Colorectal cancer staging: comparison of whole-body PET/CT and PET/MR

Purpose

Correct staging is imperative for colorectal cancer (CRC) since it influences both prognosis and management. Several imaging methods are used for this purpose, with variable performance. Positron emission tomography–magnetic resonance (PET/MR) is an innovative imaging technique recently employed for clinical application. The present study was undertaken to compare the staging accuracy of whole-body positron emission tomography–computed tomography (PET/CT) with whole-body PET/MR in patients with both newly diagnosed and treated colorectal cancer.

Methods

Twenty-six patients, who underwent same day whole-body (WB) PET/CT and WB-PET/MR, were evaluated. PET/CT and PET/MR studies were interpreted by consensus by a radiologist and a nuclear medicine physician. Correlations with prior imaging and follow-up studies were used as the reference standard. Correct staging was compared between methods using McNemar’s Chi square test.

Results

The two methods were in agreement and correct for 18/26 (69%) patients, and in agreement and incorrect for one patient (3.8%). PET/MR and PET/CT stages for the remaining 7/26 patients (27%) were discordant, with PET/MR staging being correct in all seven cases. PET/MR significantly outperformed PET/CT overall for accurate staging (P = 0.02).

Conclusion

PET/MR outperformed PET/CT in CRC staging. PET/MR might allow accurate local and distant staging of CRC patients during both at the time of diagnosis and during follow-up.

     

Relative clinical utility of simultaneous 18F-fluorodeoxyglucose PET/MRI and PET/CT for preoperative cervical cancer diagnosis

ObjectiveTo investigate the utility of ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) positron emission tomography/magnetic resonance imaging (PET/MRI) for the preoperative diagnosis of cervical cancer.MethodsWe retrospectively analyzed 114 patients who were diagnosed with cervical cancer and underwent PET/MRI (n = 59) or PET/computed tomography (PET/CT) (n = 65) before surgery. The maximal standardized uptake value (SUV_max) and mean SUV (SUV_mean) were determined for regions of interest in the resultant radiographic images.ResultsRelative to PET/CT, ¹⁸F-FDG PET/MRI exhibited higher specificity and sensitivity in defining the primary tumor bounds and higher sensitivity for detection of bladder involvement. The SUV_max and SUV_mean of PET/MRI were remarkably higher than those of PET/CT as a means of detecting primary tumors, bladder involvement, and the lymph node status. However, no significant differences in these values were detected when comparing the two imaging approaches as a means of detecting vaginal involvement or para-aortic lymph node metastasis.ConclusionsThese outcomes may demonstrate the capability of ¹⁸F-FDG PET/MRI to clarify preoperative cervical cancer diagnoses in the context of unclear PET/CT findings. However, studies directly comparing SUVs in different lesion types from patients who have undergone both PET/MRI and PET/CT scans are essential to validate and expand upon these findings.     

18FDG PET/CT与增强CT对胰腺癌分期的价值

目的比较PET/CT与增强CT(CECT)对胰腺癌T和N分期的准确性;探讨PET/CT对胰腺癌治疗前M分期的影响以及最大标准摄取(SUVmax)值与远处转移的关系。方法收集经病理或临床、影像学随诊证实的胰腺癌患者46例,术前全部患者接受PET/CT检查,43例并接受CECT检查,中位间隔时间为6天;对接受手术切除或探查的19例患者以手术所见为参照,比较PET/CT与CECT检查对胰腺癌T和N分期的准确率。结果 19例胰腺癌患者术中发现肿瘤与周围血管粘连或侵犯周围血管/器官,术前CECT明确诊断17例(17/18,94.44%),PET/CT明确诊断3例(3/19,15.79%),CECT对T分期的准确率高于PET/CT。对于N分期,CECT和PET/CT的敏感度、特异度和准确率分别为66.67%(8/12)、100%(7/7)、78.95%(15/19)和75.00%(9/12)、100%(7/7)和84.21%(16/19),二者诊断区域淋巴结转移差异无统计学意义(P=1.00)。46例胰腺癌患者中,PET/CT发现28例血行转移及远隔淋巴结转移,常规影像学分期检出其中的15例。PET/CT明确诊断了5例CT不能肯定的肝脏病灶,并发现2例患者同时存在第二原发癌;ROC曲线分析表明,SUVmax越高,发生血行转移的可能越大,其曲线下面积为0.68,诊断界值为4.80。结论 PET/CT对胰腺癌T分期的准确率远低于CECT;PET/CT和CECT对N分期的敏感度、特异度、准确率相似;PET/CT对M分期和远隔淋巴结转移具有明显优势,并可同时发现第二原发癌灶,SUVmax越高,发生血行转移的可能越大。     

肝脏局灶性病变18F-FDG PET/CT与PET/MR比较分析

目的 比较¹⁸F-FDG PET/CT与PET/MR显像对肝脏局灶性病变（FLLs）的临床应用价值。方法 回顾性分析41例FLLs患者的临床资料、¹⁸F-FDG全身PET/CT及上腹部MR扫描图像。比较CT、MRI、PET、PET/CT及PET/MR对FLLs的检出率。结果 41例FLLs患者中共检出69个病灶,包括肝脏良性病灶22个、肝细胞癌（HCC）17个、转移瘤30个。CT、MRI、PET、PET/CT及PET/MR对FLLs的总体检出率分别为72.46%（50/69）、94.20%（65/69）、55.07%（38/69）、79.71%（55/69）及100%（69/69）。PET/MR对肝脏良性病灶及HCC的检出率（22/22,100%;17/17,100%）均高于PET/CT（13/22,59.09%;12/17,70.59%;P均<0.05）,二者对转移瘤的检出率均为100%（30/30）。结论 PET/MR对FLLs的检出率较高,具有良好的临床应用价值。     

比较PET/CT与PET/MRI诊断成人淋巴瘤

目的 比较PET/CT与PET/MRI诊断成人淋巴瘤的效能。方法 前瞻性观察45例淋巴瘤患者，行全身PET/CT和PET/MR检查，分别由2名医师独立评估PET/CT和PET/MRI，获得病灶最大标准摄取值（SUV_max）及对应D值、D^*值和f值，分析两种模式的诊断效能及分期差异。结果 PET/CT与PET/MRI均测出55个淋巴结和5个结外病灶的SUV_max，基于体素内不相干运动（IVIM）模型测出39个病灶的对应值。医师间对阳性病灶检测率一致性极强（k=1.000），PET/CT与PET/MRI的一致性极强（k=0.956）；对于淋巴瘤分期，PET/CT与PET/MRI一致性极强（k=0.965）；PET/CT与PET/MRI的SUV_max呈高度相关（r=0.892，P<0.001），D值与SUV值低度相关（r=-0.312，P<0.050），f值与SUV值呈中度相关（r=0.520，P<0.001）。结论 PET/CT与PET/MRI对成人均有良好诊断效能，PET/MRI可提高淋巴瘤诊断及分期的准确率，多参数联合可预测和评估肿瘤异质性。     

PET/CT和MRI术前定位神经节细胞胶质瘤相关药物难治性癫痫

目的 评价¹⁸F-FDG PET/CT脑显像和头颅MRI术前定位神经节细胞胶质瘤（GG）相关药物难治性癫痫的价值。方法 回顾性分析23例药物难治性癫痫、且术后病理证实为GG患者，术前均接受MR及PET/CT检查；定性分析MRI信号特点及PET/CT低代谢范围，与术后CT所示手术区域相对照，分析两种方法术前定位GG相关药物难治性癫痫的价值。结果 23例中，12例致痫灶为单一病理类型，11例为多重病理类型，包括5例GG和皮质发育不良（FCD）、4例GG和皮质胶质增生、1例GG累及海马及1例GG、FCD和海马硬化。23例中，18例MRI显示单一部位实性或囊实性异常信号，其中8例（单一病理类型）与手术切除致痫灶范围完全一致；5例MRI阴性。¹⁸F-FDG PET/CT示8例幕上单一部位葡萄糖代谢减低，均与手术所示GG病灶部位一致；15例幕上多部位代谢减低，其中11例与手术切除范围完全一致。MRI定位准确率34.78%，阳性率78.26%；¹⁸F-FDG PET/CT定位准确率82.61%，阳性率为100%（P均<0.05）。结论 ¹⁸F-FDG PET/CT脑显像术前定位GG相关药物难治性癫痫优于MRI；联合应用二者有助于提高定位精准度。     

对比PET/MRI与PET/CT检出肝转移癌效能

目的 对比观察PET/MRI与PET/CT检出肝转移癌的效能。方法 纳入78例共409个肝转移癌病灶,比较PET/CT及PET/MRI检出肝转移癌的阳性率。对A组50例283个病灶先行PET/CT后行PET/MR检查,B组28例126个病灶先行PET/MR后行PET/CT。采用Spearman秩相关分析和Wilcoxon秩和检验评价组内不同检查方法所获病灶最大标准摄取值（SUV_max）的相关性及其差异。结果 PET/MRI对肝转移癌的检出率（381/409,93.15%）明显高于PET/CT（285/409,69.68%,P<0.05）。A组PET/MRI的阳性率（266/283,93.99%）明显高于PET/CT（197/283,69.61%,P<0.05）;PET/MRI与PET/CT的SUV_max高度相关（r=0.84,P<0.05）,而PET/MRI的SUV_max显著高于PET/CT的SUV_max（P<0.05）。B组PET/MRI阳性率（115/126,91.27%）明显高于PET/CT（88/126,69.84%,P<0.05）;PET/MRI与PET/CT的SUV_max中度相关（r=0.74,P<0.05）,且差异无统计学意义（P>0.05）。结论 PET/MRI检出肝转移癌效果优于PET/CT;二者所获SUV_max相关性较好。     

对比分析头颈部鳞状细胞癌PET/CT与PET/MR特征

目的 探讨头颈部鳞状细胞癌（HNSCC）的PET/CT及PET/MR特征。方法 纳入未经抗肿瘤治疗的头颈部鳞状细胞癌患者40例,所有患者均接受PET/CT及头颈部MR检查。由2名观察者独立观察PET阳性病灶,包括阳性原发灶及阳性淋巴结;并对PET/CT、PET/MR T1WI及PET/MR T2WI的图像质量、融合准确度、病灶清晰度、病灶特征等进行评分。分析2名观察者间的一致性。结果 40例患者共90个PET阳性病灶,包括阳性原发灶40个、阳性淋巴结50个。PET/CT、PET/MR T1WI及PET/MR T2WI在图像质量及融合准确度方面差异均无统计学意义（P均>0.05）;在显示阳性原发灶及阳性淋巴结的清晰度方面,PET/MR T1WI及PET/MR T2WI均优于PET/CT（P均<0.05）。40个阳性原发灶中,PET/MR T2WI对29个原发灶的特征显示多于PET/CT,4个原发灶与PET/CT相仿,7个原发灶较PET/CT少。结论 PET/MR在HNSCC诊断中的应用是可行的,在显示头颈部局部病灶时较PET/CT更具优势。     

18F-FDG PET/CT在肾脏肿瘤诊疗中的应用

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。     

Whole-Body [18F]FDG-PET/MRI vs. [18F]FDG-PET/CT in Malignant Melanoma

Purpose

To assess the diagnostic performance of simultaneous whole-body 2-deoxy-2-[¹⁸F]fluoro-D-glucose ([¹⁸F]FDG) positron emission tomography (PET)/magnetic resonance imaging (MRI) compared to [¹⁸F]FDG PET/x-ray computed tomography (CT) for detection of distant metastatic disease in patients with malignant melanoma.

Procedures

We included patients with malignant melanoma who underwent a single injection [¹⁸F]FDG dual-imaging protocol that included whole-body PET/CT and subsequent whole-body PET/MRI for staging or restaging purposes in a prospective setting. Images from both modalities were analyzed by two rater teams for the presence of metastatic lesions. PET/CT–PET/MRI overall agreement as well as region-based accuracies, sensitivities (Se), and specificities (Sp) were computed.

Results

Between July 2014 and December 2018, 22 patients were enrolled. Interrater agreement and overall accuracy (consensus reading) were 78.8 % (95 % CI 71–84.9) and 96.1 % (95 % CI 92.3–98) for PET/MRI and 78 % (70.2–84.3) and 97.4 % (95 % CI 93.7–98.9) for PET/CT, respectively (P?=?0.42). PET/MRI reached a region-based Se of 89.1 % (95 % CI 79.4–94.5) and a Sp of 100 %, whereas PET/CT showed a region-based Se of 92.7 % (95 % CI 84–96.9) and a Sp of 100 % for the detection of metastatic disease in malignant melanoma.

Conclusions

Whole-body [¹⁸F]FDG-PET/MRI appears to be comparable to [¹⁸F]FDG-PET/CT for lesion detection in patients with malignant melanoma.

     

SimPET: a Preclinical PET Insert for Simultaneous PET/MR Imaging

Purpose

SimPET/M7 system is a small-animal dedicated simultaneous positron emission tomography and magnetic resonance imaging (PET/MRI) scanner. The SimPET insert has been upgraded from its prototype with a focus on count rate performance and sensitivity. The M7 scanner is a 1-T permanent magnet-based compact MRI system without any cryogens. Here, we present performance evaluation results of SimPET along with the results of mutual interference evaluation and simultaneously acquired PET/MR imaging.

Procedures

Following NEMA NU 4-2008 standard, we evaluated the performance of the SimPET system. The M7 MRI compatibility of SimPET was also assessed by analyzing MRI images of a uniform phantom under different PET conditions and PET count rates with different MRI pulse sequences. Mouse imaging was performed including a whole-body ¹⁸F-NaF PET scan and a simultaneous PET/MRI scan with ⁶⁴Cu-NOTA-ironoxide.

Results

The spatial resolution at center based on 3D OSEM without and with warm background was 0.7 mm and 1.45 mm, respectively. Peak sensitivity was 4.21 % (energy window?=?250–750 keV). The peak noise equivalent count rate with the same energy window was 151 kcps at 38.4 MBq. The uniformity was 4.42 %, and the spillover ratios in water- and air-filled chambers were 14.6 % and 12.7 %, respectively. In the hot rod phantom image, 0.75-mm-diameter rods were distinguishable. There were no remarkable differences in the SNR and uniformity of MRI images and PET count rates with different PET conditions and MRI pulse sequences. In the whole-body ¹⁸F-NaF PET images, fine skeletal structures were well resolved. In the simultaneous PET/MRI study with ⁶⁴Cu-NOTA-ironoxide, both PET and MRI signals changed before and after injection of the dual-modal imaging probe, which was evident with the exact spatiotemporal correlation.

Conclusions

We demonstrated that the SimPET scanner has a high count rate performance and excellent spatial resolution. The combined SimPET/M7 enabled simultaneous PET/MR imaging studies with no remarkable mutual interference between the two imaging modalities.

     

Ferumoxytol Does Not Impact Standardized Uptake Values on PET/MR Scans

Purpose

Tumor response assessments on positron emission tomography (PET)/magnetic resonance imaging (MRI) scans require correct quantification of radiotracer uptake in tumors and normal organs. Historically, MRI scans have been enhanced with gadolinium (Gd)-based contrast agents, which are now controversial due to brain deposition. Recently, ferumoxytol nanoparticles have been identified as an alternative to Gd-based contrast agents because they provide strong tissue enhancement on MR images but are not deposited in the brain. However, it is not known if the strong T1- and T2-contrast obtained with iron oxide nanoparticles such as ferumoxytol could affect MR-based attenuation correction of PET data. The purpose of our study was to investigate if ferumoxytol administration prior to a 2-deoxy-2-[¹⁸F]fluoro-d-glucose [¹⁸F]FDG PET/MR scan would change standardized uptake values (SUV) of normal organs.

Procedures

Thirty pediatric patients (6–18 years) with malignant tumors underwent [¹⁸F]FDG-PET/MR scans (dose 3 MBq/kg). Fifteen patients received an intravenous ferumoxytol injection (5 mg Fe/kg) prior to the [¹⁸F]FDG-PET/MR scans (group 1). Fifteen additional age- and sex-matched patients received unenhanced [¹⁸F]FDG-PET/MR scans (group 2). For attenuation correction of PET data, we used a Dixon-based gradient echo sequence (TR 4.2 ms, TE 1.1, 2.3 ms, FA 5), which accounted for soft tissue, lung, fat, and background air. We used a mixed linear effects model to compare the tissue MRI enhancement, quantified as the signal-to-noise ratio (SNR), as well as tissue radiotracer signal, quantified as SUVmean and SUVmax, between group 1 and group 2. Alpha was assumed at 0.05.

Results

The MRI enhancement of the blood and solid extra-cerebral organs, quantified as SNR, was significantly higher on ferumoxytol-enhanced MRI scans compared to unenhanced scans (p?<?0.001). However, SUVmean and SUVmax values, corrected based on the patients’ body weight or body surface area, were not significantly different between the two groups (p?>?0.05).

Conclusion

Ferumoxytol administration prior to a [¹⁸F]FDG PET/MR scan did not change standardized uptake values (SUV) of solid extra-cerebral organs. This is important, because it allows injection of ferumoxytol contrast prior to a PET/MRI procedure and, thereby, significantly accelerates image acquisition times.

     

18F-FDG PET/CT参数联合临床特征预测手术治疗早期宫颈癌患者预后

目的探讨18 F-FDG PET/CT参数联合临床特征对预测早期宫颈癌患者手术治疗后预后的价值。方法回顾性分析70例术前接受18 F-FDG PET/CT检查的早期宫颈癌患者,比较术后复发组与无复发组间代谢参数的差异,评价18 F-FDG PET/CT参数结合临床特征对预后的预测价值。结果术后平均随访(53.86±15.74)个月,期间11例(11/70,15.71%)肿瘤复发。相关18 F-FDG PET/CT参数中,峰值标准摄取值(SUV peak)可预测肿瘤复发(AUC=0.672,P=0.03)。多因素比例风险模型(Cox)显示,淋巴结转移状态及SUV peak是最主要的预测因素。结论SUV peak和淋巴结转移状态是评价手术治疗后早期宫颈癌患者预后的主要指标。     

18F-FDG PET/CT在乳腺外Paget病分期及随访中的应用(附11例报道)

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。     

18F-FDG PET/CT半定量分析诊断颈部淋巴结转移癌的价值

目的 探讨18 F-FDG PET/CT诊断颈部淋巴结转移癌的价值.方法 回顾性分析48例颈部淋巴结肿大患者的CT、PET及PET/CT图像,在CT图像上分别以淋巴结最短径＞0.5 cm(A标准)、最短径＞1.0 cm(B标准)及最长径＞1.0 cm(C标准)为判定淋巴结转移的诊断标准;在PET图像上,以淋巴结出现异常18F-FDG摄取浓聚灶最大标准化摄取值(SUVmax)＞2.5(D标准),SUVmax＞1.93(E标准)、TSUVmax/NSUVmax＞3.11(F标准)为判定淋巴结转移的诊断标准;在PET/CT图像上,将结合CT图像A标准及PET图像E标准确定的G标准为判定以淋巴结转移的诊断标准.以病理诊断为标准,比较不同影像标准在颈部淋巴结转移中的诊断价值.结果 颈部阳性淋巴结与阴性淋巴结在最长径、最短径、SUVmax值之间的差异均有统计学意义.7种标准中,PET(E标准)及PET/CT(G标准)具有较高的诊断准确率与病理吻合度,与单纯CT比较具有较高诊断价值.不同PET及PET/CT诊断标准差异无统计学意义.结论 18F-FDG PET/CT对颈部淋巴结转移的诊断具有较高的临床价值.     

18F-FDG PET/CT诊断肾细胞癌

目的 探讨¹⁸F-FDG PET/CT诊断肾细胞癌（RCC）的价值。方法 回顾性分析32例确诊为RCC患者的病理及PET/CT影像资料,比较不同病理类型（透明细胞癌与非透明细胞癌）、Fuhrman分级（高级别与低级别透明细胞癌）和临床分期（有无远处转移）RCC的肿瘤直径和最大标准摄取值（SUV_max）差异。结果 32例患者共33个原发灶,PET/CT检出31个,2个假阴性,检出率为93.94%（31/33）。31个原发灶PET/CT表现为肾实质内混杂密度的软组织团块,其¹⁸F-FDG摄取可接近、高于或低于正常肾实质;2个原发灶PET/CT未见异常表现。8例伴静脉瘤栓,19例伴远处转移,瘤栓及转移灶的FDG摄取均高于受累器官本底。不同病理类型组和不同Fuhrman分级RCC的肿瘤最长径及SUV_max差异无统计学意义;不同临床分期RCC的肿瘤最长径差异无统计学意义,SUV_max差异有统计学意义（t=3.852,P=0.001）。结论 RCC原发灶的PET/CT表现多样,较小的低级别肾透明细胞癌可无明显异常表现而漏诊;¹⁸F-FDG PET/CT在RCC术前分期中具有重要价值。     

磁共振弥散加权成像在宫颈癌诊断和分期中的价值

目的 探讨磁共振弥散加权成像(DWI)及表观弥散系数(ADC)值对于宫颈癌检测的敏感性及分期的准确性.方法 对经病理证实的67例宫颈癌患者(宫颈癌组)、20名女性健康志愿者(对照组)行常规MRI及DWI检查;比较DWI结合MR常规序列与单纯MR常规序列对宫颈癌分期诊断的差异;分析正常志愿者宫颈三层(颈管内膜、结合带、肌层)与宫颈癌的ADC值差异.结果 DWI结合MRI常规序列检出全部病例,单纯MRI常规序列检测出64例,漏诊3例,准确率为95.52%.对于各期宫颈癌及全部病例分期诊断中,DWI结合MRI常规序列与单纯MRI常规序列之间差异均无统计学意义.对照组宫颈三层平均ADC值分别为颈管内膜(1.54±0.15)×10-3 mm2/s,结合带(1.56±0.16)×10-3 mm2/s,肌层(1.81±0.16)×10-3 mm2/s;宫颈内膜与结合带间差异无统计学意义,二者与肌层之间差异有统计学意义;颈管癌平均ADC值为(1.05±0.20)×10-3 mm2/s,正常颈管内膜与宫颈癌之间差异有统计学意义.结论 相对于MRI常规序列,DWI结合常规MRI序列对于检测宫颈癌更敏感;DWI对于区分正常宫颈与宫颈癌有重要价值.     

18F-FDG PET/CT诊断多发性骨髓瘤

目的 探讨18F-FDG PET/CT对多发性骨髓瘤(MM)的诊断价值.方法 MM患者20例,均于治疗前进行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.肿瘤病灶根据穿刺活组织病理学检查、多种影像学检查和临床随访结果 诊断.结果 19例18F-FDG PET/CT检出阳性病灶(95.00%),SUV为2.81±0.98(1.30～6.00), 共检出病灶303处,其中PET有222处表现为18F-FDG摄取增高(73.27%),CT检出268处灶状溶骨性改变(88.45%).PET和CT同时检出的病灶为187处(61.72%);PET检出而同机CT未检出的病灶35处(11.55%);同机CT检出而PET未检出病灶81处(26.73%).结论 18F-FDG PET/CT对于MM的诊断及评价全身累及范围具有一定价值.     

同时性多发原发癌治疗前的18F-FDG PET/CT显像

目的 探讨对同时性多发原发癌患者治疗前进行¹⁸F-FDG PET/CT显像的价值。方法 回顾性分析经手术或活组织病理学检查确诊的治疗前同时性多发原发癌患者11例,均接受全身¹⁸F-FDG PET/CT检查,通过诊断试验法计算PET/CT检查的灵敏度。结果 治疗前11例同时性多发原发癌患者中,7例(7/11,63.64%)肿瘤来源于消化系统;共检出病灶25个,包括食管7个、胃部4个、结肠5个、直肠2个,肺部4个,喉部2个,骨髓1个,其中18个(18/25,72.00%)肿瘤起源于消化系统。PET/CT诊断灵敏度为88.00%。假阴性发生在肺泡细胞癌、黏液腺癌及微小病灶;假阳性发生在腺瘤性息肉。2例无症状查体者PET/CT检查发现多发原发癌,其中1例接受5次PET/CT检查,PET/CT随访无肿瘤复发。3例患者在明确原发灶、寻找转移灶过程中发现第二原发癌。结论 PET/CT在同时性多发原发癌的发现及诊断中具有一定价值。     

一体化^(18)F-FDG PET/MRI用于诊断胰腺肿瘤北大核心CSCD

目的探讨一体化^(18)F-FDG PET/MRI鉴别胰腺良、恶性病变和检测淋巴结和/或远处转移的价值。方法回顾性分析45例临床疑诊胰腺肿瘤并接受^(18)F-FDG PET/MRI患者,包括38例胰腺恶性病变和7例良性病变,以病理或随访结果为标准,评价一体化PET/MRI诊断胰腺良、恶性病变的效能。结果取3.20为最大标准摄取值(SUV_(max))的截断值,^(18)F-FDG PET/MRI诊断胰腺癌的敏感度、特异度、准确率、阳性预测值和阴性预测值分别为89.47%(34/38)、85.71%(6/7)、88.89%(40/45)、97.14%(34/35)和60.00%(6/10);以1.78作为平均表观弥散系数(ADC_(mean))的截断值时,其敏感度、特异度、准确率、阳性预测值和阴性预测值分别为97.37%(37/38)、71.43%(5/7)、93.33%(42/45)、94.87%(37/39)和85.71%(6/7);联合应用二者则分别为100%(38/38)、71.43%(5/7)、95.56%(43/45)、95.00%(38/40)和100%(5/5)。15例检查前未发现肝、肺、骨及淋巴结转移患者中,根据^(18)F-FDG PET/MRI结果,12例的治疗方案获得修正。结论一体化^(18)F-FDG PET/MRI是检测胰腺癌淋巴结和/或远处转移的较好方法;SUV_(max)与ADC_(mean)对于鉴别胰腺良、恶性病变具有较高价值。