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目的 探讨18F-FDG PET与99Tcm-MDP显像对肿瘤骨转移的诊断价值。方法 93例肿瘤患者2周内行18F-FDG PET和99Tcm-MDP显像,比较分析两种显像结果。结果 93例肿瘤患者PET和MDP诊断骨转移64例。64例骨转移患者中PET和MDP阳性43例,PET阳性而MDP阴性16例,PET阴性而MDP阳性5例。18F-FDG PET和99Tcm-MDP显像诊断骨转移的灵敏度分别为92.2 %,75.0 %(P<0.05);特异度分别为93.1 %,79.3 %(P>0.05);准确度分别为92.5 %,76.3 %(P<0.01)。结论 18F-FDG PET诊断肿瘤骨转移的灵敏度和准确性显著高于99Tcm-MDP显像。18F-FDG PET对骨转移有一定的诊断价值。 相似文献
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摘 要:[目的] 评价18F-FDG PET/CT在心脏肿瘤诊断中的临床应用价值。[方法] 回顾性分析自2014年10月至2017年3月在首都医科大学附属北京安贞医院行18F-FDG PET/CT全身显像的心脏肿瘤患者共27例,患者最终诊断以手术病理结果或随访结果为依据。18F-FDG PET/CT影像心脏占位病变可见明显异常FDG浓聚灶,SUVmax≥5.7判断为恶性病变可能大,并与最终诊断结果进行比较,分析18F-FDG PET/CT在心脏占位性病变良恶性的鉴别能力。采用两样本t检验分析数据。[结果] 27例心脏肿瘤患者中,恶性11例,良性占位16例。18F-FDG PET/CT显像,恶性占位(n=11)平均SUVmax 9.03±4.5(2.0~15.9)明显高于良性心脏占位性病变(n=16)平均SUVmax 3.25±2.51(0.6~10.2),差异有统计学意义(t=4.25,P<0.001)。将SUV≥5.7作为恶性诊断的阈值,18F-FDG PET/CT诊断心脏恶性肿瘤的灵敏度81.8% (9/11),特异性93.8%(15/16),准确率88.9%(24/27)。[结论] 全身18F-FDG PET/CT检查对心脏肿瘤,特别是原发性心脏肿瘤良恶性诊断有重要的临床价值。 相似文献
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18F-FDG PET显像在恶性肿瘤诊断中的应用 总被引:2,自引:0,他引:2
目的:探讨18F-FDGPET在恶性肿瘤诊断过程中的应用。方法:收集2001年1月1日~2005年6月1日之间疑诊或确诊恶性肿瘤患者进行PET检查。测量PET发现病灶的标准化摄取比(standarizeduptakevalue,SUV值)、病灶直径,记录病灶个数。采用SPSS11·5软件对数据进行统计。结果:共收集患者113例,行PET检查141例次,以寻找原发灶为目的的共有15例次,其中有46·7%(7例)找到原发灶;以明确良恶性为目的的67例次,PET判断良恶性的敏感性和特异性分别为75·0%和78·3%;以早期发现转移为目的的共有108例次,在PET发现的40例复发转移中有42·5%(17/40)是真正意义上的早期发现。原发病灶SUV值明显高于转移淋巴结的SUV值(P<0·001),二者分别为5·64±3·72(n=63)和3·64±2·54(n=58);肺原发肿瘤SUV值明显高于肺转移性肿瘤的SUV值(P<0·01),二者分别为6·13±3·26(n=26)和2·98±2·77(n=15)。结论:18F-FDGPET在肿瘤诊断过程中起着非常重要的作用。 相似文献
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目的:旨在评估18F-FDGPET/CT在无症状肿瘤标志物升高患者中的应用价值。方法:选取2008年6 月至2015年7 月间至少有一项肿瘤标志物升高后于天津医科大学肿瘤医院行18F-FDGPET/CT 检查的受检者183 例,并对所有受检者进行随访,分析肿瘤标志物升高与18F-FDGPET/CT 诊断结果之间的关系,研究18F-FDGPET/CT 在无症状肿瘤标志物升高患者中的应用价值。结果:统计分析显示18F-FDGPET/CT 诊断阳性患者43例,其中真阳性患者34例,最常见的阳性部位为肺部,其次为肠道。18F-FDGPET/CT在CEA ,CA199 和(或)CA242 升高患者中具有较好的阳性诊断准确率,其中单项CEA 升高的18F-FDG PET/CT阳性诊断准确率为13.0% 、灵敏度为79.0% ;CEA 或CA242 单项高水平异常时,18F-FDGPET/CT 阳性诊断准确率与其升高水平相关。多项肿瘤标志物升高时,如果包含CA242 或CA724,则18F-FDGPET/CT 阳性诊断准确率与升高肿瘤标志物的个数相关。结论:CEA或CA242 单项高水平异常时,推荐进行18F-FDGPET/CT 检查;当多项肿瘤标志物升高时,若其中包含CA242 或CA724,倾向于推荐18F-FDGPET/CT应用;而对于CA199 和CA724 单项升高的人群,不推荐首选18F-FDGPET/CT检查。 相似文献
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睾丸非精原细胞瘤改良腹膜后淋巴结清扫术的疗效观察 总被引:1,自引:0,他引:1
背景与目的:腹膜后淋巴结清扫术是睾丸非精原细胞瘤的主要治疗方法之一,对于Ⅰ/Ⅱ期肿瘤可取得较高的治愈率.但目前手术时机尚有争论,而且传统术式并发症较高.本研究主要总结改良腹膜后淋巴结清扫术治疗Ⅰ/Ⅱ期非精原细胞瘤的疗效,探讨合理的治疗策略.方法:回顾性分析2003年8月至2007年8月在中山大学肿瘤防治中心收治的31例睾丸非精原细胞瘤患者,临床分期Ⅰ期22例.ⅡA期1例,ⅡB期5例,ⅡC期3例.所有患者于睾丸癌根治术后再行改良腹膜后淋巴结清扫术,2例于清扫术前及2例于术前、术后行BEP方案化疗2~3程,11例于清扫术后行BEP,/VIP方案化疗1~5程.结果:改良腹膜后淋巴结清扫术的平均手术时间为147 min(120~200 min),术中平均出血量为116 mL(50~300 mL),送病理检查的淋巴结平均15枚(3~40枚).15例患者有腹膜后淋巴结转移,2例淋巴结呈化疗后改变.术后病理分期Ⅰ期16例,ⅡA期6例,ⅡB期6例,ⅡC期3例,无手术并发症发生.随访8~58个月,平均32个月,29例无肿瘤生存,血AFP和HCC亦无异常升高.1例术后17个月清扫区域外腹膜后肿瘤复发,予挽救化疗2程后肿瘤标志物降至正常,继续随访2个月复发灶SD.1例术后6个月出现肝肺转移,化疗6程后达CR,随访4个月无肿瘤复发.30例(96.8%)患者术后保留了正常射精功能.术前化疗组和无化疗组RPLND的平均手术时间分别为175 min和143 min(P=0.002),术中平均出血量分别为200 mL和104 mL(P<0.001).结论:改良腹膜后淋巴结清扫术能够有效地治疗Ⅰ/Ⅱ期非精原细胞瘤,并且在规范化手术范围的同时又减少了对正常组织器官的损伤,降低了术后并发症发生. 相似文献
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18F-FDG PET/CT对原发性乳腺癌诊断和淋巴结分期的临床价值 总被引:2,自引:0,他引:2
目的评价18F-脱氧葡萄糖(18F-FDG)PET/CT对原发性乳腺癌诊断和淋巴结分期的临床价值。方法临床拟诊为乳腺癌的27例女性患者,手术前分别行乳腺钼靶X线和18F-FDG PET/CT检查。全部患者均行手术治疗,共切除32个病灶。23例患者接受了腋淋巴结廓清术,并行病理学诊断。结果32个病灶中,25个为乳腺癌病灶,7个为良性病变。18F-FDG PET/CT诊断的敏感度为80.0%,特异度为71.4%。T1期病灶8个,PET/CT诊断阳性6个;T2期病灶14个,PET/CT诊断阳性12个;T3期病灶2个,PET/CT均诊断阳性。对区域淋巴结转移,PET/CT诊断的敏感度为60.0%,特异度为84.6%,诊断准确度为73.9%。结论对于怀疑多中心乳癌、病期较晚、需要全面评价区域淋巴结状态或疑有远处转移的患者,PET/CT具有优势,对乳腺癌的分期有重要帮助,但尚不适宜于作为乳腺癌的常规检查。 相似文献
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18F-脱氧葡萄糖PET对判断脑胶质瘤手术并放疗后肿瘤残留的价值 总被引:9,自引:1,他引:8
背景与目的:恶性肿瘤治疗后残留的判断靠CT或MRI有时是很困难的,18F-脱氧葡萄糖(fluorodeoxyglucose,FDG)正电子发射型体层摄影术(positron emission tomography,PET)在这方面的应用是放射肿瘤学目前研究的热点之一.本研究旨在探讨18F-FDG PET在判断脑胶质瘤手术后并放疗后肿瘤残留的临床价值.方法:对23例脑胶质瘤手术后并放疗后临床疑肿瘤残留患者同期行18F-FDG PET和CT/MRI检查,最后诊断结合手术后病理检查和临床随访.结果:23例患者中18F-FDGPET显像阳性12例,阴性11例,其中3例为假阴性.9例CT/MRI未能确定肿瘤残留,PET显示其中7例FDG异常浓聚,2例FDG摄取缺损;8例CT/MRI诊断为肿瘤残留者PET显示FDG异常浓聚.18F-FDG PET显像检查的准确率为87.0%(20/23),而CT/MRI检查的准确率为60.9%(14/23),前者准确率明显高于后者(P<0.05).结论:18F-FDG PET在判断脑胶质瘤手术后并放疗后的脑损伤和肿瘤残留方面具有明显的优势,结合CT和MRI能更好的提供解剖结构和功能改变的综合信息. 相似文献
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目的:探讨18F-FDG PET/CT诊断老年患者肝细胞肝癌方面,不同时相内产生的不同表现,确定出是否可以提高肝癌诊断的准确性。方法:分别在两家医院共选取120例病例,18F-FDG PET/CT检查后,行肝部手术,取病理证实,分肝癌组和良性病变组。分别计算早期及延迟期病灶的最大标准摄取值(SUVmax)和滞留指数,以及病灶SUVmax与肝脏本底SUVmax的比值(T/N)。分析肝癌组和良性病变组病灶的变化规律。结果:所选病例中肝癌组早期及延迟相SUVmax间差异具有统计学意义,良性病变组早期及延迟相SUVmax无统计学意义。肝癌组T/N比值在早期及延迟相也存在显著差异,良性病变组早期及延迟相T/N比值间均无统计学意义。两组滞留指数差异没有统计学意义。结论:18F-FDG PET/CT双时相显像可以提高肝脏细胞癌诊断的准确性。 相似文献
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背景与目的 氟-18-脱氧葡萄糖正电子发射体层摄影术(18 F-fluorodeoxyglucose positron emission tomography,18F-FDG PET)被认为是除病理诊断之外对胸部恶性肿瘤最有价值的诊断方法之一.然而在临床工作中,18F-FDG PET诊断同病理诊断不符的病例并不罕见.本研究的目的是对18F-FDG PET在胸部恶性肿瘤诊断中的价值作初步评价.方法 收集在西安地区行18F-FDG PET检查,并通过手术、经皮穿刺活检、经支气管镜活检、胸水涂片等方法获得病理诊断的胸部肿瘤患者51例.对比其18F-FDG PET诊断及最终病理诊断的结果,并计算PET对胸部恶性肿瘤诊断的功效率、敏感性、特异性、假阳性率、假阴性率、阳性预示值、阴性预示值.结果 18F-FDG PET诊断与最终病理诊断相符合者共34例,其中真阳性31例,真阴性3例.不符者共有17例,其中假阳性11例,病理诊断分别为:结节病2例,肺结核病6例,肺内炎性假瘤2例,肺隐球菌病1例;假阴性6例.计算得出其各项评价指标分别为:功效率66.67%,敏感性83.78%,特异性21.43%,假阳性率78.57%,假阴性率16.22%,阳性预示值73.81%,阴性预示值33.33%.结论 18F-FDGPET仍然是目前诊断胸部恶性肿瘤的较为先进的无创检查技术,但其对某些代谢状态较为活跃的良性疾病如结核等,难以与恶性肿瘤相鉴别.因此临床医生必须将PET诊断结果与临床实际相结合,才能最大程度发挥18F-FDG PET在胸部恶性肿瘤诊断方面的优势. 相似文献
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José R. García Marc Simo Marina Huguet Montserrat Ysamat Francisco Lomeña 《Clinical & translational oncology》2006,8(2):124-128
Purpose Retrospectively analysed our experience in Renal Cell carcinoma (RCC) patients studied with 18-Fluorodeoxyglucose Positron
Emission Tomography (FDG PET) to rule out the incidence and clinical impact of heart metastases.
Material and methods In two years, 37 patients with RCC were studied with FDG PET. 10 were studied for initial staging and 27 patients were evaluated
for suspected recurrence or re-staging.
Results In two patients (5%), PET scan showed pathological focal uptake in myocardium. On the bases of this finding. MRI was performed
visualizing a myocardial mass in both lesions and confirmed by histology in one of them. The hypothesis of prolepses of the
tumour by thrombus in RCC patients justified the surgery.
Conclusion Whole-body FDG PET in RCC patients could help to diagnose cardiac metastasis, and allows the possibility of therapeutic surgery,
due to the thrombus significance of heart involvement. 相似文献
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This retrospective study was undertaken to determine the outcome of patients with non-seminomatous germ cell tumour who achieved a serological complete response but who had residual radiologic abnormalities upon completion of primary platinum-based chemotherapy. This was an analysis of 76 consecutive patients treated at Mount Vernon Hospital between 1983 and 1997. The patients were placed into two groups based upon whether they had surgical resection (surgery group, 48 patients) or observation (observation group, 28 patients) of residual radiologic masses on completion of initial chemotherapy (to enter the surgery group, complete surgical resection must have been achieved). The primary end-points were progression-free and overall survival. The percentage of patients alive with median follow-up 66 months was 90% for the surgery group and 80% for the observation group (P = 0.53, not significant). The percentage of patients continuously disease-free was 70% in the surgery group and 80% in the observation group (P = 0.31, not significant). In the small sub-group of patients with differentiated teratoma (TD) in the primary lesion who were observed, there was no excess risk of relapse or death. Patients who achieve a serological complete response after primary chemotherapy, but are left with = 2 cm radiological masses that are not cystic and have responded, can be safely observed with diligent follow-up. 相似文献
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The indication for postchemotherapy lymph node dissection in clinical stage IS nonseminomatous germ cell tumor 总被引:3,自引:0,他引:3
BACKGROUND: The initial management of patients with clinical stage IS (cIS) nonseminomatous germ cell tumor (NSGCT) has evolved from primary retroperitoneal lymph node dissection (RPLND) to induction chemotherapy. The objectives of the current study were to determine the clinical outcome, patterns of relapse, and incidence of teratoma in the retroperitoneum for men with cIS NSGCT. METHODS: Between 1988 and 2004, 24 patients with cIS stage NSGCT were evaluated and treated at Memorial Sloan-Kettering Cancer Center. Clinical and pathologic data were obtained from the institutional prospective database. Seven patients underwent primary RPLND, and 17 patients received induction chemotherapy as initial management. Clinical outcomes, patterns of relapse, and pathologic findings were reported. RESULTS: Six of the 7 patients who underwent primary RPLND had viable germ cell tumor (GCT) present. Four of those patients did not receive adjuvant chemotherapy, and all experienced systemic relapse. Of the 17 patients who received induction chemotherapy, 3 patients underwent elective postchemotherapy RPLND (PC-RPLND), and 14 patients were followed expectantly. Four patients who were followed expectantly relapsed in the retroperitoneum and underwent PC-RPLND. Of the 7 patients who underwent PC-RPLND, 1 patient had fibrosis (14%), but 6 patients (86%) had teratoma, including 1 patient who also had a viable GCT in the retroperitoneum. Overall, the incidence of teratoma or viable GCT in the retroperitoneum after chemotherapy was 43% (6 of 14 patients). At a median follow-up of 35 months, 23 men remained alive, and 1 man had died of disease. CONCLUSIONS: The current data suggest that patients with cIS stage NSGCT will benefit from adjuvant PC-RPLND. 相似文献
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M R Kim J-L Roh J S Kim J H Lee K-J Cho S-H Choi S Y Nam S Y Kim 《European journal of surgical oncology》2007,33(5):633-638
BACKGROUND: 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) has been reported to be superior to computed tomography (CT)/magnetic resonance imaging (MRI) in the evaluation of head and neck cancers, but little is known about its usefulness in oropharyngeal squamous cell carcinoma (SCC). We therefore compared FDG PET and CT/MRI in the preoperative staging of previously untreated oropharyngeal SCC. METHODS: Thirty-two consecutive patients with oropharyngeal SCC underwent FDG PET and CT/MRI before surgery. Each method was interpreted separately to assess primary tumor and cervical node status. Their sensitivity and specificity were compared relative to histopathologic analysis. RESULTS: Histopathology revealed metastases in 29 of 39 dissected neck sides and in 47 of 163 dissected cervical levels. FDG PET had higher sensitivities than CT/MRI for primary tumor detection (25/32 vs. 30/32, P=0.063) and for identification of cervical metastases on neck side (22/29 vs. 28/29, P<0.05) and level-by-level (37/47 vs. 45/47, P<0.05) bases. In contrast, the specificity of the two methods did not differ significantly (P>0.5). FDG PET correctly interpreted the false-negative results of CT/MRI in 6 of 7 primary tumors and 8 of 10 cervical levels. CONCLUSIONS: The improved preoperative staging of FDG PET may help in planning treatment, but its accuracy is insufficient to replace pathologic staging based on neck dissection. 相似文献
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Onur Yaprak Sencan Acar Gokhan Ertugrul Murat Dayangac 《World journal of gastrointestinal oncology》2018,10(10):336-343
The last two decades have seen a paradigm shift in the selection of patients with hepatocellular carcinoma (HCC) for liver transplantation. Microvascular invasion and differentiation have been the most significant factors affecting post-transplant recurrence; however, because of inherent disadvantages of pre-transplant biopsy, histological criteria never gained popularity. Recently, the selection criteria evolved from morphological to biological criteria, such as biomarkers and response to loco-regional therapy. With the introduction of multimodality imaging, combination of computed tomography with nuclear medicine imaging, particularly, 18F-fluorodeoxyglucose positron emission tomography fulfilled an unmet need and rapidly became a critical component of HCC management. This review article will focus on the use of 18F-fluorodeoxyglucose positron emission tomography combined with computed tomography in the pre-transplant evaluation of HCC patients with special discussion on its ability to predict HCC recurrence after liver transplantation. 相似文献
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【摘要】 目的 探讨18F-脱氧葡萄糖正电子发射计算机断层显像(FDG-PET)对淋巴瘤患者分期及预后评估的作用。 方法 对初诊的41例淋巴瘤患者,化疗前和化疗4个疗程后行FDG-PET,中位随访30个月,比较化疗前FDG-PET分期和化疗4个疗程后FDG-PET结果对预后的影响。 结果 41例患者治疗前结内、外病灶的最大标准摄取值(SUVmax)分别为9.7±6.9和8.4±6.8。侵袭性非霍奇金淋巴瘤(NHL)和惰性NHL比较,结内、外病灶的SUVmax值差异有统计学意义(侵袭性NHL分别为10.3±7.5和9.1±6.5,惰性NHL分别为4.7±2.1和2.4±0.6,均P<0.05)。NHL和霍奇金淋巴瘤(HL)、B细胞和T细胞NHL、活化B与生发中心来源弥漫大B细胞淋巴瘤治疗前FDG-PET的SUVmax差异无统计学意义(P>0.05)。化疗前 22例(54 %)患者FDG-PET检出结外器官病变;6例(15 %)因FDG-PET发现CT等其他检查未显示的淋巴结或结外病变而提高临床分期。治疗前经FDG-PET分期为Ⅰ、Ⅱ期的患者15例(37 %),Ⅲ、Ⅳ期的患者26例(63 %)。随访期间,FDG-PET分期Ⅰ、Ⅱ期的患者中1例(7 %)因疾病进展死亡,Ⅲ、Ⅳ期的患者中6例(23 %)因疾病进展死亡。41例患者化疗4个疗程后行FDG-PET检查,FDG-PET阴性的患者17例(41 %)中,随访期间1例(6 %)因疾病复发死亡,FDG-PET阳性的患者24例(59 %)中,随访期间6例(25 %)因疾病进展死亡。 结论 化疗前FDG-PET检查有助于对淋巴瘤患者进行准确的临床分期,化疗4个疗程后FDG-PET检查有助于评估淋巴瘤患者的预后,指导进一步治疗。 相似文献
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Chamie K Kurzrock EA Evans CP Litwin MS Koppie TM Wootton-Gorges SL Boone JM Lara PN Devere White RW 《Cancer》2011,117(18):4219-4230