^(18)F-FDG hPET／CT显像诊断结直肠癌术后复发转移  

^(18)F-FDG hPET/CT in the diagnosis of recurrent and metastatic colorectal cancer

作　　者：李林法[1] 赵葵[1] 沈文华[1] 林建江[2] 徐加鹤[2] 闻世凤[1] 罗旭光[1] 朱阳军[1] 程唯荷[1] 

机构地区：[1]浙江大学医学院附属第一医院核医学科,杭州310003 [2]浙江大学医学院附属第一医院肛肠科,杭州310003

出　　处：《中华普通外科杂志》2006年第8期557-559,共3页Chinese Journal of General Surgery

摘　　要：目的评价18F-FDG hPET／CT代谢显像对结直肠癌患者术后复发转移的诊断价值。方法对81例结直肠癌术后临床可疑肿瘤复发或转移的患者采用GE HAWKEYE符合线路SPECT进行18F-FDG显像,获得经X线衰减校正后的三维断层图像,由计算机完成各断层图像的融合,以目测法进行诊断分析,并与CT、病理学检查、临床随访作出的最后诊断进行对比。结果18F-FDG hPET／CT代谢显像对结直肠癌术后复发、转移诊断的灵敏度为93％(57／61),特异性为80％(16／20),阳性预测率为93％(57／61),阴性预测率为80％(16／20);而常规CT对结直肠癌术后复发转移诊断的灵敏度、特异性、阳性预测值、阴性预测值分别为67%(37／55)、73％(19／26)、84％(37／44)、51％(19／37);18F-FDG hPET／CT代谢显像共检出病灶126个,65例相同视野hPET／CT代谢显像与诊断CT常规影像检查复发转移病灶检出数分别为91个和46个。结论18F-FDG hPET／CT显像对结直肠癌术后复发转移的诊断价值优于CT;通过与同机定位CT图像融合可有效地对病变进行定性定位。Objective To evaluate ^18F-FDG hPET/CT in the diagnosis of postoperative recurrence and metastasis of colorectal cancer. Methods GE HAWKEYE coincidence SPECT was carried out in 81 colorectal cancer patients with suspected recurrence or metastasis after intravenous injection of 259 - 298 MBq （7 -8 mCi） ^18F-FDG. The acquired data were reconstructed using iterative algorithm and attenuationcorrected X-ray. The results were compared with the final diagnosis established by histological examination of resected specimens, and clinical follow-up. Results The sensitivity, specificity, positive predictive value （PPV） and negative predictive value（NPV） was 93% （57/61） ,80% （16/20） ,93% （57/61） ,80% （ 16/20 ） for ^18F-FDG hPET/CT respectively. For conventional CT the sensitivity, specificity, PPV and NPV was 67% （ 37/55 ） ,73% （ 19/26 ）, 84% （ 37/44 ） ,51% （ 19/37 ） respectively; ^18F-FDG hPET/CT detected 91 recurrent or metastatic lesions whereas only 46 lesions were detected by conventional CT in 65 patients. Conclusions ^18F-FDG hPET/CT has unique value in the diagnosis of recurrence and metastasis in postoperative colorectal cancer patients which was superior to conventional CT. Combined ^18F-FDG coincidence imaging with localizing CT improves the detection and localization of postoperative recurrence and/or metastasis in colorectal cancer patients.

关 键 词：结直肠肿瘤 诊断技术和方法 ^18氟-脱氧葡萄糖 SPECT 

分 类 号：R735.3[医药卫生—肿瘤]