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1.
Kitajima K Ueno Y Suzuki K Kita M Ebina Y Yamada H Senda M Maeda T Sugimura K 《European journal of radiology》2012,81(11):3557-3562
Objective
To evaluate low-dose non-enhanced CT (ldCT) and full-dose contrast-enhanced CT (ceCT) in integrated 18F-fluorodeoxyglucose (FDG)-PET/CT studies for restaging of ovarian cancer.Materials and methods
One hundred and twenty women who had undergone treatment for ovarian cancer underwent a conventional PET/CT scans with ldCT, and then ceCT. Two observers interpreted and decided in consensus on the PET/ldCT and PET/ceCT images by a 3-point scale (N: negative, E: equivocal, P: positive) per patient and lesion site. Final diagnoses were obtained by histopathological examinations, or clinical follow-up for at least 6 months.Results
Patient-based analysis showed that the sensitivity, specificity, and accuracy of PET/ceCT was 86.9% (40/46), 95.9% (71/74), and 92.5% (111/120), respectively, whereas those of PET/ldCT were 78.3% (36/46), 95.0% (70/74), and 88.3% (106/120), respectively. All sensitivity, specificity, and accuracy significantly differed between two methods (McNemar test, p < 0.0005, p = 0.023, and p < 0.0001, respectively). The scales of detecting 104 recurrent lesion sites were N:14, E:6, P:84 for PET/ceCT, and N:15, E:17, P:72 for PET/ldCT, respectively. Eleven equivocal and one negative regions by PET/ldCT were correctly interpreted as positive by PET/ceCT.Conclusion
PET/ceCT is a more accurate imaging modality with higher confidence for assessing ovarian cancer recurrence than PET/ldCT. 相似文献2.
PET/CT在指导直肠癌术后放疗中的意义 总被引:3,自引:0,他引:3
目的回顾性探讨PET/CT在检测直肠癌术后患者的分期,分析PET/CT对直肠癌术后骶前软组织肿块的诊断准确率,以及对放射治疗的指导作用.方法选择手术后直肠癌29例,在行放射治疗前行PET/CT检查,其结果分别与同期的CT结果相比较.结果29例中发现7例11处高代谢灶,骶骨前间隙3例,髂骨+腰椎1例,盆腔淋巴结+肝脏2例,腹膜后淋巴结+锁骨上淋巴结1例.结论PET/CT能够更准确地反映手术后直肠癌患者的病变范围,能够指导治疗方案的选择. 相似文献
3.
Mona A. El-Hariri Ghada K. Gouhar Ali M. Refat 《The Egyptian Journal of Radiology and Nuclear Medicine》2012
Purpose
The purpose of this study was to evaluate the role of integrated PET/CT in the staging of lung cancer compared with CT alone or PET alone.Materials and methods
Thirty-three patients underwent integrated PET/CT for the staging of lung cancer. The tumor, node and metastasis (TNM) stages were assessed with CT, PET and integrated PET–CT and compared with the surgical and pathological staging.Results
CT correctly evaluated the (T) status in (64%) of the patients, PET in (59%) and PET/CT in (86%). CT correctly evaluated the (N) status in (73%) of the patients, PET in (76%), and PET/CT (88%) with accuracy, sensitivity, specificity, PPV and NPV were 73%, 78%, 71%, 50% and 94% for CT, 76%, 67%, 79%, 55% and 95% for PET and 88%, 89%, 88%, 73% and 100% for PET/CT respectively, and for (M) status were 91%, 86%, 92%, 75% and 96% for CT, 88%, 71%, 92%, 71% and 92% for PET and 97%, 100%, 96%, 88% and 100% for PET/CT respectively. Regarding the overall TNM staging CT correctly staged 24 patients. PET correctly staged 23 cases while PET/CT correctly staged 30 cases. A significant difference in the accuracy of overall tumor staging between PET/CT and CT (P = 0.0412) or PET (P = 0.0233).Conclusion
The integrated PET/CT is superior to either CT or PET in the staging of lung cancer which has an important impact on selection of the appropriate treatment regimen. 相似文献4.
H.A. Vargas O. Akin H. Schöder S. Olgac G. Dalbagni H. Hricak B.H. Bochner 《European journal of radiology》2012
Purpose
To prospectively evaluate the diagnostic performance of magnetic resonance imaging (MRI), 11C-acetate positron emission tomography/computed tomography (PET/CT) and contrast-enhanced CT for bladder cancer staging, using whole-mount pathologic review of radical cystectomy and pelvic lymph node specimens as the reference standard.Materials and methods
The institutional review board approved this prospective study, which was compliant with the Health Insurance Portability and Accountability Act. Written informed consent was obtained from 16 patients with histologically confirmed bladder cancer who underwent MRI, 11C-acetate PET/CT and contrast-enhanced CT before radical cystectomy and pelvic lymph node dissection. Before imaging 4/16 patients had received intravesical Bacillus Calmette-Guérin treatment, 6 had received systemic chemotherapy, 3 had received both and 3 had received neither. Measures of diagnostic performance including accuracy, sensitivity and specificity were estimated separately for each imaging modality.Results
MRI correctly staged 56% of patients (9/16), overstaged 38% (6/16) and understaged 6% (1/16). CT correctly staged 50% of patients (8/16), overstaged 44% (7/16) and understaged 6% (1/16). In 9 patients, 11C-acetate PET/CT showed uptake within the bladder wall; the uptake was true-positive in 7 patients and false-positive in 2 patients. Of the remaining 7 patients, 5 had true-negative and 2 had false-negative PET/CT results for cancer in the bladder wall. For all modalities, staging accuracy was reduced in patients with a history of prior intravesical and/or systemic chemotherapy.Conclusion
In staging bladder cancer, MRI, 11C-acetate PET/CT and CT displayed similar levels of accuracy. For all modalities, a history of intravesical and/or systemic chemotherapy affected staging accuracy. 相似文献5.
Albert Dirisamer Benjamin S. Halpern Florian Wolf Marius E. Mayerhoefer 《European journal of radiology》2010,73(2):324-328
Objective
The purpose of this study was to assess the diagnostic value of PET/CT as a one step examination in patients with colorectal cancer. Therefore we proved whether diagnostic PET/CT adds information over PET or contrast-enhanced CT alone for staging or restaging of patients with colorectal cancer.Methods
Seventy-three patients (46 males and 27 females; age range: 50-81 years; mean age: 67 years) with known colorectal cancer underwent 18F-FDG-PET/CT for staging or restaging.Results
Of the 73 patients 26 patients underwent PET/CT for staging and 47 for restaging. 266 metastases could be detected in 60 patients. Contrast-enhanced PET/CT had a lesion-based sensitivity of 100%, contrast-enhanced CT of 91% and PET of 85%. PET/CT identified 2 lesions as false positive. PET/CT could also reach a patient-based sensitivity of 100%, which was superior to contrast-enhanced CT and PET.Conclusion
Our study clearly demonstrated the added value of contrast-enhanced PET/CT in staging and restaging patients with colorectal cancer over CT and PET alone. 相似文献6.
Pfannenberg AC Aschoff P Brechtel K Müller M Bares R Paulsen F Scheiderbauer J Friedel G Claussen CD Eschmann SM 《European journal of nuclear medicine and molecular imaging》2007,34(1):36-44
PURPOSE: To evaluate low dose non-enhanced CT and standard dose contrast-enhanced CT in combined PET/CT protocols for staging and therapy planning of non-small cell lung cancer (NSCLC). METHODS: Retrospective analysis was performed of 50 consecutive patients with proven NSCLC who had been referred for primary staging (n=41) or restaging (n=9). All patients underwent a multi-phase PET/CT consisting of a low dose non-enhanced attenuation scan and an arterial and portal-venous contrast-enhanced CT scan followed by whole-body PET. Fused datasets of non-enhanced and contrast-enhanced PET/CT were compared per patient by using the TNM staging system, and per lesion regarding localisation, characterisation and delineation of tumour lesions. The staging results were validated either by histopathology or by clinical-radiological follow-up for >or=6 months. RESULTS: In 47/50 patients, the results of T staging did not differ between the two PET/CT protocols. Three patients could only be correctly classified as having T4 tumours after contrast application. Regarding N staging, both protocols yielded the same results. In M staging, there was only one patient with an improvement of the results as a result of contrast application. The lesion-based analysis of 92 sites showed no difference in the accuracy of lesion localisation and only one revision of lesion characterisation by contrast-enhanced PET/CT. The assessment of tumour delineation was altered by contrast application in 58/92 sites (p<0.0001). In 10/50 patients, contrast-enhanced PET/CT detected additional clinically important findings. CONCLUSION: In patients with advanced NSCLC, contrast-enhanced CT as part of the PET/CT protocol more accurately assessed the TNM stage in 8% of patients compared with non-contrast PET/CT. However, for planning of 3D conformal radiotherapy and non-conventional surgery, contrast-enhanced PET/CT protocols are indispensable owing to their superiority in precisely defining the tumour extent. 相似文献
7.
Ukihide Tateishi Ako Hosono Atsushi Makimoto Yuki Nakamoto Tomohiro Kaneta Hiroshi Fukuda Koji Murakami Takashi Terauchi Tsuyoshi Suga Tomio Inoue Edmund E. Kim 《Annals of nuclear medicine》2009,23(2):155-161
Objective The current study was conducted to compare the diagnostic accuracy between 18F-fluoro-2-deoxy-d-glucose (FDG) positron emission tomography (PET)/computed tomography (CT), and conventional imaging (CI) for the staging
and re-staging of patients with rhabdomyosarcomas.
Methods Thirty-five patients who underwent FDG PET/CT prior to treatment were evaluated retrospectively. CI methods consisted of 99mTc-hydroxymethylene diphosphonate bone scintigraphy, chest radiograph, whole body CT, and magnetic resonance imaging of the
primary site. The images were reviewed and two boardcertified radiologists reached a diagnostic consensus. Tumor stage was
confirmed by histological examination and/or follow-up examinations.
Results Interpretation on the basis of FDG PET/CT, and CI, diagnostic accuracies of the T and N stages were similar. Using FDG PET/CT,
the M stage was correctly assigned in 31 patients (89%), whereas the accuracy of CI in M stage was 63%. TNM stage was correctly
assessed with FDG PET/CT in 30 of 35 patients (86%) and with CI in 19 of 35 patients (54%). The overall TNM staging and M
staging accuracies of FDG PET/CT were significantly higher than that of CI (P < 0.01).
Conclusions FDG PET/CT is more accurate than CI regarding clinical staging and re-staging of patients with rhabdomyosarcomas. 相似文献
8.
Kazuhiro Kitajima Yuko Suenaga Yoshiko Ueno Tomonori Kanda Tetsuo Maeda Satoru Takahashi Yasuhiko Ebina Yoshiya Miyahara Hideto Yamada Kazuro Sugimura 《European journal of radiology》2013
Purpose
To investigate the diagnostic value of retrospective fusion of pelvic MRI and 18F-fluorodeoxyglucose (18F-FDG) PET images for assessment of locoregional extension and nodal staging of endometrial cancer.Materials and methods
Thirty patients with biopsy-proven endometrial cancer underwent preoperative contrast-enhanced PET/CT (PET/ceCT) and pelvic dynamic contrast-enhanced MRI for initial staging. Diagnostic performance of PET/ceCT, contrast-enhanced MRI, and retrospective image fusion from PET and MRI (fused PET/MRI) for assessing the extent of the primary tumor (T stage) and metastasis to regional LNs (N stage) was evaluated by two experienced readers. Histopathological and follow-up imaging results were used as the gold standard. The McNemar test was employed for statistical analysis.Results
Fused PET/MRI and MRI detected 96.7% of the primary tumors, whereas PET/ceCT detected 93.3%. Accuracy for T status was 80.0% for fused PET/MRI, and MRI proved significantly more accurate than PET/ceCT, which had an accuracy of 60.0% (p = 0.041). Patient-based sensitivity, specificity and accuracy for detecting pelvic nodal metastasis were 100%, 96.3% and 96.7% for both fused PET/MRI and PET/ceCT, and 66.7%, 100% and 96.7% for MRI, respectively. These three parameters were not statistically significant (p = 1).Conclusion
Fused PET/MRI, which complements the individual advantages of MRI and PET, is a valuable technique for assessment of the primary tumor and nodal staging in patients with endometrial cancer. 相似文献9.
Eun Young KimWon Jae Lee Dongil ChoiSoon Jin Lee Joon Young ChoiByung-Tae Kim Hyung Sik Kim 《European journal of radiology》2011,79(2):183-188
Aim
To date, no data are available on the use of PET/CT for preoperative staging of gastric cancer. We attempted to evaluate the value of PET/CT for preoperative staging of advanced gastric cancer, and to compare the use of PET/CT with contrast-enhanced CT (CECT).Materials and methods
We analyzed PET/CT of 78 patients with surgically proven advanced gastric cancer who had undergone preoperative CECT. Qualitative analysis was conducted by assessing the presence of primary tumors and metastases with PET/CT and CECT.Results
Among 71 patients who underwent a gastrectomy, 69 primary tumors (93%) were diagnosed by PET/CT, while 64 primary tumors (90%) were detected by CECT (p = 0.55). For regional lymph node metastasis, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of PET/CT vs. CECT were 41% vs. 25% (p = 0.00019), 100% vs. 92% (p = 0.31), 100% vs. 98% (p = 0.46), 26% vs. 42% (p = 0.14), and 51% vs. 72% (p = 0.00089), respectively.Conclusion
Overall, PET/CT showed comparable diagnostic performance to CECT in diagnosing primary tumors and regional lymph node metastases, though PET/CT was inferior to CECT for the sensitivity and accuracy in diagnosing regional lymph node metastases. Nevertheless, PET/CT would be useful when CECT findings were equivocal due to its high positive predictability. 相似文献10.
Hyun Su Kim MD Kyung Soo Lee MD Yoshiharu Ohno MD PhD Edwin J.R. van Beek MD PhD 《Journal of magnetic resonance imaging : JMRI》2015,42(2):247-260
Positron emission tomography / computed tomography (PET/CT), with its metabolic data of 18F‐fluorodeoxyglucose (FDG) cellular uptake in addition to morphologic CT data, is an established technique for staging of lung cancer and has higher sensitivity and accuracy for lung nodule characterization than conventional approaches. Its strength extends outside the chest, with unknown metastases detected or suspected metastases excluded in a significant number of patients. Lastly, PET/CT is used in the assessment of therapy response. Magnetic resonance imaging (MRI) in the chest has been difficult to establish, but with the advent of new sequences is starting to become an increasingly useful alternative to conventional approaches. Diffusion‐weighted MRI (DWI) is useful for distinguishing benign and malignant pulmonary nodules, has high sensitivity and specificity for nodal staging, and is helpful for evaluating an early response to systemic chemotherapy. Whole‐body MRI/PET promises to contribute additional information with its higher soft‐tissue contrast and much less radiation exposure than PET/CT and has become feasible for fast imaging and can be used for cancer staging in patients with a malignant condition. J. Magn. Reson. Imaging 2015;42:247–260. 相似文献
11.
Performance of integrated FDG-PET/contrast-enhanced CT in the diagnosis of recurrent uterine cancer: comparison with PET and enhanced CT 总被引:1,自引:0,他引:1
Kitajima K Murakami K Yamasaki E Domeki Y Kaji Y Morita S Suganuma N Sugimura K 《European journal of nuclear medicine and molecular imaging》2009,36(3):362-372
Purpose To evaluate the accuracy of integrated positron emission tomography and computed tomography (PET/CT) with iodinated contrast
agent and 18F-fluorodeoxyglucose (FDG) in the diagnosis of suspected uterine cancer recurrence and to assess the impact of PET/CT findings
on clinical management, compared with PET alone and enhanced CT alone.
Methods Of 103 women who had undergone treatment for histopathologically proven uterine cervical or endometrial cancer, 90 underwent
FDG-PET/contrast-enhanced CT examination for suspected recurrence. PET-alone, CT-alone, and fused PET/CT images were interpreted
by two radiologists by consensus for each investigation. Lesion status was determined on the basis of histopathology, radiological
imaging and clinical follow-up for longer than 6 months. Differences among the three modalities were tested using the Cochran
Q test, followed by multiple comparisons using the McNemar test with Bonferroni adjustment.
Results Patient-based analysis showed that the sensitivity, specificity, and accuracy of PET alone were 79.5% (35/44), 73.9% (34/46),
and 76.7% (69/90), respectively, whereas those of CT alone were 68.2% (30/44), 87.0% (40/46), and 77.8% (70/90), respectively,
and those of PET/CT were 90.9% (40/44), 93.5% (43/46), and 92.2% (83/90), respectively. PET/CT findings resulted in a change
of management in 38 of the 90 patients (42%) with an additional effect on patient management in 13 patients (14%) diagnosed
by CT alone and 14 patients (16%) diagnosed by PET alone.
Conclusion FDG-PET/contrast-enhanced CT is a more accurate modality for assessing recurrence of uterine cancer, and led to more appropriate
subsequent clinical management than that resulting from PET alone or enhanced CT alone. 相似文献
12.
Diagnostic accuracy of integrated FDG-PET/contrast-enhanced CT in staging ovarian cancer: comparison with enhanced CT 总被引:1,自引:0,他引:1
Kitajima K Murakami K Yamasaki E Kaji Y Fukasawa I Inaba N Sugimura K 《European journal of nuclear medicine and molecular imaging》2008,35(10):1912-1920
Purpose The purpose of the study is to evaluate the accuracy of integrated positron emission tomography and computed tomography (PET/CT)
with 18F-fluorodeoxyglucose (FDG) with IV contrast for preoperative staging of ovarian cancer, in comparison with enhanced CT, using
surgical and histopathological findings as the reference standard.
Materials and methods Forty patients with ovarian cancer underwent FDG-PET/contrast-enhanced CT scans for staging before primary debulking surgery.
PET/CT and the CT component separately, were interpreted by two experienced radiologists by consensus for each investigation.
Status with regard to lesion inside and outside the pelvis was determined on the basis of histopathology. The significance
of differences between the two imaging modalities was determined using the McNemar test.
Results Staging revealed stage I in 18 patients (IA, n = 9; IB, n = 3; IC, n = 6), stage II in seven (IIA, n = 2; IIB, n = 3; IIC, n = 2), stage III in 14 (IIIA, n = 1; IIIB, n = 3; IIIC, n = 10), and stage IV in one. The results of CT and PET/CT were concordant with the final pathological staging in 22 out of
40 (55%) and 30 out of 40 (75%) cases, respectively. The overall lesion-based sensitivity improved from 37.6% (32 out of 85)
to 69.4% (59 out of 85), specificity from 97.1% (578 out of 595) to 97.5% (580 out of 595), and accuracy from 89.7% (610 out
of 680) to 94.0% (639 out of 680) between CT and PET/CT. There were significant differences in sensitivity and accuracy, with
p values of 5.6 × 10−7 and 1.2 × 10−7, respectively.
Conclusion Integrated FDG-PET/contrast-enhanced CT is a more accurate imaging modality for staging ovarian cancer and useful for selecting
appropriate treatment than enhanced CT. 相似文献
13.
Kazuhiro Kitajima Erena Yamasaki Yasushi Domeki Masahiro Tsubaki Masakatsu Sunagawa Yasushi Kaji Narufumi Suganuma Kazuro Sugimura 《European journal of nuclear medicine and molecular imaging》2009,36(9):1388-1396
Purpose The aim of our study was to evaluate the accuracy of integrated positron emission tomography and computed tomography (PET/CT)
using 18F-fluorodeoxyglucose (FDG) with IV contrast for depiction of suspected recurrent colorectal cancer and to assess the impact
of PET/contrast-enhanced CT findings on clinical management compared with PET/non-contrast-enhanced CT and CT component.
Methods One hundred seventy patients previously treated for colorectal cancer underwent PET/CT consisting of non-enhanced and contrast-enhanced
CT for suspected recurrence. PET/contrast-enhanced CT, PET/non-contrast-enhanced CT and enhanced CT were interpreted by two
experienced radiologists by consensus for each investigation. Lesion status was determined on the basis of histopathology,
radiological imaging and clinical follow-up for longer than 6 months.
Results Patient-based analysis showed that the sensitivity, specificity and accuracy of PET/contrast-enhanced CT were 93.2 (69/74),
95.8 (92/96) and 94.7% (161/170), respectively, whereas those of PET/non-contrast-enhanced CT were 89.2 (66/74), 94.8 (91/96)
and 92.4% (157/170), respectively, and those of enhanced CT were 79.7 (59/74), 93.8 (90/96) and 87.6% (149/170), respectively.
Sensitivity and accuracy differed significantly among the three modalities (Cochran’s Q test: p = 0.0004 and p = 0.0001, respectively).The findings of PET/contrast-enhanced CT resulted in a change of management for 64 of the 170 patients
(38%) and had an effect on patient management in 12 patients (7%) diagnosed by enhanced CT alone and 4 patients (2%) diagnosed
by PET/non-contrast-enhanced CT.
Conclusion Integrated PET/contrast-enhanced CT is an accurate modality for assessing colorectal cancer recurrence and led to changes
in the subsequent appropriate therapy. 相似文献
14.
Purpose
Our aim was to clarify the diagnostic impact of contrast-enhanced (CE) 18F-fluorodeoxyglucose (FDG)–positron emission tomography (PET)/computed tomography (CT) for staging of pancreatic cancer compared to non-CE PET/CT.Method and materials
Between April 2006 and November 2009, a total of 95 patients (age range, 36–83 years [mean age, 67]) with primary pancreatic cancer underwent 18F-FDG PET/CT examinations. Diagnostic accuracy was compared between non-CE PET/CT and CE PET/CT. Images were analyzed visually and quantitatively by two blinded reviewers. Reference standard was histological examination in 48 patients (51%) and/or confirmation of an obvious progression in number and/or size of the lesions on follow-up CT examinations in 47 patients (49%).Results
For T-staging, invasion of duodenum (n = 20, 21%), mesentery (n = 12, 13%), and retroperitoneum (n = 13, 14%) was correctly diagnosed by both modalities. The ROC analyses revealed that the Az values of celiac artery (CA), common hepatic artery (CHA), splenic artery (SV), and superior mesenteric vein (SMV) invasion were significantly higher in the CE PET/CT group for both readers. Nodal metastasis was correctly diagnosed by CE PET/CT in 38 patients (88%) and by non-CE PET/CT in 45 patients (87%). Diagnostic accuracies of nodal metastasis in two modalities were similar. Using CE PET/CT, distant metastasis, scalene node metastasis, and peritoneal dissemination were correctly assigned in 39 patients (91%), while interpretation based on non-CE PET/CT revealed distant metastasis, scalene node metastasis, and peritoneal dissemination in 42 patients (81%). Diagnostic accuracy of distant metastasis, scalene node metastasis, and peritoneal dissemination with CE PET/CT was significantly higher than that of non-CE PET/CT (p < 0.05).Conclusion
CE PET/CT allows a more precise assessment of distant metastasis, scalene node metastasis, and peritoneal dissemination in patients with pancreatic cancer. 相似文献15.
Minamimoto R Senda M Uno K Jinnouchi S Iinuma T Ito K Okuyama C Oguchi K Kawamoto M Suzuki Y Tsukamoto E Terauchi T Nakashima R Nishio M Nishizawa S Fukuda H Yoshida T Inoue T 《Annals of nuclear medicine》2007,21(9):481-498
Objective The aim of this study is to survey the situation of 18F-fluorodeoxyglucose-positron emission tomography (FDG-PET) cancer screening in Japan and to describe its performance profile.
Methods “FDG-PET for cancer screening” was defined as FDG-PET or positron emission tomography and computed tomography (PET/CT) scan
with or without other tests performed for cancer screening of healthy subjects. We sent questionnaires regarding FDG-PET cancer
screening to 99 facilities in which FDG-PET tests were performed during the fiscal year 2005. Replies were obtained from 68
of the 99 facilities, of which 46 facilities performed FDG-PET cancer screening. The total number of subjects who underwent
FDG-PET cancer screening was 50 558. From 38 of 46 facilities, reliable results of thorough examinations were obtained for
the subjects who were positive by FDG-PET and/or one or more of the combined screening tests was performed and were referred
for further evaluation. The total number of subjects in these 38 facilities amounted to 43 996.
Results A total of 50 558 healthy subjects underwent FDG-PET (including PET/CT) scanning with or without other tests for cancer screening
in 46 PET centers during the fiscal year of 2005 in Japan. Thorough examination was indicated for 9.8% of the cases as a result
of positive findings suggesting possible cancer. On analyzing 43 996 cases from 38 PET centers from which detailed information
was obtained, 500 cases of cancers (1.14%) were found, of which 0.90% were PET positive and 0.24% were PET negative, resulting
in the relative sensitivity of PET being 79.0%. Cancers of the thyroid, colon/rectum, lung, and breast were most frequently
found (107, 102, 79, and 35 cases, respectively) with high PET sensitivity (88%, 90%, 80%, and 92%). PET showed an overall
positive predictive value of 29.0%. PET/CT had a better detection rate, sensitivity, and positive predictive value than dedicated
PET (P < 0.01).
Conclusions We were able to clarify the performance profile of “FDG-PET for cancer screening” on the basis of a Japanese nationwide survey.
The number of facilities possessing PET is increasing steadily, highlighting the necessity of evaluating the usefulness of
“FDG-PET cancer screening” as soon as possible by undertaking long-term investigations of large series of subjects. 相似文献
16.
PET/CT在乳腺癌中的应用 总被引:2,自引:0,他引:2
乳腺癌是女性最常见的恶性肿瘤,如能得到早期诊断并早期治疗可明显地改善患者的预后情况甚至可以完全治愈。近年来正电子发射断层显像(PET)以及18F-FDG的广泛应用极大地改善了肿瘤患者的诊断和分期问题,及时改变了相应的治疗方法,而单纯的PET显像由于解剖定位欠清,有时正常生理性摄取与异常病理性摄取可能会难以鉴别,PET/CT的出现弥补了上述缺点,使FDGPET/CT在乳腺癌的分期与再分期、疗效监测、术前评估、原发病灶的诊断以及治疗方案的制订中都体现出自身独特的优势。 相似文献
17.
Mohamed Houseni Amr Osama Dalia Ibrahim Mohamed Shahinda Salem 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(1):67-74
Purpose
To assess the value of contrast enhanced CT (ceCT) when added to positron emission tomography combined with the standard low-dose non-contrast CT (PET/CT) protocols for staging patients with malignant pleural mesothelioma (MPM).Methods
Retrospective analysis of 47 patients with pathologically proved MPM. All patients underwent PET/CT with low dose CT followed by ceCT. PET/CT and ce-CT were evaluated separately then in combination. All the results were validated either by histopathology and/or clinical-radiological follow-up. Staging was performed based on TNM system.Results
For T-stage, the sensitivities for PET/CT, ceCT and combined PET/CT-ceCT were 89.1%, 86.9%, and 97.5%, respectively, p = 0.04. Regarding nodal stage, the sensitivity, specificity and accuracy for PET/CT were 88.5%, 90.5%, and 89.4%; for ceCT 73.1%, 95.2% and 82.9%; and for PET/CT-ceCT 96.2%, 95.2% and 95.7%, respectively. PET/CT-ceCT significantly associated with the sensitivity, p = 0.05. Considering the metastatic disease, the sensitivity, specificity and accuracy for PET/CT were 81.3%, 96.8%, and 91.5%; for ceCT 56.3%, 90.3% and 78.7%; and for PET/CT-ceCT 93.8%, 96.8% and 95.7%, respectively. PET/CT-ceCT significantly improved the sensitivity (p = 0.03) and accuracy (p = 0.02). Furthermore, combined PET/CT-ceCT significantly identified patients not suitable for surgery.Conclusion
The addition of ceCT to PET/CT protocol has significantly contributed to the staging of MPM. 相似文献18.
Capirci C Rampin L Erba PA Galeotti F Crepaldi G Banti E Gava M Fanti S Mariani G Muzzio PC Rubello D 《European journal of nuclear medicine and molecular imaging》2007,34(10):1583-1593
PURPOSE: Prediction of rectal cancer response to preoperative, neo-adjuvant chemo-radiation therapy (CRT) provides the opportunity to identify patients in whom a major response is expected and who may therefore benefit from alternative surgical approaches. Traditional morphological imaging techniques are effective in defining tumour extension in the initial diagnostic and staging work-up, but perform poorly in distinguishing residual neoplastic tissue from scarring post CRT, when restaging the patient before surgery. Fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) is a promising tool for monitoring the effect of anti-tumour therapy. The aim of this study was to prospectively assess the value of sequential FDG-PET scans in predicting the response of locally advanced rectal cancer to neo-adjuvant CRT. METHODS: Forty-four consecutive patients with locally advanced (cT3-4) primary rectal cancer and four patients with pelvic recurrence of rectal cancer were enrolled in this prospective study. Treatment consisted of external beam intensified radiotherapy (50 Gy to the posterior pelvis, 56 Gy to the tumour), chemotherapy (in most cases PVI 5-FU at 300 mg/m(2) per day) and, 8-10 weeks later, surgery with curative intent. All patients underwent FDG-PET/CT both before CRT and 5-6 weeks after completing CRT. One patient died before surgery because of acute myocardial infarction, and was therefore excluded from further analysis. Semi-quantitative measurements of FDG uptake (SUV(max)), absolute difference (DeltaSUV(max)) and percent SUV(max) difference (Response Index, RI) between pre- and post-CRT PET scans were considered. Results were correlated with pathological response, assessed both by histopathological staging of the surgical specimens (pTNM) and by the tumour regression grade (TRG) according to Mandard's criteria (patients with TRG1-2 being defined as responders and patients with TRG3-5 as non-responders). RESULTS: Following neo-adjuvant CRT, of the 45 patients submitted to surgery, 23 (51.1%) were classified as responders according to Mandard's criteria (8 TRG1 and 15 TRG2), while the remaining 22 (48.9%) were non-responders (9 TRG3 and 13 TRG4-5). Considering all patients, the mean pre-CRT SUV(max) was 15.6, significantly higher than the mean value of 5.4 post CRT (p < 0.001). Nevertheless, when stratifying patients according to response to CRT (using Mandard's criteria), the mean RI was significantly higher in responders than in non-responders (75.9% versus 46.9%,p = 0.0015). Using a 66.2% SUV(max) decrease as the cut-off value (identified by ROC analysis) for defining response to therapy, the following parameters were obtained: 79.2% specificity, 81.2% sensitivity, 77% positive predictive value, 89% negative predictive value and 80% overall accuracy. CONCLUSION: The results suggest the potential utility of FDG-PET as a complementary diagnostic and prognostic procedure in the assessment of neo-adjuvant CRT response of locally advanced rectal cancer. DeltaSUV(max) and RI seem the best predictors of CRT response. 相似文献
19.
Tomonori Kanda Kazuhiro Kitajima Yuko Suenaga Jyunya Konishi Ryohei Sasaki Koichi Morimoto Miki Saito Naoki Otsuki Ken-ichi Nibu Kazuro Sugimura 《European journal of radiology》2013
Purpose
To assess the clinical value of retrospective image fusion of neck MRI and 18F-fluorodeoxyglucose (18F-FDG) PET for locoregional extension and nodal staging of neck cancer.Materials and methods
Thirty patients with carcinoma of the oral cavity or hypopharynx underwent PET/CT and contrast-enhanced neck MRI for initial staging before surgery including primary tumor resection and neck dissection. Diagnostic performance of PET/CT, MRI, and retrospective image fusion of PET and MRI (fused PET/MRI) for assessment of the extent of the primary tumor (T stage) and metastasis to regional lymph nodes (N stage) was evaluated.Results
Accuracy for T status was 87% for fused PET/MRI and 90% for MRI, thus proving significantly superior to PET/CT, which had an accuracy of 67% (p = 0.041 and p = 0.023, respectively). Accuracy for N status was 77% for both fused PET/MRI and PET/CT, being superior to MRI, which had an accuracy of 63%, although the difference was not significant (p = 0.13). On a per-level basis, the sensitivity, specificity and accuracy for detection of nodal metastasis were 77%, 96% and 93% for both fused PET/MRI and PET/CT, compared with 49%, 99% and 91% for MRI, respectively. The differences for sensitivity (p = 0.0026) and accuracy (p = 0.041) were significant.Conclusion
Fused PET/MRI combining the individual advantages of MRI and PET is a valuable technique for assessment of staging neck cancer. 相似文献20.
Value of integrated PET/CT for lesion localisation in cancer patients: a comparative study 总被引:3,自引:1,他引:2
Pelosi E Messa C Sironi S Picchio M Landoni C Bettinardi V Gianolli L Del Maschio A Gilardi MC Fazio F 《European journal of nuclear medicine and molecular imaging》2004,31(7):932-939
The aim of this study was to retrospectively compare the value of integrated PET/CT and separate PET plus morphological imaging studies for lesion localisation in cancer patients. Two different series of consecutive patients who had previously been treated for neoplastic disease were considered. One series consisted of 105 patients who had undergone [18F]fluorodeoxyglucose (FDG) PET/CT (n=70) or [11C]choline PET/CT (n=35) studies (PET/CT group). The other series comprised 105 patients who had undergone FDG PET scan (n=70) or [11C]choline PET scan (n=35) alone; in this series, PET findings were correlated with the results of morphological imaging (MI) studies, i.e. CT (n=92) or MR imaging (n=13) (PET+MI group). Regions of abnormal tracer uptake at PET scanning were classified as ambiguous or unambiguous depending on their precise anatomical localisation. A total of 207 and 196 lesions were found in the PET/CT and PET+MI groups, respectively. The difference in terms of number of lesions per patient detected with the two imaging protocols was not statistically significant (P=0.718). When analysis of lesion localisation was performed, there were 7/207 (3.4%) and 30/196 (15.3%) ambiguous lesions in the PET/CT and PET+MI groups, respectively. The number of ambiguous lesions was significantly higher in the PET+MI group than in the PET/CT group (2=15.768, P<0.0001). Comparison of the effect of use of the different tracers on reporting of PET/CT versus PET+MI revealed that the improvement in the final report in [11C]choline PET/CT studies was similar to that observed in [18F]FDG studies. In cancer patients, PET/CT shows higher diagnostic accuracy for lesion localisation than PET plus morphological imaging studies performed independently. This result does not seem to be affected by the type of tracer used. 相似文献