^18F-FDG PET/CT诊断骨与软组织肉瘤术后复发及转移

目的 探讨18F-FDG PET/CT在诊断原发性骨与软组织肉瘤术后局部复发和（或）远处转移中的临床价值.方法 回顾性分析28例于2008年5月至2010年6月间,在我中心行手术切除的原发性骨与软组织肉瘤患者的病例资料,并随访其后续的诊治情况.以病理结果 或临床随访作为复发和转移灶的确认标准.随访至少3个月.结果 PET/CT提示局部复发16例,与临床、病理相符15例,假阳性1例.PET/CT监测肿瘤局部复发的敏感性、特异性、准确率、阳性预测值、阴性预测值分别为100﹪、92﹪、96﹪、94﹪和100﹪.PET/CT提示远处转移17例,正确诊断14例,假阳性3例.PET/CT监测远处转移的敏感性、特异性、准确率、阳性预测值、阴性预测值分别为100﹪、79﹪、89﹪、82﹪和100﹪.结论 PET/CT对于诊断原发性骨与软组织肉瘤术后复发及转移,表现为高度敏感性、中度特异性;可以更准确、更全面的发现肿瘤术后局部复发和（或）远处转移,为临床决策提供依据.

The clinical value of fluorine-18-fluorodeoxyglucose positron emission tomography and computed tomography in the detection of postoperative recurrence and metastasis of bone and soft tissue sarcomas

Objective To investigate the clinical value offluorine-18-fluorodeoxyglucose positron emission tomography and computed tomography （^18F-FDG PET/CT） in the detection of local recurrence and （or） distant metastasis of primary bone and soft tissue sarcomas after surgery. Methods The data of 28 patients with primary bone and soft tissue sarcomas who underwent surgical resection in our center were retrospectively analyzed from May 2008 to June 2010, and they were followed up for at least 3 months in their subsequent treatments. The pathologic findings or clinical follow-ups were taken as the recognition criteria for recurrence and metastasis. Results PET/CT revealed local recurrence in 16 cases, among which the diagnosis of 15 cases were identical with the clinical and pathological results with 1 false positive case, and the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of PET/CT in the detection of local recurrence were 100%, 92%, 96%, 94% and 100% respectively. PET/CT revealed distant metastasis in 17 cases, among which 14 cases were diagnosed accurately with 3 false positive cases, and the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of PET/CT in the detection of distant metastasis were 100%, 79%, 89%, 82% and 100% respectively. Conclusions PET/CT is a new modality with high sensitivity and moderate specificity in the detection of postoperative recurrence and metastasis of primary bone and soft tissue sarcomas. It is more accurate and more comprehensive in evaluating the local recurrence and （or） distant metastasis of sarcomas after surgery and provides more reliable evidence for the clinical decision making.