RÉSUMÉ
Objective To compare the diagnostic results of 18 F-deoxyglucose positron emission tomographic-computed tomographic (18 F-FDG PET-CT)imaging ,CT and golden standards in TNM stating of non-small cell lung cancer (NSCLC), and to evaluate the diagnostic value of 18 F-FDG PET-CT imaging in TNM staging of NSCLC.Methods 18 F-FDG PET-CT was performed in the 65 patients with NSCLC who were diagnosed by pathology.Blind interpretation was used to dignose the TNM staging.The sensitivity(Se),specificity(Sp), positive predict value(PPV)and negative predict value(NPV),coincidence rate and Kappa analysis were performed to evaluate the values of PET-CT and CT in diagnosing TNM staging of NSCLC.Results Compared with golden standard,the diagnostic results of T staging among 65 NSCLC patients by CT and PET-CT were respectively as coincidence rate=72.31%,Kappa=0.46;coincidence rate=78.46%,Kappa=0.60;the diagnostic results of N staging among 58 NSCLC patients by CT and PET-CT were respectively as coincidence rate=74.14%,Kappa=0.50;coincidence rate = 87.94%,Kappa=0.78;the diagnostic results of lymph node metastasis by CT and PET-CT were respectively as Se=64.04%,Sp=77.53%,PPV=85.07%,NPV=51.88%,coincidence rate =68.54%,Kappa=0.37;Se=91.01%,Sp=83.15%,PPV=91.53%,NPV=82.22%,coincidence rate =88.39%,Kappa=0.74;the total detection rate and amount of metastasis by PET-CT were significantly higher than that by CT. Conclusion 18 F-FDG PET-CT has significant value on the diagnosis of the TNM staging of NSCLC.
RÉSUMÉ
OBJETIVO: avaliar a efetividade de métodos de diagnóstico por imagem utilizados na localização vertical de sítios eleitos para inserção de mini-implantes. METODOLOGIA: a amostra foi composta de quatro pacientes, nos quais foram estabelecidos 32 sítios inter-radiculares, na região posterior, para instalação de mini-implantes, sítios estes representados por orifícios preenchidos com guta-percha em moldeiras de acetato (PCg - ponto de contato das coroas dentárias na moldeira de acetato; PIg - ponto de inserção do mini-implante na moldeira de acetato). Foram feitas radiografias periapicais, interproximais e tomografias computadorizadas de feixe cônico, com as moldeiras posicionadas em boca, sendo considerados os seguintes pontos: PC - imagem radiodensa do ponto PCg; PI - imagem radiodensa do ponto PIg; PCx - ponto de contato entre as coroas dentárias, determinado sobre a radiografia. Medidas verticais utilizadas: padrão-ouro - de PCg a PIg; medida 1 - de PC a PI; e medida 2 - de PCx a PI. As medidas foram comparadas através de análise descritiva e do teste t de Student. RESULTADOS: para a medida 1, foi observada diferença estatisticamente significante, em relação ao padrão-ouro, em 4,1 por cento, 25 por cento e 100 por cento das medidas avaliadas nas tomografias computadorizadas, radiografias interproximais e periapicais, respectivamente. Para a medida 2, foi observada diferença estatisticamente significante, em relação ao padrão-ouro, em 4,1 por cento, 56,2 por cento e 100 por cento das medidas avaliadas nas tomografias computadorizadas, radiografias interproximais e periapicais, respectivamente CONCLUSÕES: a tomografia computadorizada de feixe cônico foi o exame mais preciso na avaliação da posição vertical dos sítios eleitos para instalação de mini-implantes; a radiografia interproximal pode, com reserva, ser utilizada; a radiografia periapical apresentou resultados insatisfatórios, sendo contra-indicada para este fim.
OBJECTIVE: Evaluate the effectiveness of image diagnosis methods used in the vertical location of sites elect to insert mini-implants. METHODS: The sample was composed of four patients, in which 32 inter-radicular sites were established in the subsequent area, for setting up mini-implants. These sites were represented by holes filled out with guta-percha in acetate moulder (PCg - contact point of dental crowns in the acetate moulder; PIg - point of insertion of the mini-implant in the acetate moulder). Periapical X-rays, interproximal and computerized tomographies of cone-beam, with the moulders positioned in mouth, were performed and the following points were taken into consideration: PC - radiodense image of the PCg point; PI - radiodense image of the PIg point; PCx - contact point among the determined dental crowns on the X-ray. Vertical measures used: gold-pattern from PCg to PIg; measure 1 - from PC to PI; and measure 2 - from PCx to PI. The measures were compared through descriptive analysis and test t of Student. RESULTS: For the measure 1, differences statistically significant were observed (4.1 percent), in relation to the gold-pattern, 25 percent and 100 percent of the appraised measures in the computerized tomographies, interproximal and periapical X-rays, respectively. For the measure 2, differences statistically significant were observed in relation to the gold-pattern (4.1 percent), 56.2 percent and 100 percent of the appraised measures in the computerized tomographies, interproximal and periapical X-rays, respectively CONCLUSIONS: The cone-beam computerized tomography was the most precise exam in the evaluation of the vertical position of the elect sites to install mini-implants; the interproximal X-ray can, with reservation, be also used; the periapical X-ray presented unsatisfactory results, being contraindicated for this purpose.