~18F-FDG PET 显像在头颈部肿瘤中的应用  

The usefulness of ~18F-FDG PET in patients with head and neck tumors

作　　者：程午樱[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核医学科PET中心,100730

出　　处：《中华核医学杂志》2006年第5期273-275,共3页Chinese Journal of Nuclear Medicine

摘　　要：目的探讨^(18)F-脱氧葡萄糖(FDG)PET 显像在头颈部肿瘤中的应用。方法 39例头颈部肿瘤患者,共行56次^(18)F-FDG PET 检查。图像分析采用视觉和半定量(标准摄取值,SUV)方法。结果①5例治疗前患者,PET 显像使3例改变了分期;34例治疗后患者中,PET 显像发现6例头颈部有残存或复发灶,11例淋巴结转移,4例肺部转移,3例骨转移。②22例 PET 显像阳性患者中,20例经手术病理检查或随访证实,2例假阳性;17例 PET 显像为阴性的患者均得到随访证实。PET 显像用于头颈部肿瘤病情监测的灵敏度为100%,特异性为89.5%,准确性为94.9%。③21例患者有近期 CT 或 MRI 检查结果,其中6例 PET 显像发现了 CT 或 MRI 未发现的局部复发病灶和转移淋巴结。6例患者 CT 或 MRI 提示有肿瘤复发或转移,但 PET 显像结果阴性,并经随访证实。④9例患者多次进行 PET 检查随访,其中5例病灶消失,3例病情进展,1例无变化。结论 ^(18)F-FDG PET 显像可较准确地发现头颈部肿瘤的残存、转移和复发病灶,并为肿瘤分期提供重要依据,但应与炎症鉴别。Objective The purpose of this study is to assess the usefulness of is ^18F-fluorodeoxyglucose （FDG） PET in patients with head and neck tumors. Methods Thirty-nine patients （56 studies） with pathologically confirmed head and neck tumors underwent whole body is ^18F-FDG PET imaging for staging （5 cases） or for post-therapeutic monitoring and restaging. The results of whole body is F-FDG PET imaging were evaluated with both visual and semiquantitative analyses （standardized uptake value, SUV）. ResnIts （1）^18F-FDG PET helped to define the extent of lesions in 3 patients and downstage another patient before treatment, and accurately detected residual or recurrent lesions in 6 , local lymph node metastasis in 11, lung and bone metastases in 4 and 3 cases after treatment. （2）Of 22 positive is F-FDG PET imaging, 20 were true positive confirmed by surgeries or follow-up studies. All of 17 patients with negative is F-FDG PET findings remained disease-free during follow-up. The sensitivity, specificity and accuracy of ^18F-FDG PET imaging in detecting residual, recurrent and metastatic lesions were 100% , 89.5% , and 94.9% respectively. （3）^18F-FDG PET imaging detected more lesions than CT or MRI in 3 of 21 cases, and corrected another 6 CT or MRI false-positive findings. （4）Consecutive PET studies were carried out in 9 patients. Remission was found in 5 patients and progression in 3. In one patient with nasopharyngeal carcinoma, PET imaging showed complete response of primary lesion and metastatic lymph nodes to treatment, but found another high uptake focus in the middle part of descending colon which was confirmed to be an adenoma by colonoscopy. Conclusion Due to its high sensitivity and accuracy in the detection of residual, recurrent, metastatic lesions and of second primary tumor, FDG PET imaging is a useful modality for staging and post-therapeutic follow-up in patients with head and neck tumors.

关 键 词：头颈部肿瘤 体层摄影术 发射型计算机 脱氧葡萄糖 

分 类 号：R739.91[医药卫生—肿瘤]