph node metastasis. The difference between primary lung lesions in patients with and without lymph node metastasis was statistically significant only in the semi-quantitative analysis of 99mTc-3PRGD2 SPECT/CT (P = 0.007), with an AUC of 0.807 (95% CI, 0.641-0.974).99mTc-3PRGD2 SPECT/CT imaging may notably perform in the direct diagnosis of lymph node metastasis of primary malignant lung tumors and indirectly predict the presence of lymph node metastasis through uptake in the primary lesions.Copyright © 2023 The Korean Society of Radiology.