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1.
18F-FDG PET 显像在判断恶性肿瘤复发及再分期上的应用   总被引:6,自引:3,他引:3  
目的 利用PET判断恶性肿瘤复发并进行再分期。方法 应用^18F-FDG PET于23例恶性肿瘤,以胸腹部断层显像和标准化摄取值(SUV)评价7例(A组)无肿瘤复发和16例(B组)经病理和临床证实的肿瘤复发病人。结果 6例无肿瘤复发病人PET表现与正常人相似。1例放射性肺炎病人于放疗部位可见轻中度放射性摄取增高,其他部位未见异常浓聚灶。16例肿瘤复发病人影像分为三型;3例仅在原发肿瘤部位复发;8例  相似文献   

2.
目的对18FFDGPET在中枢神经系统疾病临床诊断中应用的初步体会作一介绍。方法18FFDGPET检查共计17例,所有患者静脉注射18F脱氧葡萄糖(FDG)10mCi后40分钟进行脑18FFDG正电子发射断层显像(PET),其结果与同期的CT、MRI、EEG结果进行比较。结果在10例癫痫发作间歇期病人中,40%的病例18FFDGPET显示病侧局部脑叶葡萄糖代谢即FDG摄取低下(较正常健侧皮层放射性计数降低20%以上),50%的病例脑叶葡萄糖代谢正常;脑梗塞、脑外伤后软化灶18FFDGPET均显示为局部脑叶葡萄糖代谢明显下降或缺损,其余多发性硬化、多发小脓肿、蛛网膜囊肿均表现为脑内葡萄糖代谢正常。结论初步的临床应用显示,18FFDGPET在中枢神经系统疾病诊断中具有重要的临床价值  相似文献   

3.
目的 本文着重探讨18FFDGPET与CT、MR影像诊断技术在肿瘤临床诊断、手术方案的确定和治疗后随访中的互补作用。方法 对28 例临床诊断的恶性肿瘤同期进行18FFDGPET、CT和MRI检查,其中21 例经手术病理或活检证实;采用双盲法,将PET诊断结果与同期的CT和/或MR影像进行比较。结果 本组27 例肿瘤中,18FFDGPET 显像结果与CT、MRI诊断相符20 例( 占74% ),18FFDGPET 显像进一步肯定或明确CT、MRI的结论7 例( 占26% );另1 例临床、CT和MRI均误诊为乳腺癌术后脑转移病例,经18FFDGPET 显示为脑梗塞;PET影像上,恶性肿瘤病灶均表现为局部18FFDG明显浓聚;CT和/或MR 影像上,20 例肿瘤有局部神经、血管和重要脏器等的侵犯,以及肿瘤瘤内出血、坏死和瘤周水肿等,但PET 均不能显示。结论 虽然18FFDGPET 对恶性肿瘤的定性诊断具有较高的准确性和特异性,但是18FFDGPET仍不能取代CT 和MRI在肿瘤诊断中的作用;最好的方法是结合PET、CT 和MRI多种影像结果分析,才能为临床提供有关肿瘤病变的解剖细节和功能异常改变的综合信息。  相似文献   

4.
目的 地^18F-FDGPET在中枢神经系统疾病临床诊断中应用的初步体会作一介绍。方法 ^18F-FDGPET检查共计17例,所有患者静脉注射^18F-脱氧葡萄糖(FDG)10mCi后40分钟进行脑^18F-FDG正电子发射断层显像(PET)。其结果与同期的CT、MRI、EEG结果进行比较。结果 在10例癫痫发作间歇期病人中,40%的病例^18F-FDGPET显示病侧局部脑叶葡萄代谢正常、脑梗塞、  相似文献   

5.
~(18)F-FDGPET全身显像诊断乳腺癌及其转移灶的价值山东淄博万杰医院PET中心(255202)赵军,孙启银,李家敏,王明芳,孙爱君,徐顾海山东淄博万杰医院普外科石杏芬乳腺癌是妇女最常见的致命性肿瘤之一,占女性肿瘤的3%。乳腺X线摄影是最早用于?..  相似文献   

6.
PET在肿瘤影像诊断中与CT,MRI的相互关系:附28例^18F—FD …   总被引:1,自引:0,他引:1  
目的 本文着重探讨^18F-FDG PET与CT、MR影像诊断技术在肿瘤临床诊断、手术方案的确定和治疗后随访中的互补作用。方法 对28例临床诊断的恶性肿瘤同期进行^18F-FDG PET、CT和MRI检查,其中21例经手术病理在检证实;采用双盲法,将PET诊断结果与同期的CT和/或MR影像进行比较。结果 本组27例肿瘤中,^18F-FDG PET显像结果与CT、MRI诊断相符20例(占74%),^  相似文献   

7.
利用正电子核素药物 ̄(13)N-NH_3、 ̄(18)F-FDG进行心肌血流灌注PET显像和心肌代谢PET显像,进行CAD的早期诊断和心肌存活性判断。总结了15例CAD患者;10例健康查体者15例心肌梗塞患者心脏PET显像检查的护理操作与放射防护。并探讨了静注潘生丁后出现副作用的应急护理。  相似文献   

8.
目的:采用相对定量分析法评估99mTc-ECD脑血流灌注显像对小儿原发性癫痫定性和病灶定位的诊断价值。方法:21例CT检查正常的小儿原发性癫痫病人进行99mTc-ECD脑显像和相对定量分析,并同步进行EEG检查。结果:21例病人SPECT显像18例异常,3例正常,阳性率857%,假阴性10%,18例脑显像异常患儿中,16例局部脑血流(rCBF)减少,99mTc-ECD摄取率726±89%,2例在额叶有限局性rCBF增加,99mTc-ECD摄取率分别为1495%和1309%。EEG检查21例病人20例异常,1例正常,阳性率952%,能定位诊断的7例,定位率为35%。结论:99mTc-ECD脑显像相对定量分析法对小儿原发性癫痫病灶的定位有临床意义,优于EEG。  相似文献   

9.
^99mTc—tetrofosmin SPECT显像评价脑肿瘤的临床研究   总被引:1,自引:0,他引:1  
目的:探讨99mTc-tetrofosmin(TF) SPECT显像对脑肿瘤诊断的临床价值。方法:在28例CT或MR示脑占位性病变患者中,术前1周内进行脑99mTc-TF SPECT显像,其中17例还进行了2~3小时的延迟显像,观察病变部位99mTc-TF的摄取变化情况,并进行定性和半定量分析,即在横断面或冠状面图像上寻找肿瘤区摄取放射性最高的断面,画取肿瘤部位和相应对侧部位同样大小的感兴趣区(ROI),计算肿瘤摄取比值(TUR)。结果: 25例99mTc-TF SPECT断层显像病灶处TF摄取不同程度的增高,3例未见TF摄取。半定量分析结果显示:17例早期和延迟显像肿瘤病灶的TF、TUR分别为2.34 ±0.41和2.06±0.29、未见明显变化(P>0.05)。Ⅲ-Ⅳ级胶质瘤的TF、TUR(2.44±0.14)与Ⅰ~Ⅱ级胶质瘤的TF、TUR(1.46±0.36),两者有显著差异(P<0.01),诊断灵敏度为89.3%。结论:99mTc-TF SPECT显像在脑肿瘤诊断上有一定的临床价值,特别是在区分脑胶质瘤的恶性程度上。  相似文献   

10.
利用正电子核素药物^13N-NH3,^18F-FDG进行心肌血流灌注PET显像和心肌代谢PET显像,进行CAD的早期诊断和心肌存活性判断。总结了15例CAD患者;10例健康查体者;5例心肌梗塞患者心脏PET显像检查的护理操作与放射护护。并探讨了静注潘生丁后出现副作用的应急护理。  相似文献   

11.
18F-FDG PET/CT在肾脏肿瘤诊疗中的应用   总被引:1,自引:0,他引:1       下载免费PDF全文
目的评价18F-FDG PET/CT在肾脏肿瘤诊断和治疗中的价值。方法对30例CT或MRI确诊或怀疑肾脏肿瘤的患者行18F-FDG PET/CT显像,22例患者行延迟显像。所有肾脏肿瘤均经手术或穿刺活检后病理确诊。评价18F-FDG PET/CT对患者治疗方案的影响。结果 30例中,肾细胞癌(RCC)24例,肾神经内分泌肿瘤1例,淋巴瘤3例,肺癌肾转移1例,肾脏炎性病变1例。PET/CT诊断肾脏肿瘤的灵敏度为89.66%(26/29),特异度为100%(1/1),准确率为90.00%(27/30),阳性预测值为100%(26/26),阴性预测值为25.00%(1/4)。PET/CT检出肾癌伴肾门淋巴结转移2例,远处转移5例。8例(RCC 4例、肾淋巴瘤3例及肾转移癌1例)接受PET/CT后治疗方案发生改变。显像阳性肾癌患者Fuhrman分级高于阴性患者(P<0.05),显像阳性肾癌平均直径大于阴性者(P<0.05)。22例肾癌早期最大标准摄取(SUVmax)值与延迟显像SUVmax值差异无统计学意义(P>0.05)。结论 18F-FDG PET/CT可准确显示肾肿瘤患者局部病变及远处转移。对可疑肾淋巴瘤及肾转移瘤患者应行18F-FDG PET/CT显像,以明确分期并寻找原发灶。  相似文献   

12.
目的 分析肺转移瘤的18F-FDG PET/CT显像结果 ,以期提高诊断正确率,减少漏诊和误诊. 方法 对68例肿瘤患者肺转移灶的18F-FDG PET/CT显像结果 进行回顾性分析. 结果 68例CT显示阳性病例中,PET显示阳性18例,部分阳性27例,总阳性率为66.18%;阴性23例,占33.82%.CT发现病灶数目575个,PET显示194个,PET检出率为33.74%.FDG有无摄取以及摄取的程度与转移灶大小有明显关系,与原发肿瘤的来源无关.随着病灶增大,PET阳性率和SUV值均明显增高. 结论 18F-FDG PET对肺转移瘤、尤其是单个转移灶的鉴别诊断价值有限.  相似文献   

13.
Purpose

Myocardial uptake can hamper visualization of lung tumors, atherosclerotic plaques, and inflammatory diseases in 2-deoxy-2-[18F]fluoro-D-glucose ([18F]FDG) studies because it leads to spillover in adjacent structures. Several preparatory pre-imaging protocols (including dietary restrictions and drugs) have been proposed to decrease physiological [18F]FDG uptake by the heart, although their effect on tumor glucose metabolism remains largely unknown. The objective of this study was to assess the effects of a ketogenic diet (as an alternative protocol to fasting) on tumor glucose metabolism assessed by [18F]FDG positron emission tomography (PET) in a mouse model of lung cancer.

Procedures

PET scans were performed 60 min after injection of 18.5 MBq of [18F]FDG. PET data were collected for 45 min, and an x-ray computed tomograph (CT) image was acquired after the PET scan. A PET/CT study was obtained for each mouse after fasting and after the ketogenic diet. Quantitative data were obtained from regions of interest in the left ventricular myocardium and lung tumor.

Results

Three days on a ketogenic diet decreased mean standard uptake value (SUVmean) in the myocardium (SUVmean 0.95?±?0.36) more than one night of fasting (SUVmean 1.64?±?0.93). Tumor uptake did not change under either dietary condition.

Conclusions

These results show that 3 days on high-fat diets prior to [18F]FDG-PET imaging does not change tumor glucose metabolism compared with one night of fasting, although high-fat diets suppress myocardial [18F]FDG uptake better than fasting.

  相似文献   

14.
胰腺癌18F-FDG PET/CT显像及诊断方法   总被引:1,自引:0,他引:1  
目的 评价18F-FDG PET/CT诊断胰腺癌的价值及分析方法。方法 回顾性分析88例接受18F-PET/CT检查的胰腺原发疾病患者资料,其中恶性65例,良性23例,采用目测和半定量方法分析胰腺疾病的PET/CT特点。目测法分别根据病变CT特征、PET摄取程度和PET/CT特点制定CT、PET和PET/CT五级分析方法;定量分析方法主要在PET图像上测量病变的最大标准化摄取值(SUVmax),并与最后诊断结果进行诊断学试验评价。结果 CT、PET及PET/CT目视五分法诊断胰腺癌的灵敏度、特异度和准确率分别为92.31%(60/65)、69.57%(16/23)、86.36%(76/88);90.77%(59/65)、78.26%(18/23)、87.50%(77/88);98.46%(64/65)、91.30%(21/23)、96.59%(85/88)。三种方法的ROC曲线下面积(ROC-AUC)均大于0.90。胰腺癌SUVmax平均值为8.06±2.96,胰腺良性病变SUVmax平均值为3.13±2.09 (t=7.344,P<0.01)。胰腺癌转移组与非转移组SUVmax分别为8.06±3.01和7.23±2.96(t=0.693,P=0.38),以SUVmax=4.65为判断良恶性的阈值,PET诊断胰腺癌的灵敏度和特异度为87.69%和86.96%。结论 18F-FDG PET/CT在胰腺癌的诊断上具有较大价值;PET/CT目视五分法是鉴别胰腺良恶性病变较好的方法。  相似文献   

15.

Purpose

Tumor delineation within an atelectasis in lung cancer patients is not always accurate. When T staging is done by integrated 2-deoxy-2-[18F]fluoro-d-glucose ([18F]FDG)-positron emission tomography (PET)/X-ray computer tomography (CT), tumors of neuroendocrine differentiation and slowly growing tumors can present with reduced FDG uptake, thus aggravating an exact T staging. In order to further exhaust information derived from [18F]FDG-PET/CT, we evaluated the impact of CT density and maximum standardized uptake value (SUVmax) for the classification of different tumor subtypes within a surrounding atelectasis, as well as possible cutoff values for the differentiation between the primary tumor and atelectatic lung tissue.

Procedures

Seventy-two patients with histologically proven lung cancer and adjacent atelectasis were investigated. Non-contrast-enhanced [18F]FDG-PET/CT was performed within 2 weeks before surgery/biopsy. Boundaries of the primary within the atelectasis were determined visually on the basis of [18F]FDG uptake; CT density was quantified manually within each primary and each atelectasis.

Results

CT density of the primary (36.4 Hounsfield units (HU)?±?6.2) was significantly higher compared to that of atelectatic lung (24.3 HU?±?8.3; p?<?0.01), irrespective of the histological subtype. The discrimination between different malignant tumors using density analysis failed. SUVmax was increased in squamous cell carcinomas compared to adenocarcinomas. Irrespective of the malignant subtype, a possible cutoff value of 24 HU may help to exclude the presence of a primary in lesions below 24 HU, whereas a density above a threshold of 40 HU can help to exclude atelectatic lung.

Conclusion

Density measurements in patients with lung cancer and surrounding atelectasis may help to delineate the primary tumor, irrespective of the specific lung cancer subtype. This could improve T staging and radiation treatment planning (RTP) without additional application of a contrast agent in CT, or an additional magnetic resonance imaging (MRI), even in cases of lung tumors of neuroendocrine differentiation or in slowly growing tumors with less avidity to [18F]FDG.
  相似文献   

16.
目的 探讨18F-FDG PET/CT在原发性肝癌和肝转移瘤诊断中的应用价值。方法 回顾性分析108例肝脏肿瘤患者临床资料、常规影像(超声、增强CT和MRI)及PET/CT资料,病灶18F-FDG浓集水平高于周围正常肝组织为诊断恶性标准。结果 108例肝脏肿瘤各种影像检查共检出194个病灶,70个肝细胞癌病灶18F-FDG PET/CT发现34个,最大标准摄取值(SUVmax)为4.95±3.86;23个胆管细胞癌病灶PET/CT发现22个,SUVmax为7.65±3.88;101个肝内转移瘤病灶PET/CT发现97个,SUVmax为9.65±5.34。18F-FDG PET/CT对肝转移瘤和胆管细胞癌的阳性检出率(96.04%和95.65%)均高于肝细胞癌(48.57%),差异均有统计学意义(P均<0.05);肝转移瘤与肝细胞癌、胆管细胞癌与肝细胞癌之间SUVmax的差异均有统计学意义(P均<0.05)。不同原发肿瘤来源的肝转移灶的SUVmax值差异无统计学意义(F=2.07,P>0.05)。结论 18F-FDG PET/CT对原发性肝癌和肝转移瘤的病灶检出率不同,病灶的SUVmax值亦存在差异;在肝脏肿瘤诊断与分期时需科学合理应用18F-FDG PET/CT。  相似文献   

17.

Purpose

Anti-1-amino-3-[18F]fluorocyclobutane-1-carboxylic acid (anti-3-[18F]FACBC) is a synthetic amino acid positron emission tomography (PET) radiotracer with utility in detection of prostate carcinoma and brain tumors and has also been shown to have uptake in lung tumor cell lines. The purpose of this study is to determine the uptake characteristics of anti-3-[18F]FACBC in lung carcinoma and if this radiotracer may help characterize pulmonary lesions.

Procedures

Ten patients with pulmonary lesions scheduled for surgical resection or biopsy underwent 45-min dynamic PET-CT imaging of the thorax after IV injection of 214.6–384.8MBq of anti-3-[18F]FACBC. Anti-3-[18F]FACBC uptake was compared with that of routine 2-deoxy-2-[18F]fluoro-d-glucose ([18F]FDG) PET-CT scans of the same patient and validated with a combination of pathology, imaging and clinical follow-up. Immunohistochemistry for Ki-67 was performed on tissue samples.

Results

There were nine malignant (seven lung nodules and two mediastinal nodes), two inflammatory, and one carcinoid lesion ranging from 1 to 3.75 cm. Mean(±SD) SUVmax of malignant lesions was 6.2(±2.6), 5.9(±2.7), 5.9(±3.4), and 5.7(±3.3), at 8, 16, 28, and 40 min, respectively; while for inflammatory lesions at the same time points, 4.1(±0.6), 3.3(±0.9), 2.2(±0.03), and 2.3(±0.03), respectively. The carcinoid tumor had SUVmax of 2.8, 2.6, 1.5, and 0.9 at similar time points. Mean SUVmax of all malignant lesions was higher than that of inflammatory lesions for anti-3-[18F]FACBC, and was statistically significant at greater than 28 min post-radiotracer infusion (p?<?0.05). There was no significant correlation of anti-3-[18F]FACBC activity with Ki67, though there was a positive trend. There was a strong correlation between anti-3-[18F]FACBC and [18F]FDG uptake.

Conclusions

Anti-3-[18F]FACBC uptake in malignant lesions is greater than in inflammatory lesions with a higher degree of separation of uptake on delayed imaging. More comprehensive study is required to determine the diagnostic performance of anti-3-[18F]FACBC in the characterization of pulmonary lesions.  相似文献   

18.
We evaluated the diagnostic performance of 18F‐FDG PET/CT and MRI for the assessment of head and neck squamous cell carcinoma (HNSCC) relapse. Since early treatment might prevent inoperable relapse, we also evaluated THE performance of early unenhanced 18F‐FDG PET/CT in residual tumor detection. The study was prospectively performed on 32 patients who underwent 18F‐FDG PET/CT and MRI before treatment and at 4 and 12 months after treatment. 18F‐FDG PET/CT was also performed 2 weeks after the end of radiotherapy. Histopathology or a minimum of 18 months follow‐up were used as gold standard. Before treatment 18F‐FDG PET/CT and MRI detected all primary tumors except for two limited vocal fold lesions (sensitivity 94%). MRI was more sensitive than 18F‐FDG PET/CT for the detection of local extension sites (sensitivity 75 vs 58%), but at the cost of a higher rate of false positive results (positive predictive value 74 vs 86%). For relapse detection at 4 months, sensitivity was significantly higher for 18F‐FDG PET/CT (92%) than for MRI (70%), but the diagnostic performances were not significantly different at 12 months. For the detection of residual malignant tissue 2 weeks post‐radiotherapy, sensitivity and specificity of 18F‐FDG PET/CT were respectively 86 and 85% (SUV cut‐off value 5.8). 18F‐FDG PET/CT is effective in the differentiation between residual tumor and radiation‐induced changes, as early as 2 weeks after treatment of a primary HNSCC. For follow‐up, performance of 18F‐FDG PET/CT and MRI are similar except for a higher sensitivity of 18F‐FDG PET/CT at 4 months. Copyright © 2011 John Wiley & Sons, Ltd.  相似文献   

19.
目的 探讨18F-FDG PET/CT在乳腺外Paget病的分期及治疗后随访中的临床应用价值。方法 回顾性分析11例经手术或活检病理证实的乳腺外Paget病患者临床及影像学检查资料。结果 11例患者中,7例术前接受18F-FDG PET/CT检查,4例术后接受18F-FDG PET/CT检查。10例检查时存在皮肤病变,1例无皮肤病变;9例病灶位于阴囊,2例病灶位于腋窝。皮肤病灶18F-FDG PET/CT均表现为轻、中度摄取增高。5例患者伴有腹股沟淋巴结转移(5/11,45.45%)。2例既往有其他恶性肿瘤病史的患者均未见肿瘤复发征象;1例阴囊Paget病手术切除后1年局部复发患者,18F-FDG PET/CT发现升结肠肿物,伴肝脏、骨骼及淋巴结多发转移。结论 18F-FDG PET/CT有助于乳腺外Paget病的术前分期,并可用于临床随访。  相似文献   

20.
目的 探讨水灌肠PET/CT鉴别结直肠良恶性病变的价值。方法 对常规PET/CT检查发现的45例直肠及乙状结肠局灶性或弥漫性FDG浓聚患者行水灌肠PET/CT显像,与肠镜或术后病理结果进行对照。结果 水灌肠PET/CT扫描后诊断生理性摄取准确率为100%(15/15);诊断恶性肿瘤的敏感度为100%(18/18),特异度为92.59%(25/27),准确率为95.56%(43/45),阳性预测值为90.00%(18/20),阴性预测值为100%(27/27)。结论 水灌肠PET/CT可有效排除结直肠生理性摄取18F-FDG,准确鉴别常规PET/CT难以诊断的良恶性结直肠病变。  相似文献   

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