^(18)F-FDG PET显像在胃恶性肿瘤治疗后随访中的应用  

Evaluation of ^(18)F-FDG PET imaging in post-therapeutic patients with gastric malignancy

作　　者：崔瑞雪[1] 周前[1] 

机构地区：[1]中国医学科学院,中国协和医科大学北京协和医院PET中心,100730

出　　处：《中华核医学杂志》2005年第5期282-284,共3页Chinese Journal of Nuclear Medicine

摘　　要：目的评价18F-脱氧葡萄糖(FDG)PET显像在胃恶性肿瘤治疗后随访中的价值。方法回顾性分析1999年1月-2004年11月做18F—FDG PET检查的52例经病理检查确诊为胃恶性肿瘤的PET图像,其中49例患者有同期CT检查结果。PET显像结果均由病理或临床及其他影像学检查随访证实。结果①23例患者治疗后胃局部18F-FDG摄取增高,其中9例证实有肿瘤残余或局部复发,标准摄取值(SUV)为4.24±2.98。14例为生理性摄取或胃炎、吻合口炎、胃动力异常等良性摄取,SUV 2.72±0.62。两组比较差异有显著性(t=1.87,P<0.05)。②对转移灶的检出,18F- FDG PET显像和CT检查的灵敏度分别为90.0%(27/30例)、50.0%(15/30例),两者差异有显著性(x2=11.43,P<0.005)。PET显像9例与CT检查结果相符;6例PET发现的病灶多于CT;10例PET发现转移灶而CT未见异常,其中2例B超检查阳性而CT检查阴性,PET显像证实了B超所见; 2例PET否定了CT提示的转移灶,但发现其他部位转移。5例仅血清肿瘤标志物水平升高,其他检查阴性,而PET显像发现转移灶。25例PET显像未发现转移灶者中有3例假阴性。结论18F-FDG PET显像对胃肿瘤治疗后残余或复发及转移灶检出率高于其他影像学检查,但特异性差。Objective To evaluate the usefulness of ^18F-fluorodeoxyglucose （FDG） PET imaging in post-therapeutlc patients with gastric malignancy. Methods 52 post-therapeutlc patients with gastric malignancy underwent ^18F-FDG PET imaging. CT imaging was performed in 49 patients within 30 d of the PET study. Results of ^18F-FDG PET imaging were verified by histopathology or clinical follow-up and other imaging examination. Results ①23 patients showed regional ^18F-FDG uptake in gastric site. The hypermetabolic loci were proved to be recurrent or residual tumors [ standardized uptake value （SUV） 4.24 ± 2. 98] in 9 patients and benign including physiological, inflammatory or abnormal gastric： motility uptake （ SUV 2.72 ± 0.62） in 14 patients. There was significant difference between them （ P 〈 0.05 ）.②The sensitivity of PET imaging for detecting metastatic lesions was 90.0% （27/30） , and that of CT was 50.0% （15/30）. For metastatic lesions, PET imaging was concordant with CT in 9 patients, found more lesions than CT in 6 patients, and detected lesions in 10 patients while CT was negative. In 2 patients PET imaging ruled out lesions suspected by CT but found lesions in other sites. PET imaging also detected metastases in 5 patients with slightly elevated tumor marker and no positive findings by other imaging modalities. In 25 PET imaging negative patients there were 3 false negatives. Conclusions PET imaging has high sensitivity but low specificity for detecting residual or recurrent lesions in patients with gastric malignancy after therapy. However, PET is more useful in finding metastatic lesions than CT.

关 键 词：胃肿瘤 体层摄影术 发射型计算机 脱氧葡萄糖 随访研究 ^18F-FDGPET显像 治疗后随访 胃恶性肿瘤 ^18F-脱氧葡萄糖 标准摄取值 血清肿瘤标志物 

分 类 号：R735.2[医药卫生—肿瘤]