FDG PET判断鼻咽癌放疗后鼻咽病灶残留的临床价值  

Detection of Residue of Nasopharyngeal Carcinoma with FDG PET

作　　者：陈应瑞[1] 辜梅新[1] 李伟雄[1] 潘燚[1] 

机构地区：[1]广东省人民医院放疗科,广东广州510080

出　　处：《癌症》2002年第6期651-653,共3页Chinese Journal of Cancer

基　　金：广东省医学科学技术研究基金项目(A2000038)

摘　　要：背景与目的:18F-2脱氧葡萄糖(FDG)正电子发射计算机断层显像(PET)在判断恶性肿瘤治疗后病灶残留上的应用是放射肿瘤学目前研究的热点之一。本文旨在探讨FDGPET显像在鼻咽癌放射治疗后鼻咽肿瘤残留中的应用。方法:25例鼻咽癌放疗后,临床疑鼻咽肿瘤残留,均行FDGPET显像,显像时间为放疗后2～6个月,其中23例同期行CT检查。最后诊断依靠病理检查和临床随访。结果:25例患者中FDGPET显像阳性18例,其中4例假阳性;阴性7例,其中2例假阴性。FDGPET显像的准确率为76.0%(19/25),CT检查的准确率为52.2%(12/23)。11例CT未见鼻咽肿瘤残留,FDGPET显示其中2例有鼻咽局部FDG异常浓聚;7例CT诊为肿瘤残留,FDGPET均显示局部病变有FDG异常浓聚,5例CT未能确定残留,PET显示其中3例FDG异常浓聚。12例FDG异常浓聚的病变处经活检病理证实为肿瘤残留。结论:判断鼻咽癌放疗后鼻咽肿瘤残留,FDGPET比CT有更高的准确性。Background and Objective: The use of F 18 fluoro 2 deoxy d glucose positron emission tomography (FDG PET) in detection of suspected residue of malignant tumor after treatment has become one of the most important targets of study in radiotherapy. This study was designed to evaluate FDG PET in detection of suspected residue of nasopharyngeal carcinoma(NPC) after treatment, in comparison with CT imaging. Methods:Twenty five patients with clinically suspected residue of NPC did FDG PET Scaning, 23 of them also examined with CT imaging. The diagnosis of residue were confirmed by pathology or clinical follow up. Results:FDG PET correctly detected residue in 19/25 patients. There were 4 false positive and 2 false negative patients. The accuracy of FDG PET was 76.0%(19/25), compared to 52.2%(12/23) of CT scan. Eleven of 23 patients did not show any residue by CT scan, while, FDG PET scan showed significantly increased FDG metabolism, indicating residue in 2 of these patients. In 7 patients, both CT and FDG PET indicated residue tumor. Conclusion:Compared with CT imaging, FDG PET has a higher accuracy in detection of residue nasopharyngeal carcinoma after treatment.

关 键 词：FDG PET 鼻咽癌 鼻咽病灶残留 放射疗法 CT 诊断 

分 类 号：R739.63[医药卫生—肿瘤]