^(18)F-脱氧葡萄糖PET-CT检测食管癌病变长度的临床价值  

Value of ^(18)FDG PET-CT in defining the length of esophageal cancer

作　　者：袁双虎[1] 于金明[1] 于甬华[1] 杨新华[1] 付政[2] 杨国仁[2] 郭洪波[3] 王晓航[4] 周英智[5] 陈少卿[1] 

机构地区：[1]山东省肿瘤医院放疗科 [2]山东省肿瘤医院核医学科,济南250117 [3]山东省肿瘤医院胸外科,济南250117 [4]山东省立医院胸外科 [5]山东大学

出　　处：《中华放射肿瘤学杂志》2006年第5期389-392,共4页Chinese Journal of Radiation Oncology

摘　　要：目的评价^(18)F-脱氧葡萄糖(FDG)PET-CT诊断食管癌病变长度的临床价值,并和其他检测方法比较。方法选择食管癌患者32例,其中胸上段食管癌1例,胸中段22例,胸下段9例。术前分别行食管镜、食管钡餐、CT和FDG PET-CT检查,并检测食管癌原发灶病变位置和长度。1周内行食管癌手术,手术大体标本与检查结果比较。结果食管钡餐、CT、FDG PET-CT分段与大体标本全部符合,而食管镜检查有2例分段与大体标本不符合。食管镜、食管钡餐、CT、PET-CT所示食管癌病变长度与大体标本的相关系数分别是0．741、0．746、0．870、0．876(P值均为0．000)；所示食管癌原发灶长度分别为(3．8±1．4)、(4．1±1．5)、(4．4±1．6)、(5．3±1．9)和(4．7±1．7)cm,4种检查结果与大体标本差异均有统计学意义(P=0．000、0．007、0．025、0．001),病变长度从小到大依次为食管镜、食管钡餐、CT、大体标本、PET-CT。但考虑到标本离体后有一定程度的回缩,实际病变长度与PET-CT最接近。结论PET-CT较准确的显示食管癌病变实际长度,有一定临床价值。对手术病例,PET-CT可用于指导术者选择食管癌切除的剖胸径路及食管切除长度；对放疗病例,PET-CT有助于指导放疗靶区的精确确定。Objective To assess the value of 18-fluoro-deoxy-glucose positron emission-CT（ FDG PET-CT） in defining the length of primary esophageal cancer. Methods Thirty-two patients had undergone esophagoscopy,esophagography and FDG PET-CT scans one week before esophagectomy. There was one tumor located in the upper thoracic esophagus, 22 in the middle thoracic esophagus, and 9 in the lower thoracic esophagus. The location and length of primary lesion of the tumor was determined by esophagoscopy, esophagography,and FDG PET-CT. The length of the abnormality seen on the CT portion of the PET-CT scan was determined separately and independently by two radiologists. All resuhs were compared with the resected specimen. Results According to esophagography, CT and PET-CT, all lesion lengths were compared with that of the resected specimen. It was found that the tumor location determined by esophagoscopy was not in accordance with the resected specimen in 2 patients. The mean length of the primary tumor,being from short to long, were （ 3.8 ± 1.4 ）, （4.1 ± 1.5 ）, （4.4 ± 1.6 ）, （ 5.3 ± 1.9 ） and （ 4.7 ± 1.7 ） cm, as determined by esophagoscopy,esophagography, CT,actral length of the resected specimen and PET-CT. Compared with the resected specimen, there was obvious difference （ P = 0. 000,0. 007,0. 025,0. 001 ）. Considering that there might be some kind of shrinkage in the resected specimen （ about 83.59% ,as reported by Ma et al ） , we rectified the length of resected specimen and compared with other findings again . It was found that insig- nificant difference existed between PET-CT and rectified length value of the resected specimen （ P = 0. 082）. Condusions FDG PET-CT is effective in the length determination of primary esophageal cancer. It may be used to determine the length of esophagus to be resected for patients indicated for esophagectomy. It may also be used to accurately delineate the gross tumor volume for patients eligible for radiotherapy.

关 键 词：食管肿瘤/外科学 病变长度 体层摄影术 正电子发射型 体层摄影术 X线计算机 图像处理 计算机辅助 食管镜 食管钡餐 

分 类 号：R735.1[医药卫生—肿瘤]