^(18)F-FDG PET/CT在软组织肉瘤诊断及预后中的价值  

Diagnostic and prognostic value of ^(18)F-FDG PET/CT in soft tissue sarcomas

作　　者：丁重阳[1] 孙晋[1] 杨文平[1] 李洋洋[1] 徐绪党[1] 李天女[1] 黎宏斐 

机构地区：[1]南京医科大学第一附属医院核医学科,江苏南京210029 [2]南京市浦口医院神经内科,江苏南京210031

出　　处：《中国医学影像技术》2014年第11期1691-1695,共5页Chinese Journal of Medical Imaging Technology

基　　金：南京市科技计划项目(201303038)

摘　　要：目的探讨18F-FDG PET/CT在软组织肉瘤诊断及预后中的价值。方法回顾性分析30例经病理证实的软组织肉瘤患者资料,所有患者于治疗前接受18F-FDG PET/CT检查。采用Kaplan-Meier法分析原发灶的SUVmax与患者生存之间的关系。结果 130例软组织肉瘤原发灶中,18 F-FDG PET/CT显像假阴性1例,其对原发灶的阳性检测率为96.67%(29/30)。218F-FDG PET/CT提示远处转移17例,正确诊断15例,假阳性2例,假阴性1例,PET/CT诊断软组织肉瘤远处转移的灵敏度、特异度、准确率、阳性预测值及阴性预测值分别为93.75%、85.71%、90.00%、88.24%及92.31%。333.33%(10/30)的患者因18F-FDG PET/CT发现远处转移而改变治疗方案。以10.1作为SUVmax界限值,SUVmax≤10.1与SUVmax>10.1两组患者的PFS期、OS期、2年PFS率及2年OS率差异均有统计学意义(P均<0.05)。结论 18F-FDG PET/CT对于软组织肉瘤原发灶及转移灶的诊断具有较高的灵敏度及特异度,原发灶SUVmax与患者的预后具有较强的相关性,可为临床决策提供依据。Objective To investigate the diagnostic and prognostic value of ^18F-FDG PET/CT in soft tissue sarcomas （STS）. Methods The PET/CT data of 30 patients with STS confirmed by pathology were retrospectively analyzed, who underwent baseline ^18F-FDG PET/CT before treatment. The relationship between the maximal standardized uptake value （SUVm=） of the primary tumor and survival was evaluated with Kaplan-Meier analysis. Results ①^18F-FDG PET/CT had 96.67% （29/30） positive detection rate for soft tissue sarcoma, with one false negative of 30 cases. ②^18 F-FDG PET/CT suggested distant metastases in 17 cases, among which 15 cases were diagnosed accurately with 2 false positive cases and 1 false negative case, and the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of PET/CT in the detection of distant metastases were 93.75%, 85.71%, 90.00%, 88. 24% and 92.31%, respectively. ③ Totally 10 patients （10/30, 33.33M） altered the treatment due to the 18F-FDG PET/CT results. With the cut-off values of 10.1, the progression-free survival （PFS） time, overall survival （OS） time, 2-year PFS and 2-year OS rate were significantly different between the patients with SUVmax≤10. 1 and SUVmax〉10.1 （both P〈0. 05）. Conclusion ^18F-FDG PET/ CT is a new modality with high sensitivity and specificity in the detection of primary lesions and metastases of soft tissue sarcoma. There is strong relationship between the SUVmax of the primary tumor and survival, which provides more reliable evidence for the clinical decision.

关 键 词：软组织 肉瘤 正电子发射型体层摄影术 18F氟脱氧葡萄糖 

分 类 号：R738.6[医药卫生—肿瘤]