18F-FDG PET/CT在可疑神经系统副肿瘤综合征中的应用价值

目的 探讨18F-脱氧葡萄糖(FDG)PET/CT显像探测临床可疑神经系统副肿瘤综合征(PNS)患者潜在肿瘤病灶的应用价值.方法 回顾性分析20例可疑PNS患者18F-FDG PET/CT显像资料,对所有患者行随访病理检查或临床最终诊断,并将结果与PET/CT显像和随访结果进行比较.结果 20例中PET/CT显像发现可疑恶性病变或既往肿瘤复发和(或)转移者9例,阴性11例.9例阳性者中3例为假阳性.PET/CT显像对PNS恶性肿瘤检出的灵敏度、特异性、准确性、阳性预测值和阴性预测值分别为6/6,78.57%(11/14),85.00%(17/20),6/9和100.00%(11/11).6例真阳性中4例治疗方案得以修正,经抗肿瘤和免疫疗法后神经异常症状得到改善.结论 18F-FDG PET/CT显像在可疑PNS中的应用有积极意义,有助于发现恶性肿瘤,也能对肿瘤分期提供帮助.     

18F-FDG PET/CT在可疑神经系统副肿瘤综合征中的应用价值

目的 探讨18F-脱氧葡萄糖（FDG）PET/CT显像探测临床可疑神经系统副肿瘤综合征（PNS）患者潜在肿瘤病灶的应用价值.方法 回顾性分析20例可疑PNS患者18F-FDG PET/CT显像资料,对所有患者行随访病理检查或临床最终诊断,并将结果与PET/CT显像和随访结果进行比较.结果 20例中PET/CT显像发现可疑恶性病变或既往肿瘤复发和（或）转移者9例,阴性11例.9例阳性者中3例为假阳性.PET/CT显像对PNS恶性肿瘤检出的灵敏度、特异性、准确性、阳性预测值和阴性预测值分别为6/6,78.57%（11/14）,85.00%（17/20）,6/9和100.00%（11/11）.6例真阳性中4例治疗方案得以修正,经抗肿瘤和免疫疗法后神经异常症状得到改善.结论 18F-FDG PET/CT显像在可疑PNS中的应用有积极意义,有助于发现恶性肿瘤,也能对肿瘤分期提供帮助.     

18-FDG PET/CT在肝癌治疗后AFP升高患者中的应用

目的 探讨18F-脱氧葡萄糖(FDG)PET/CT检测肝癌治疗后甲胎蛋白(AFP)升高患者肿瘤复发和(或)转移病灶的价值.方法 原发性肝细胞癌治疗后血清AFP升高患者123例,皆行全身18F-FDG PET/CT显像.所有图像经图像融合后,进行PET/CT融合图像、PET图像和CT图像帧对帧对比分析.肿瘤复发和(或)转移病灶根据病理检查结果、多种影像学诊断及临床随访而确诊.随访时间均>6个月.采用SPSS 11.5软件进行统计学处理,进行X2检验.结果 123例患者中,明确诊断肿瘤复发和(或)转移者111例.18F-FDG PET显像诊断肿瘤复发和(或)转移78例,其灵敏度为70.3%(78/111);18F.FDG PET/CT显像诊断肿瘤复发和(或)转移97例,灵敏度提高至87.4%(97/111,χ2=9.744,P=0.002).18F.FDG PET/CT诊断肝癌复发和转移的特异性、准确性、阳性预测值和阴性预测值分别为83.3%(10/12)、87.0%(107/123)、98.0%(97/99)和41.7%(10/24).9例高分化肝细胞癌患者均确诊为肿瘤复发和(或)转移,18F-FDG PET/CT显像诊断其肿瘤复发和(或)转移5例,灵敏度(5/9)明显低于总体灵敏度(87.4%;χ2=6.616,P=0.01).结论 18F-FDG PET/CT显像在检测原发性肝癌治疗后AFP升高患者肿瘤复发和(或)转移病灶中有较好的应用价值,但高分化肝细胞癌可能出现假阴性.     

腹腔积液患者14例18F-FDG PET临床分析

目的 探讨腹腔积液患者18F-脱氧葡萄糖(FDG)PET显像的临床应用价值.方法 对14例腹腔积液患者的18F-FDG PET显像资料进行回顾性分析,随访其最终的病理检查结果、生存期等,并将18F-FDG PET显像资料和随访结果进行比较.用SAS 6.12软件进行统计学处理.结果 18F-FDG PET显像发现腹腔积液由恶性肿瘤引起者5例,良性病变引起者6例,假阳性1例和假阴性2例.18F-FDG PET显像对恶性肿瘤引起腹腔积液原发灶的检出灵敏度、特异性、阳性预测值和阴性预测值分别为5/7,6/7,5/6和6/8;18F-FDG PET显像示阳性者及阴性者其平均生存期分别为8.5(1～36)个月和15.5(3～50)个月,2组间差异有统计学意义(χ2=4.42,P≤0.05).结论 18F-FDG PET显像在腹腔积液患者的临床应用中有积极意义,尤其对于恶性腹腔积液原发灶的检出有一定的应用价值;同时,有助于预测腹腔积液阳性显像患者的生存期.     

PET/CT显像在宫颈癌原发灶诊断及盆腔淋巴结分期的价值

目的:评价18F-FDG PET/CT显像在诊断宫颈癌原发灶及盆腔淋巴结分期中的临床应用价值.方法:回顾性分析58例患者在手术前PET/CT显像结果,所有恶性肿瘤患者均经手术治疗并行盆腔淋巴结清扫,良性患者经病理及组织学证实,将PET/CT显像结果与病理结果进行对比分析.结果:58例患者中,有28例为宫颈癌,PET/CT显像真阳性24例,真阴性28例,假阴性4例,假阳性2例,与病理结果对比,PET/CT诊断宫颈癌准确率、灵敏度、特异性、阳性预测值和阴性预测值分别为87.9%、85.7%、90%、92.3%、84.3%.28例恶性肿瘤患者,手术共取出盆腔大小不同淋巴结162枚,其中转移淋巴结35枚,与病理和随访结果对比,PET/CT诊断真阳性29枚,假阳性10枚,其诊断的准确率、灵敏度、特异性、阳性预测值和阴性预测值分别为90.1%、82.9%、92.1%;74.4%、95.1%.结论:PET/CT显像对诊断宫颈癌原发灶与盆腔淋巴结转移的准确率高.     

18F-FDG PET/CT在黑色素瘤中的应用价值

目的 探讨18F-脱氧葡萄糖(FDG)PET/CT显像在黑色素瘤诊断、临床分期及监测治疗后肿瘤复发与转移灶中的应用价值.方法 黑色素瘤患者61例,均进行18F-FDG PET/CT全身显像.所有PET、CT及PET/CT融合图像均通过融合软件进行帧对帧对比分析.肿瘤病灶根据病理学检查、多种影像学检查及临床随访结果诊断.结果 18F-FDG PET/CT显像对黑色素瘤病灶检出的灵敏度、特异性和准确性分别为90.9%(40/44)、88.2%(15/17)和90.2%(55/61).其中12例治疗前患者中,18F-FDG PET/CT显像诊断的灵敏度为83.3%(10/12).在黑色素瘤病灶局部切除、尚未进行其他治疗的9例患者中,5例残余病灶18F-FDG PET/CT显像检出3例;4例远处转移灶患者全被检出,提高了临床分期,改变了治疗方案.首先发现转移性黑色素瘤病灶并且手术切除后,寻找原发灶的7例患者中,18F-FDG PET/CT检出原发灶2例,4例其他转移灶全被检出.黑色素瘤患者根治术后监测肿瘤复发或转移患者33例,18F-FDG PET/CT显像灵敏度、特异性和准确性分别为100.0%(19/19)、85.7%(12/14)和93.9%(31/33).与同期临床其他影像学检查比较,18F-FDG PET/CT显像发现更多,33例患者中,16例(48.5%)病灶提高临床分期;7例(21.2%)排除可疑病灶,降低临床分期;10例(30.3%)检出病灶与临床一致.结论 18F-FDG PET/CT显像对于黑色素瘤的诊断,残余病灶、复发病灶及转移灶的检出,临床分期的明确具有重要价值.     

11C-胆碱对18F-FDG PET/CT显像诊断鼻咽癌和肝细胞肝癌的补充价值

目的 探讨11C-胆碱(CHO) PET/CT对18F-FDG PET/CT显像诊断鼻咽癌(NPC)和HCC的补充价值.方法 将明确诊断的NPC和HCC患者纳入该研究.该研究经医院伦理委员会通过,患者均签署知情同意书.2007年12月至2010年1月,15例局部进展型NPC和76例HCC患者均行18 F-FDG PET/CT显像,其中43例(15例NPC和28例HCC)同时行局部11C-CHO PET/CT显像.病灶处出现18 F-FDG或11C-CHO高摄取者为阳性.半定量分析采用SUVmax、肿瘤/脑(T/B)比值和肿瘤/肝(T/L)比值等指标.统计学分析采用两样本t检验、x2检验、Fisher确切概率法和直线相关分析.结果 (1)在15例局部进展型NPC患者中,病灶处18F-FDG SUVmax明显高于11 C-CHO SUVmax (12.81 ±5.00与6.84±2.76;t =6.416,P＜0.01),但11C-CHO PET/CT显像T/B比值明显高于18F-FDG PET/CT显像(18.62±7.95与1.38±0.59;t=8.801,P＜0.01).2种显像剂在病灶处的摄取结果明显相关(r =0.712,P＜0.01).与18F-FDG PET/CT显像比较,11C-CHO显像改进了50.0％(12/12与6/12;x2=8.000,P＜0.05)患者颅内侵犯病灶、4/14患者颅底侵犯病灶和3/3患者眼眶侵犯病灶的显示.(2)在76例HCC患者中,63.1％ (48/76)的患者18F-FDG PET/CT显像阳性.在28例18 F-FDG PET/CT显像阴性者中,71.4％ (20/28)的患者11C-CHO PET/CT显像阳性.18F-FDG联合11C-CHO使PET/CT诊断HCC的灵敏度从63.1％(48/76)提高到89.5％ (68/76;x2=14.559,P＜0.01).与18F-FDG PET/CT显像比较,11C-CHO PET/CT显像倾向易于检出高分化HCC[6/9与35.7％(5/14);P =0.214];在检测中分化HCC方面,两者差异无统计学意义[6/7与72.0％(18/25),P=0.648].11C-CHO PET/CT显像在检测直径＜5.0 cm的HCC方面较18 F-FDG PET/CT显像灵敏[72.7％ (16/22)与42.1％ (16/38);x2=5.249,P＜0.05],特别是＜2.0 cm病灶[5/7与0/7;P=0.021].结论 11C-CHO与18F-FDG相结合可提高PET/CT对局部进展型NPC T分期诊断的准确性.11C-CHO可弥补18F-FDG显像在高中分化HCC诊断中的不足,从而提高PET/CT的诊断灵敏度.     

PET-CT显像在结肠直肠癌术后复查的临床应用

目的:评价18F-脱氧葡萄糖(FDG)PET-CT显像与CT扫描在诊断结肠直肠癌术后转移与否的准确性。方法:20例临床可疑(血清癌胚抗原(CEA)升高或CT显像阳性或可疑)结肠直肠癌术后转移的患者行全身18F-FDG PET-CT显像,PET-CT显像结果与CT扫描结果对比分析。结果:20例患者共有病灶27个,病理组织学结果及临床随访结果证实,20个恶性病灶,7个良性病灶。PET-CT显像的阳性预测值为94.7%,阴性预测值为75%,CT扫描结果的阳性预测值为81.3%,阴性预测值为36.3%,两者有显著性差异。结论:全身18F-FDG PET-CT显像在诊断结肠直肠癌术后转移与否的准确性高于比CT扫描结果。     

18F-FDG PET显像在头颈部肿瘤中的应用

目的 探讨^18F-脱氧葡萄糖（FDG）PET显像在头颈部肿瘤中的应用.方法 39例头颈部肿瘤患者,共行56次^18F-FDG PET检查.图像分析采用视觉和半定量（标准摄取值,SUV）方法.结果 ①5例治疗前患者,PET显像使3例改变了分期;34例治疗后患者中,PET显像发现6例头颈部有残存或复发灶,11例淋巴结转移,4例肺部转移,3例骨转移.②22例PET显像阳性患者中,20例经手术病理检查或随访证实,2例假阳性;17例PET显像为阴性的患者均得到随访证实.PET显像用于头颈部肿瘤病情监测的灵敏度为100%,特异性为89.5%,准确性为94.9%.③21例患者有近期CT或MRI检查结果,其中6例PET显像发现了CT或MRI未发现的局部复发病灶和转移淋巴结.6例患者CT或MRI提示有肿瘤复发或转移,但PET显像结果阴性,并经随访证实.④9例患者多次进行PET检查随访,其中5例病灶消失,3例病情进展,1例无变化.结论 ^18F-FDG PET显像可较准确地发现头颈部肿瘤的残存、转移和复发病灶,并为肿瘤分期提供重要依据,但应与炎症鉴别.     

18F-FDG PET/CT显像在宫颈癌术后复发和转移中的应用价值

目的 探讨18F-FDG PET/CT显像在宫颈癌术后复发和转移中的应用价值.方法 搜集临床可疑宫颈癌术后复发和转移患者65例,年龄23～77岁,平均48.7岁.所有宫颈癌患者均经手术病理确诊并行根治性治疗,其中鳞癌47例,腺癌12例,腺鳞癌4例,透明细胞癌1例,小细胞癌1例.患者均行18F-FDG PET/CT全身显像检查,采用目测法和半定量法判断结果,并与组织病理或临床随访结果比较其诊断的准确性,以及评价其诊断的真实性和可靠性.结果 65例患者经组织病理或临床随访证实50例复发和转移.18F-FDG PET/CT显像诊断肿瘤局部复发18例,肿瘤转移33例,复发和转移病灶的SUVmax 2.91 ～ 16.70,平均SUVmax 9.81,18F-FDG PET/CT显像诊断宫颈癌术后复发和转移的灵敏度为98.00％,特异性为86.67％,准确性为95.38％,阳性预测值为96.08％,阴性预测值为92.86％;18F-FDG PET/CT显像诊断结果与组织病理或临床随访结果比较差异无统计学意义(经x2检验,P＞0.05);二者结果的吻合度有统计学意义且吻合度较强(系数k=0.867,P=0.000).结论 18F-FDG PET/CT显像能够准确、直观地显示宫颈癌术后复发和转移,且真实性和可靠性好;同时18F-FDG PET/CT全身显像检查是肿瘤远处转移探测最有效的方法,可较全面评估患者病情,对协助临床确定个体化治疗方案具有重要价值.     

^18F-FDG PET／CT显像诊断妇科肿瘤复发、转移的价值

目的探讨^18F-脱氧葡萄糖（FDG）PET／CT显像诊断妇科肿瘤复发、转移的价值,并评价其对临床再分期及治疗决策的影响。方法对47例临床可疑复发、转移的妇科肿瘤患者行^18F—FDG PET／CT显像,对PET、CT及PET／CT图像进行对比分析。采用SPSS12．0软件,对数据行∥检验、校正的,检验及确切概率法分析。结果47例患者中共发现病灶158处,其中恶性病灶149处,良性病灶9处。^18F-FDG PET／CT诊断妇科肿瘤复发、转移的灵敏度、特异性、准确性、阳性预测值及阴性预测值分别为95．97％（143／149）,6／9,94．30％（149／158）,97．95％（143／146）及50．00％（6／12）。PET／CT在诊断妇科肿瘤复发、转移的灵敏度、准确性及阴性预测值方面明显优于单纯CT（χ^2=18．198,18．890,6．825,P均〈0．05）;^18F-FDG PET／CT和单纯PET在各项诊断效能指标间差异无统计学意义（χ^2=0．632,0．000,0．459,0．000,0．150,P均〉0．05）,但PET／CT使33．54％（53／158）的单纯PET无法准确定位的病灶得到了准确定位。同单纯CT及PET相比,PET／CT分别使44．68％（21／47）和31．91％（15／47）的患者TNM分期改变,对T分期的影响最明显;共有19．15％（9／47）的患者临床分期改变,并改变相应的治疗决策。结论^18F—FDG PET／CT显像诊断妇科肿瘤复发、转移准确而全面,对临床再分期及治疗决策有重要影响。     

18F-FDG-PET/CT in the diagnosis of paraneoplastic neurological syndromes: a retrospective analysis

Objectives

Paraneoplastic neurological syndromes (PNS) constitute a challenging diagnostic problem, as the underlying tumour often remains unidentified for a long time, even with frequent conventional diagnostic procedures. For appropriate patient management timely identification of the tumour is critical. We evaluated the value of ¹⁸F-FDG-PET/CT in the investigation of PNS.

Methods

The case notes of 46 consecutive patients with clinically suspected PNS who underwent ¹⁸F-FDG-PET/CT were reviewed retrospectively and the performance of PET/CT for detecting underlying tumours was assessed.

Results

PET/CT detected foci of increased ¹⁸F-FDG uptake in 10 out of 46 patients. In six of these 10 patients combined PET/CT identified the underlying disease: four patients suffered from PNS; vasculitic and local metastatic disease was detected in two other patients.

Conclusions

Based on our results, we believe that the role of positron emission tomography in the detection of occult neoplasms in patients with PNS has been overestimated in the past. In clinical practice, PNS is far more often suspected than proven. In our study combined PET/CT identified malignancy as the underlying cause of suspected PNS in only 8.7% (4/46). We believe that combined PET/CT should be reserved for stringently selected patients with a high clinical index of suspicion for PNS and after conventional imaging techniques fail to detect a tumour.     

18F-FDGPET／CT诊断腹膜转移瘤的临床价值

目的评价18F-脱氧葡萄糖（FDG）PET／CT在腹膜转移瘤诊断中的临床价值。方法回顾性分析22例有原发恶性肿瘤手术史或不明原因腹腔积液而临床高度怀疑腹膜转移的患者资料。所有病例均行18F—FDGPET／CT检查,经病理检查或临床随访证实。结果22例中,有18例18F-FDGPET／CT诊断阳性,其中16例确诊腹膜转移,2例确诊为腹腔结核;4例PET／CT诊断阴性,其中3例确诊为腹膜炎性病变,1例确诊为腹膜转移瘤。18F—FDGPET／CT诊断腹膜转移瘤的灵敏度为94．1％（16／17）,特异性为3／5,阳性预测值为88．9％（16／18）,阴性预测值为3／4,准确性为86．4％（18／22）。结论在诊断腹膜转移瘤方面,18F—FDGPET／CT是一种可靠的、准确性较高的无创性检查,有重要的临床应用价值。     

Accuracy of integrated FDG-PET/contrast-enhanced CT in detecting pelvic and paraaortic lymph node metastasis in patients with uterine cancer

The purpose is to evaluate the accuracy of integrated ¹⁸F-fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography ((CT) with intravenous contrast medium in detecting pelvic and paraaortic lymph node metastasis in patients with uterine cancer, with surgical and histopathological findings used as the reference standard. Forty-five patients with endometrial or uterine cervical cancer underwent radical hysterectomy, including pelvic lymphadenectomy with or without paraaortic lymphadenectomy, after PET/CT. PET/CT findings were interpreted by two experienced radiologists in consensus. The criterion for malignancy on PET/CT images was increased tracer uptake by the lymph node, independent of node size. The overall node-based sensitivity, specificity, PPV, NPV and accuracy of PET/CT for detecting nodal metastases were 51.1% (23/45), 99.8% (1,927/1,931), 85.2% (23/27), 98.9% (1,927/1,949) and 98.7% (1,950/1,976), respectively. The sensitivity for detecting metastatic lesions 4 mm or less in short-axis diameter was 12.5% (2/16), that for between 5 and 9 mm was 66.7% (16/24), and that for 10 mm or larger was 100.0% (5/5). The overall patient-based sensitivity, specificity, positive predictive value ((PPV), negative predictive value (NPV), and accuracy were 50% (6/12), 90.9% (30/33), 66.7% (6/9), 83.3% (30/36) and 80.0% (36/45), respectively. Integrated FDG-PET/contrast-enhanced CT is superior to conventional imaging, but only moderately sensitive in predicting lymph node metastasis preoperatively in patients with uterine cancer.     

18F-FDG PET/CT显像诊断心包恶性病变的价值

目的 评价18F-脱氧葡萄糖（FDG）PET/CT对心包恶性病变的诊断价值.方法 对23例心包积液患者进行18F-FDG PET/CT显像,并采用两独立样本非参数检验分析良恶性病灶最大标准摄取值（SUVmax）差异有无统计学意义.结果 经病理检查证实恶性心包积液14例,良性心包积液9例.1例PET/CT假阴性,2例PET/CT假阳性.18F-FDG PET/CT鉴别诊断良恶性心包积液的灵敏度、特异性、准确性、阳性预测值、阴性预测值分别为92.9%（13/14）、7/9、87.0%（20/23）、86.7%（13/15）和7/8.良、恶性病变的SUVmax中位值分别为2.2和6.0,两者间比较差异有统计学意义（z=-3.279,P=0.001）.结论 18F-FDG PET/CT是评价心包恶性病变较好的无创性手段,对良恶性心包积液的诊断与鉴别诊断有一定临床价值.     

Adrenal lesions: characterization with fused PET/CT image in patients with proved or suspected malignancy--initial experience

PURPOSE: To retrospectively evaluate the accuracy of the fused positron emission tomographic (PET)/computed tomographic (CT) image for characterization of adrenal lesions in patients who have proved malignancy or are suspected of having malignancy. MATERIALS AND METHODS: Institutional review board approval was received for this retrospective HIPAA-compliant study, and informed consent was waived. Forty-one adrenal lesions in 38 patients (21 men, 17 women; mean age, 66 years; range, 37-86 years) were evaluated with PET/CT. Of the 41 lesions, nine were assumed to be malignant with documentation of enlargement (n = 8) or reduction in size in response to treatment (n = 1), and 32 were assumed to be benign with documentation of stability for 6 months (n = 31) or with confirmation with biopsy results (n = 1). The PET examination findings were positive when adrenal lesion maximum standardized uptake values (SUVs) exceeded hepatic maximum SUVs. CT contrast medium washout analysis was used to further characterize two lesions with PET findings positive for malignancy. The t test was used to assess significant (P < .05) differences between fluorine 18 fluorodeoxyglucose (FDG) uptake of benign lesions and that of malignant lesions. RESULTS: At PET/CT, findings for all malignant lesions were positive (mean adrenal lesion-liver activity ratio, 4.04; range, 1.53-17.08). Of the 32 benign lesions, most (30 of 32) had activity less than that of the liver (mean ratio, 0.66; range, 0.22-0.94). PET/CT demonstrated sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 100%, 93.8%, 81.8%, 100%, and 95.1%, respectively. Incorporating contrast material-enhanced CT with delayed imaging increased specificity to 100% because two lesions with PET findings positive for malignancy were characterized as benign. There was a significant difference between maximum SUV (P < .05) and the ratio of adrenal lesion-liver FDG activity (P < .001) in benign versus malignant adrenal lesions. CONCLUSION: PET/CT provides a powerful combination of functional and attenuation information for adrenal lesion characterization. All malignant lesions were detected at PET/CT, with no false-negative results.     

The Clinical Usefulness of 18F-FDG PET/CT in Patients with Systemic Autoimmune Disease

Purpose

Individuals with systemic autoimmune disease have an increased susceptibility to both inflammation and malignancy. The aim of this study was to evaluate the clinical usefulness of ¹⁸F-FDG PET/CT in patients with systemic autoimmune disease.

Methods

Forty patients diagnosed with systemic autoimmune disease were enrolled. Diagnostic accuracy of FDG PET/CT for detecting malignancy was assessed. FDG PET/CT findings, including maximum standardized uptake (SUVmax) of lymphadenopathy (LAP), liver, bone marrow, spleen, joint and muscles, were considered for the characterization of LAPs.

Results

FDG PET/CT could detect metabolically activated lesions in 36 out of 40 patients (90%) including inflammatory lesions in 28 out of 32 patients (88%). The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of FDG PET/CT for the detection of malignancy were 100, 67, 70, 25, and 100%, respectively. Multiple LAPs were found in 25 of 40 patients (63%), and comprised three malignancies, four cases of tuberculosis, and 18 reactive changes. A SUVmax ratio of bone marrow to liver below 0.78 could distinguish malignancy from tuberculosis + reactive change (AUC = 1.000, sensitivity: 100%, specificity: 100%). The SUVmax ratio of spleen to liver in the reactive group was also significantly higher than that in the malignancy group (P = 0.014). SUVmax of LAP in the TB group was significantly higher than that in the reactive group (P = 0.040).

Conclusions

PET/CT is useful in detecting and differentiating inflammation and malignancy in patients with systemic autoimmune disease. Frequent false-positive interpretations can be minimized by consideration of FDG uptake in bone marrow and spleen.     

18F-FLT和18F-FDG PET/CT对胸段食管癌淋巴结分期诊断的对比研究

目的 评价18F-脱氧胸苷（FLT）PET/CT对未经治疗的胸段食管癌淋巴结分期诊断的价值,并与18F-脱氧葡萄糖（FDG）PET/CT进行比较.方法 选择22例拟行手术治疗的胸段食管癌患者,术前行双显像剂PET/CT检查及淋巴结分期诊断,术后以病理学诊断为＂金标准＂,比较18F-FLT和18F-FDG PET/CT对胸段食管癌淋巴结分期的灵敏度、特异性、准确性、阳性预测值和阴性预测值.应用SPSS 13.0软件进行x2检验.结果 患者均行食管癌切除和淋巴结清扫术,病理检查结果显示16例患者存在淋巴结转移,N0期7例,N1期15例,M1a期6例（其中1例为N0M1a,另外5例为N1M1a）,全组均无M1b期.共检出424枚淋巴结,其中47枚为转移淋巴结.18F-FDG PET/CT诊断呈假阳性的淋巴结14枚,而18F-FLT诊断呈假阳性的淋巴结为3枚;18F-FDG假阴性的淋巴结8枚,18F-FLT假阴性的淋巴结12枚.18F-FLT PET/CT的诊断灵敏度、特异性、准确性、阴性预测值和阳性预测值分别为74.47%（35/47）、99.20%（374/377）、96.46%（409/424）、96.89%（374/386）和92.11%（35/38）,18F-FDG分别为82.98%（39/47）、96.29%（363/377）、94.81%（402/424）、97.84%（363/371）和73.58%（39/53）;两者比较的x2值分别为0.572,6.018,1.017,0.348,3.852,P值分别＞0.05,＜0.05、＞0.05、＞0.05和＞0.05.结论 18F-FLT对食管癌区域淋巴结的诊断灵敏度与18F-FDG显像接近,特异性高于18F-FDG,但仍存在一定的局限性.