共查询到20条相似文献,搜索用时 31 毫秒
1.
Bernhard Scher Michael Seitz Martin Reiser Edwin Hungerhuber Klaus Hahn Reinhold Tiling Peter Herzog Maximilian Reiser Peter Schneede Stefan Dresel 《Journal of nuclear medicine》2005,46(9):1460-1465
The value of PET or PET/CT with (18)F-FDG for the staging of penile cancer has yet to be determined. The objective of this study was to investigate the pattern of (18)F-FDG uptake in the primary malignancy and its metastases and to determine the diagnostic value of (18)F-FDG PET/CT in the staging and restaging of penile cancer. METHODS: Thirteen patients (mean +/- SD age, 64 +/- 14.0 y) with suspected penile cancer or suspected recurrent disease were examined with a Gemini PET/CT system (200 MBq of (18)F-FDG). The reference standard was based on histopathologic findings obtained at biopsy or during surgery. RESULTS: Both the primary tumor and regional lymph node metastases exhibited a pattern of (18)F-FDG uptake typical for malignancy. Sensitivity in the detection of primary lesions was 75% (6/8), and specificity was 75% (3/4). On a per-patient basis, sensitivity in the detection of lymph node metastases was 80% (4/5), and specificity was 100% (8/8). On a nodal-group basis, PET/CT showed a sensitivity of 89% (8/9) in the detection of metastases in the superficial inguinal lymph node basins and a sensitivity of 100% (7/7) in the deep inguinal and obturator lymph node basins. The mean +/- SD maximum standardized uptake value for the 8 primary lesions was 5.3 +/- 3.7, and that for the 16 lymph node metastases was 4.6 +/- 2.0. CONCLUSION: According to our results, the main indication for (18)F-FDG PET in the primary staging or follow-up of penile cancer patients may be the prognostically crucial search for lymph node metastases. With the use of a PET/CT unit, the additional information provided by CT may be especially useful for planning surgery. Implementing (18)F-FDG PET and PET/CT in future staging algorithms may lead to a more precise and stage-appropriate therapeutic strategy. Furthermore, invasive procedures with a high morbidity rate, such as general bilateral lymphadenectomy, may be avoided. 相似文献
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目的 研究CT及18F-氟脱氧葡萄糖(FDG) PET/CT术前诊断食管癌淋巴结转移及确定N分期的价值.资料与方法 连续随机选择经食管镜或胃镜证实、拟行手术治疗、能够耐受手术的47例食管癌患者,术前1周内行CT及18F-FDG PET/CT检查,以术后病理为“金标准”,比较CT及18F-FDG PET/CT诊断食管癌淋巴结转移及N分期的敏感性、特异性、准确性、阳性预测值及阴性预测值.结果 31例存在淋巴结转移,共切除并分离淋巴结387枚(209组),其中65枚(46组)发现转移.CT诊断淋巴结转移的敏感性、特异性、准确性、阳性预测值、阴性预测值分别为53.8%、92.8%、86.3%、60.3%和90.9%;18F-FDG PET/CT分别为89.2%、93.8%、93.0%、74.4%和97.7%.PET/CT诊断淋巴结转移的敏感性、准确性及阴性预测值均显著高于CT,差异有统计学意义(P<0.05),特异性及阳性预测值差异无统计学意义(P>0.05).CT及18F-FDG PET/CT确定淋巴结分期的准确率分别为74.5%和91.5%,差异有统计学意义(P<0.05).伴淋巴结转移的食管癌原发灶最大标准摄取值(SUVmax)为( 14.899±3.770),而无淋巴结转移者为(9.427±2.854).结论 18F-FDGPET/CT术前诊断食管癌淋巴结转移及确定N分期优于CT;食管癌原发灶SUVmax在一定程度上可以反映淋巴结转移情况. 相似文献
3.
胃癌是全球范围内最常见的恶性肿瘤之一。18F-氟脱氧葡萄糖(FDG)PET/CT在胃癌中的应用既有优点又有局限性。胃癌原发灶对18F-FDG的摄取与癌症分期、组织学分型和肿瘤大小密切相关。早期胃癌18F-FDG摄取阳性预示着内镜黏膜下剥离术的不可治愈性。进展期胃癌的最大标准化摄取值(SUVmax)在肠型与印戒细胞癌(SRC)或弥漫型胃癌间的差异显著,SRC的SUVmax与患者的总生存时间和无病生存时间呈负相关。18F-FDG PET/CT对区域淋巴结转移的诊断灵敏度较低,但其特异度很高,区域淋巴结对18F-FDG摄取呈阳性是预后不良的指征。18F-FDG PET/CT可检出隐匿的远处转移(7.2%~10.0%),其中大部分(4.7%~8.8%)使用腹腔镜也不能检出。常规性应用18F-FDG PET/CT并联合腹腔镜检查对明确胃癌分期的意义重大。因此,笔者就18F-FDG PET/CT在胃癌中的临床应用进展进行综述。 相似文献
4.
Lymph node staging of gastric cancer using (18)F-FDG PET: a comparison study with CT. 总被引:11,自引:0,他引:11
Mijin Yun Joon Seok Lim Sung Hoon Noh Woo Jin Hyung Jae Ho Cheong Jung Kyun Bong Arthur Cho Jong Doo Lee 《Journal of nuclear medicine》2005,46(10):1582-1588
This study was performed to compare (18)F-FDG PET with CT for the evaluation of primary tumors and lymph node metastases in gastric cancer. METHODS: Eighty-one patients (28 women and 53 men; mean age, 56.6 y; age range; 32-82 y) who had undergone radical (n = 74) or palliative (n = 7) gastrectomy and lymph node dissection for the management of gastric cancer were included. Preoperative (18)F-FDG PET and CT were reviewed retrospectively for primary tumors of the stomach and lymph node metastases. Any increased (18)F-FDG uptake exceeding that of the adjacent normal gastric wall was considered positive for the primary tumor. Lymph nodes were classified into 3 groups based on their anatomic sites. Because perigastric lymph nodes (N1) were often not clearly differentiated from primary tumors, N1 lymph node metastases were determined when possible. Lymph nodes were considered positive or negative on the basis of the group as a whole. Final conclusions for primary tumors and lymph node metastases were based on histopathologic specimens in all patients. RESULTS: There were 17 patients with early gastric cancer (EGC) and 64 patients with advanced gastric cancer (AGC). For primary tumors, both PET and CT showed a sensitivity of 47% (8/17) for EGC and 98% (63/64) for AGC. The sensitivity of CT for N1 disease was significantly higher than that of PET. (18)F-FDG PET had a sensitivity, specificity, and accuracy of 34% (11/32), 96% (47/49), and 72% (58/81), respectively, for N2 metastases, whereas the corresponding CT values were 44% (14/32), 86% (42/49), and 69% (56/81). For N3 metastases, PET and CT had the same sensitivity, specificity, and accuracy: 50% (3/6), 99% (74/75), and 95% (77/81), respectively. Overall, the sensitivity, specificity, and accuracy of (18)F-FDG PET were not significantly different from those of CT for primary tumors or for N2 and N3 metastases. CONCLUSION: (18)F-FDG PET is as accurate as CT for the detection of primary tumors of either EGC or AGC. The low sensitivities of PET and CT were insufficient to allow decision making on the extent of lymphadenectomy. In contrast, the high specificity of PET for N disease appeared valuable, and the presence of N disease on PET may have a clinically significant impact on the choice of initial therapy. 相似文献
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Till A Heusner Sherko Kuemmel Lale Umutlu Angela Koeninger Lutz S Freudenberg Elke A M Hauth Klaus R Kimmig Michael Forsting Andreas Bockisch Gerald Antoch 《Journal of nuclear medicine》2008,49(8):1215-1222
Our objective was to compare the diagnostic accuracy of an all-in-one protocol of whole-body 18F-FDG PET/CT and integrated 18F-FDG PET/CT mammography with the diagnostic accuracy of a multimodality algorithm for initial breast cancer staging. METHODS: Forty women (mean age, 58.3 y; range, 30.8-78.4 y; SD, 12 y) with suspected breast cancer were included. For the primary tumor, we compared 18F-FDG PET/CT mammography versus MRI mammography; for axillary lymph node status, 18F-FDG PET/CT versus clinical investigation and ultrasound; and for distant metastases, 18F-FDG PET/CT versus a multimodality staging algorithm. Histopathology and clinical follow-up served as the standard of reference. The Fisher exact test evaluated the significance of differences (P < 0.05). Alterations in patient management caused by 18F-FDG PET/CT were documented. RESULTS: No significant differences were found in the detection rate of breast cancer lesions (18F-FDG PET/CT, 95%; MRI, 100%; P = 1). 18F-FDG PET/CT correctly classified lesion focality significantly more often than did MRI (18F-FDG PET/CT, 79%; MRI, 73%; P < 0.001). MRI correctly defined the T stage significantly more often than did 18F-FDG PET/CT (MRI, 77%; 18F-FDG PET/CT, 54%; P = 0.001). 18F-FDG PET/CT detected axillary lymph node metastases in 80% of cases; clinical investigation/ultrasound, in 70%. This difference was not statistically significant (P = 0.067). Distant metastases were detected with 18F-FDG PET/CT in 100% of cases, and the multimodality algorithm identified distant metastases in 70%. This difference was not statistically significant (P = 1). Three patients had extraaxillary lymph node metastases that were detected only by PET/CT (cervical, retroperitoneal, mediastinal/internal mammary group). 18F-FDG PET/CT changed patient management in 12.5% of cases. CONCLUSION: Our data suggest that a whole-body 18F-FDG PET/CT mammography protocol may be used for staging breast cancer in a single session. This initial assessment of the 18F-FDG PET/CT protocol indicates similar accuracy to MRI for the detection of breast cancer lesions. Although MRI seems to be more accurate when assessing the T stage of the tumor, 18F-FDG PET/CT seems able to more accurately define lesion focality. Although 18F-FDG PET/CT mammography was able to detect axillary lymph node metastases with a high sensitivity, this method cannot soon be expected to replace the combination of clinical examination, ultrasound, and sentinel lymph node biopsy for axillary assessment. 相似文献
6.
Evaluation of head and neck cancer with 18F-FDG PET: a comparison with conventional methods 总被引:6,自引:0,他引:6
Kresnik E Mikosch P Gallowitsch HJ Kogler D Wiesser S Heinisch M Unterweger O Raunik W Kumnig G Gomez I Grünbacher G Lind P 《European journal of nuclear medicine》2001,28(7):816-821
The aim of this study was to evaluate the usefulness of 18F-FDG PET in the diagnosis and staging of primary and recurrent malignant head and neck tumours in comparison with conventional imaging methods [including ultrasonography, radiography, computed tomography (CT) and magnetic resonance imaging (MRI)], physical examination, panendoscopy and biopsies in clinical routine. A total of 54 patients (13 female, 41 male, age 61.3+/-12 years) were investigated retrospectively. Three groups were formed. In group I, 18F-FDG PET was performed in 15 patients to detect unknown primary cancers. In group II, 24 studies were obtained for preoperative staging of proven head and neck cancer. In group III, 18F-FDG PET was used in 15 patients to monitor tumour recurrence after radiotherapy and/or chemotherapy. In all patients, imaging was obtained at 70 min after the intravenous administration of 180 MBq 18F-FDG. In 11 of the 15 patients in group I, the primary cancer could be found with 18F-FDG, yielding a detection rate of 73.3%. In 4 of the 15 patients, CT findings were also suggestive of the primary cancer but were nonetheless equivocal. In these patients, 18F-FDG showed increased 18F-FDG uptake by the primary tumour, which was confirmed by histology. One patient had recurrence of breast carcinoma that could not be detected with 18F-FDG PET, but was detected by CT. In three cases, the primary cancer could not be found with any imaging method. Among the 24 patients in group II investigated for staging purposes, 18F-FDG PET detected a total of 13 local and three distant lymph node metastases, whereas the conventional imaging methods detected only nine local and one distant lymph node metastases. The results of 18F-FDG PET led to an upstaging in 5/24 (20.8%) patients. The conventional imaging methods were false positive in 5/24 (20.8%). There was one false positive result using 18F-FDG PET. Among the 15 patients of group III with suspected recurrence after radiotherapy and/or chemotherapy, 18F-FDG was true positive in 7/15 (46.6%) and true negative in 4/15 (26.6%). The conventional imaging methods were true positive in 5/15 (33.3%) and true negative in 4/15 (26.6%). One false negative (6.6%) and three false positive findings (20%) on 18F-FDG PET were due to inflamed tissue. The conventional imaging methods were false positive in three (20%) and false negative in three cases (20%). It is concluded that in comparison to conventional diagnostic methods, 18F-FDG PET provides additional and clinically relevant information in the detection of primary and metastatic carcinomas as well as in the early detection of recurrent or persistent head and neck cancer after radiotherapy and/or chemotherapy. 18F-FDG PET should therefore be performed early in clinical routine, usually before CT or MRI. 相似文献
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Shu-Hang Ng Tzu-Chen Yen Chun-Ta Liao Joseph Tung-Chieh Chang Sheng-Chieh Chan Sheung-Fat Ko Hung-Ming Wang Ho-Fai Wong 《Journal of nuclear medicine》2005,46(7):1136-1143
Accurate evaluation of primary tumors and cervical lymph node status of squamous cell carcinoma (SCC) of the oral cavity is important to treatment planning and prognosis prediction. In this prospective study, we evaluated the use of 18F-FDG PET, CT/MRI, and their visual correlation for the identification of primary tumors and cervical nodal metastases of SCC of the oral cavity with histologic correlation. METHODS: One hundred twenty-four patients with pathologically proven diagnoses of oral cavity SCC underwent 18F-FDG PET and CT/MRI within 2 wk before surgery. We interpreted 18F-FDG PET, CT/MRI, and visually correlated 18F-FDG PET and CT/MRI separately to assess the primary tumors and their regional lymph node status. We recorded lymph node metastases according to the neck level system of imaging-based nodal classification. Histopathologic analysis was used as the gold standard for assessment of the primary tumors and lymph node involvement. We analyzed differences in sensitivity and specificity among the imaging modalities using the McNemar test. The receiver-operating-characteristic (ROC) curve and calculation of the area under the curve were used to evaluate their discriminative power. RESULTS: The accuracy of 18F-FDG PET, CT/MRI, and their visual correlation for the identification of primary tumors was 98.4%, 87.1%, and 99.2%, respectively. The sensitivity of 18F-FDG PET for the identification of nodal metastases on a level-by-level basis was 22.1% higher than that of CT/MRI (74.7% vs. 52.6%, P < 0.001), whereas the specificity of 18F-FDG PET was 1.5% lower than that of CT/MRI (93.0% vs. 94.5%, P = 0.345). The sensitivity and specificity of the visual correlation of 18F-FDG PET and CT/MRI were 3.2% and 1.5% higher than those of 18F-FDG PET alone (77.9% vs. 74.7%, P = 0.25; 94.5% vs. 93.0%, P = 0.18, respectively). The area under the curve obtained from the ROC curve showed that 18F-FDG PET was significantly superior to CT/MRI for total nodal detection (0.896 vs. 0.801, P = 0.002), whereas the visual correlation of 18F-FDG PET and CT/MRI was modestly superior to 18F-FDG PET alone (0.913 vs. 0.896, P = 0.28). CONCLUSION: 18F-FDG PET is superior to CT/MRI in the detection of cervical status of oral cavity SCC. The sensitivity of 18F-FDG PET for the detection of cervical nodal metastasis on a level-by-level basis was significantly higher than that of CT/MRI, whereas their specificities appeared to be similar. Visual correlation of 18F-FDG PET and CT/MRI showed a trend of increased diagnostic accuracy over 18F-FDG PET alone but without a statistically significant difference, and its sensitivity was still not high enough to replace pathologic lymph node staging based on neck dissection. 相似文献
9.
Michael J Reinhardt Holger Strunk Thomas Gerhardt Roland Roedel Ursula Jaeger Jan Bucerius Tilman Sauerbruch Hans-Juergen Biersack Franz L Dumoulin 《Journal of nuclear medicine》2005,46(7):1158-1163
Detection of cholangiocarcinoma in extrahepatic bile duct strictures is a continuing challenge in clinical practice because brush cytology taken at endoscopic retrograde cholangiography has an average sensitivity of 50%. The aim of this study was to evaluate the effectiveness of dual-modality PET/CT using (18)F-FDG for noninvasive differentiation of extrahepatic bile duct strictures. METHODS: Twenty-two PET/CT studies were performed on 20 patients (10 women, 10 men; mean age +/- SD, 63 +/- 14 y) with extrahepatic bile duct strictures on endoscopic retrograde cholangiography. PET imaging was started 101 +/- 22 min after injection of 369 +/- 48 MBq of 18F-FDG. Blood glucose was 100 +/- 20 mg/dL. PET images were reconstructed iteratively with attenuation correction based on a rescaling of the CT image. CT was performed within 1 min before the PET study, with the patient in the same position. CT was used to place a volume of interest 5 cm in diameter at the liver hilus for quantitative evaluation of PET images by means of standardized uptake values (SUVs). RESULTS: Final diagnosis was histologically proven cholangiocarcinoma in 14 cases and benign causes of strictures in 8 cases without evidence of malignancy during a follow-up of 18 +/- 3 mo. All patients with cholangiocarcinoma presented with focal increased uptake in the liver hilus with an SUV of 6.8 +/- 3.3 (range, 3.9-15.8), compared with 2.9 +/- 0.3 (range, 2.5-3.3) in patients with benign causes of strictures (P = 0.003). There was a clear cutoff SUV of 3.6 for detection of malignancy in the liver hilus. CONCLUSION: 18F-FDG PET/CT provided high accuracy for noninvasive detection of perihilar cholangiocarcinoma in extrahepatic bile duct strictures. 相似文献
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The aim of this study was to investigate whether in patients with head and neck cancer, staging is possible with fluorine-18 fluorodeoxyglucose (18F-FDG) using a dual-head positron emission tomography (PET) camera. Twenty patients (ten men, ten women; mean age: 60 years) were studied using 185 MBq (5 mCi) 18F-FDG. Two of these patients who were suspected of having recurrence in the neck were restaged 19 and 12 months, respectively, after the resection of the primary tumour. The images were visually analyzed and the results were correlated with computed tomography (CT) (n = 18), ultrasonography (n = 17) and pathological findings. With respect to the primary tumour, FDG dual-head PET and CT revealed a sensitivity of 100% and 59%, respectively (P < 0.001). In seven patients lymph node metastases were found in the neck specimen. Two of them had bilateral metastases. FDG dual-head PET correctly identified all nine pathological neck sides whereas CT and ultrasonography depicted eight of nine and seven of eight pathological sides, respectively. In three patients, false-positive FDG uptake was seen, which was due to a preceding biopsy in two cases. The sensitivity of FDG dual-head PET, CT and ultrasonography in the identification of pathological neck sides was 100%, 89% and 87%, respectively, and the specificity was 90%, 93% and 50%, respectively. With knowledge of the preceding biopsies, the specificity of FDG dual-head PET would have been 97%. The smallest lymph node metastasis detected by FDG dual-head PET that was missed by CT had a diameter of 0.6 cm. Measurement of 18F-FDG with a dual-head PET camera is very sensitive in the detection of primary head and neck cancers and accurate in the preoperative assessment of lymph node metastases. The results justify a prospective study on the identification of metastases in patients with head and neck cancer. In addition, it is justified to start a study on the detection of unknown primary tumours in patients with cervical metastases. 相似文献
12.
Routine (18)F-FDG PET preoperative staging of colorectal cancer: comparison with conventional staging and its impact on treatment decision making. 总被引:20,自引:0,他引:20
Iva Kantorová Ludmila Lipská Otakar Bêlohlávek Vladimír Visokai Miroslav Truba? Michaela Schneiderová 《Journal of nuclear medicine》2003,44(11):1784-1788
The preoperative staging of colorectal cancer (CRC) with (18)F-FDG PET is not as yet generally considered to be evidence based. We have found only 1 study that evaluated (18)F-FDG PET in a nonselected population with proven CRC. Several other studies have concentrated on more advanced disease. The aim of this study was to assess the potential clinical benefit of (18)F-FDG PET in the routine staging of CRC. METHODS: Thirty-eight consecutive patients who had had CRC histologically proven by colonoscopy underwent prospective preoperative staging by plain chest radiography, sonography, CT, and (18)F-FDG PET. Sensitivity, specificity, and accuracy were retrospectively assessed by comparison with the histologic results after surgery (36 patients) or clinical follow-up (2 inoperable cases-both patients died within 1 y of the PET examination). The impact of (18)F-FDG PET on therapeutic decision making was evaluated by comparing medical records before and after (18)F-FDG PET. RESULTS: (18)F-FDG PET correctly detected 95% of primary tumors, whereas CT and sonography correctly detected only 49% and 14%, respectively. Lymph nodes were involved in 7 patients. The sensitivity, specificity, and accuracy of (18)F-FDG PET were 29%, 88%, and 75%, respectively. CT and sonography did not reveal any lymph node involvement. Liver metastases were present in 9 patients. (18)F-FDG PET, CT, and sonography had a sensitivity of 78%, 67%, and 25%, respectively; a specificity of 96%, 100%, and 100%, respectively; and an accuracy of 91%, 91%, and 81%, respectively. (18)F-FDG PET revealed further lesions in 11 patients. Levels of carcinoembryonic antigen and carbohydrate antigen 19-9 tumor markers were elevated in, respectively, only 33% and 8% of cases of proven CRC. (18)F-FDG PET changed the treatment modality for 8% and the range of surgery for 13% of patients. In total, (18)F-FDG PET changed the method of treatment for 16% of patients. CONCLUSION: Plain chest radiography and sonography did not bring any clinical benefits. No correlation was found between the level of tumor markers and the stage of disease. CT is necessary for confirmation of PET findings at extraabdominal sites (PET-guided CT) and for their morphologic specification at abdominal and pelvic sites before an operation. (18)F-FDG PET is the best method for the staging of CRC in all localities, despite the high rate of false-negative PET findings in patients with lymph node involvement. PET should be performed as a first examination after verification of CRC. We propose a PET/CT hybrid system as optimal in the staging of CRC. 相似文献
13.
E. Kresnik P. Mikosch H. Gallowitsch D. Kogler S. Wieser M. Heinisch O. Unterweger W. Raunik G. Kumnig I. Gomez G. Grünbacher P. Lind 《European journal of nuclear medicine and molecular imaging》2001,28(7):816-821
The aim of this study was to evaluate the usefulness of 18F-FDG PET in the diagnosis and staging of primary and recurrent malignant head and neck tumours in comparison with conventional imaging methods [including ultrasonography, radiography, computed tomography (CT) and magnetic resonance imaging (MRI)], physical examination, panendoscopy and biopsies in clinical routine. A total of 54 patients (13 female, 41 male, age 61.3ᆠ years) were investigated retrospectively. Three groups were formed. In group I, 18F-FDG PET was performed in 15 patients to detect unknown primary cancers. In group II, 24 studies were obtained for preoperative staging of proven head and neck cancer. In group III, 18F-FDG PET was used in 15 patients to monitor tumour recurrence after radiotherapy and/or chemotherapy. In all patients, imaging was obtained at 70 min after the intravenous administration of 180 MBq 18F-FDG. In 11 of the 15 patients in group I, the primary cancer could be found with 18F-FDG, yielding a detection rate of 73.3%. In 4 of the 15 patients, CT findings were also suggestive of the primary cancer but were nonetheless equivocal. In these patients, 18F-FDG showed increased 18F-FDG uptake by the primary tumour, which was confirmed by histology. One patient had recurrence of breast carcinoma that could not be detected with 18F-FDG PET, but was detected by CT. In three cases, the primary cancer could not be found with any imaging method. Among the 24 patients in group II investigated for staging purposes, 18F-FDG PET detected a total of 13 local and three distant lymph node metastases, whereas the conventional imaging methods detected only nine local and one distant lymph node metastases. The results of 18F-FDG PET led to an upstaging in 5/24 (20.8%) patients. The conventional imaging methods were false positive in 5/24 (20.8%). There was one false positive result using 18F-FDG PET. Among the 15 patients of group III with suspected recurrence after radiotherapy and/or chemotherapy, 18F-FDG was true positive in 7/15 (46.6%) and true negative in 4/15 (26.6%). The conventional imaging methods were true positive in 5/15 (33.3%) and true negative in 4/15 (26.6%). One false negative (6.6%) and three false positive findings (20%) on 18F-FDG PET were due to inflamed tissue. The conventional imaging methods were false positive in three (20%) and false negative in three cases (20%). It is concluded that in comparison to conventional diagnostic methods, 18F-FDG PET provides additional and clinically relevant information in the detection of primary and metastatic carcinomas as well as in the early detection of recurrent or persistent head and neck cancer after radiotherapy and/or chemotherapy. 18F-FDG PET should therefore be performed early in clinical routine, usually before CT or MRI. 相似文献
14.
目的 总结胆管癌18F-FDG PET/CT显像表现,提高胆管癌的诊断准确性.方法 回顾经病理或临床综合手段证实的53例胆道疾病的18F-FDG PET/CT表现,分析PET/CT诊断胆管癌的敏感性、特异性和准确性.结果 肝内胆管癌14例、近段胆管癌18例、中远段胆总管癌15例、胆管炎性病变或伴结石6例.肝内转移9例,腹腔及腹膜后淋巴结转移15例,椎体等远处转移3例.PET/CT诊断胆管癌的敏感性为95.7%、特异性为83.3%、准确性为94.3%.结论 18F-FDG PET/CT在胆管癌的诊断与鉴别诊断、分期、检测疗效及预后等具有独特的应用价值. 相似文献
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^18F-FDG PET/CT在胰腺癌诊断中的价值 总被引:3,自引:0,他引:3
目的评价^18F-脱氧葡萄糖(FDG)PET/CT鉴别诊断胰腺良恶性病变及检测淋巴结和(或)远处转移的价值。方法回顾性分析上海交通大学医学院附属仁济医院行^18F—FDGPET/CT检查的46例临床疑胰腺肿瘤患者的影像学检查资料和临床资料,其中胰腺癌患者26例,良性病变者20例,比较分析PET和CT的特征。结果当选择最大标准摄取值(SUVmax)=2.95为判断良恶性的界值时,对胰腺癌诊断的灵敏度是88.5%(23/26),特异性是85.0%(17/20)。^18F—FDGPET/CT显像假阳性3例,假阴性3例。同时发现16例检查前未确定的肝、肺、骨及淋巴结转移患者。根据显像结果,11例患者治疗方案得以修正。结论根据现有资料分析,^18F—FDGPET/CT是鉴别诊断胰腺良恶性病变及检测胰腺癌患者淋巴结和(或)远处转移一种较好的方法。 相似文献
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18F-DOPA positron emission tomography for tumour detection in patients with medullary thyroid carcinoma and elevated calcitonin levels 总被引:5,自引:0,他引:5
Hoegerle S Altehoefer C Ghanem N Brink I Moser E Nitzsche E 《European journal of nuclear medicine》2001,28(1):64-71
In spite of the availability of numerous procedures, diagnostic imaging of tumour manifestations in patients with medullary thyroid carcinoma and elevated calcitonin levels is often difficult. In the present study, the new procedure of fluorine-18 dihydroxyphenylalanine positron emission tomography (18F-DOPA PET) was compared with the established functional and morphological imaging methods. After evaluation of the normal distribution of 18F-DOPA, 11 patients with medullary thyroid carcinoma were examined using 18F-DOPA PET. Results of 18F-fluorodeoxyglucose (18F-FDG) PET, somatostatin receptor scintigraphy (SRS) and morphological tomographic imaging (CT/MRI) were available for all patients. All individual procedures were evaluated without reference to prior information. Data assessment for each patient was based on cooperation between experienced radiologists and specialists in nuclear medicine, who considered all the available findings (histological results, imaging, follow-up studies). This cooperation served as the gold standard against which the results of the individual procedures were evaluated. A total of 27 tumours were studied [three primary tumours (PT)/local recurrence (LR), 16 lymph node metastases (LNM) and eight organ metastases (OM)]. 18F-DOPA PET produced 17 true-positive findings (2 PT/LR, 14 LNM, 1 OM), 18F-FDG PET 12 (2 PT/LR, 7 LNM, 3 OM), SRS 14 (2 PT/LR, 8 LNM, 4 OM) and morphological imaging 22 (3 PT/LR, 11 LNM, 8 OM). The following sensitivities were calculated with respect to total tumour manifestations: 18F-DOPA PET 63%, 18F-FDG PET 44%, SRS 52%, morphological imaging 81%. Thus, the morphological imaging procedures produce the best overall sensitivity, but the specificity for PT/LR (55%) and LNM (57%) was low. With respect to lymph node staging, the best results were obtained with 18F-DOPA PET. 18F-DOPA PET is a new functional imaging procedure for medullary thyroid carcinoma that seems to provide better results than SRS and 18F-FDG PET. Moreover, the data indicate that no single procedure provides adequate diagnostic certainty. Therefore, 18F-DOPA PET is a useful supplement to morphological diagnostic imaging, improving lymph node staging and enabling a more specific diagnosis of primary tumour and local recurrence. 相似文献
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Brusabhanu Nayak Prem Nath Dogra Niraj Naswa Rakesh Kumar 《European journal of nuclear medicine and molecular imaging》2013,40(3):386-393
Purpose
Positron emission tomography/computed tomography (PET/CT) with 18F-fluorodeoxyglucose (FDG) has been used with limited success in the past in primary diagnosis and locoregional staging of urinary bladder cancer, mainly because of the pharmacokinetics of renal excretion of 18F-FDG. In the present prospective study, we have evaluated the potential application of diuretic 18F-FDG PET/CT in improving detection and locoregional staging of urinary bladder tumours.Methods
Twenty-five patients suspected of having primary carcinoma of the urinary bladder were evaluated prospectively for diagnosis and staging. All of these 25 patients underwent conventional contrast-enhanced computed tomography (CECT) of the abdomen/pelvis and whole-body diuretic 18F-FDG PET/CT. In addition, pelvic PET/CT images were obtained using the special technique of forced diuresis using intravenous furosemide (20–40 mg). Of the 25 patients, 10 underwent radical cystectomy and 15 underwent transurethral resection of the bladder tumour (TURBT). Results of CECT and diuretic 18F-FDG PET/CT were compared considering histopathology as a reference standard.Results
Of the 25 patients, CECT detected a primary tumour in 23 (sensitivity 92 %), while 18F-FDG PET/CT was positive in 24 patients (sensitivity 96 %). Mean size and maximum standardized uptake value of the bladder tumours were 3.33 cm (range 1.6–6.2) and 5.3 (range 1.3–11.7), respectively. Of the 25 patients, only 10 patients underwent radical cystectomy based on disease status on TURBT. Among those ten patients, nine had locoregional metastases. Among the nine patients who had positive lymph nodes for metastasis on histopathology, CECT and PET/CT scan had a sensitivity of 44 and 78 %, respectively. 18F-FDG PET/CT was found to be superior to CECT in the detection of the primary tumour and locoregional staging (p?<?0.05).Conclusion
Diuretic 18F-FDG PET/CT is highly sensitive and specific and plays an important role in improving detection of the primary tumour and locoregional staging of urinary bladder tumours. Diuretic 18F-FDG PET/CT demonstrated a higher diagnostic value when compared with CECT in these patients. 相似文献19.
Marcel P. M. Stokkel Frans-Willem ten Broek Peter P. van Rijk 《European journal of nuclear medicine and molecular imaging》1999,26(5):499-503
The aim of this study was to investigate whether in patients with head and neck cancer, staging is possible with fluorine-18
fluorodeoxyglucose (18F-FDG) using a dual-head positron emission tomography (PET) camera. Twenty patients (ten men, ten women; mean age: 60 years)
were studied using 185 MBq (5 mCi) 18F-FDG. Two of these patients who were suspected of having recurrence in the neck were restaged 19 and 12 months, respectively,
after the resection of the primary tumour. The images were visually analyzed and the results were correlated with computed
tomography (CT) (n = 18), ultrasonography (n = 17) and pathological findings. With respect to the primary tumour, FDG dual-head PET and CT revealed a sensitivity of 100%
and 59%, respectively (P<0.001). In seven patients lymph node metastases were found in the neck specimen. Two of them had bilateral metastases. FDG
dual-head PET correctly identified all nine pathological neck sides whereas CT and ultrasonography depicted eight of nine
and seven of eight pathological sides, respectively. In three patients, false-positive FDG uptake was seen, which was due
to a preceding biopsy in two cases. The sensitivity of FDG dual-head PET, CT and ultrasonography in the identification of
pathological neck sides was 100%, 89% and 87%, respectively, and the specificity was 90%, 93% and 50%, respectively. With
knowledge of the preceding biopsies, the specificity of FDG dual-head PET would have been 97%. The smallest lymph node metastasis
detected by FDG dual-head PET that was missed by CT had a diameter of 0.6 cm. Measurement of 18F-FDG with a dual-head PET camera is very sensitive in the detection of primary head and neck cancers and accurate in the
preoperative assessment of lymph node metastases. The results justify a prospective study on the identification of metastases
in patients with head and neck cancer. In addition, it is justified to start a study on the detection of unknown primary tumours
in patients with cervical metastases.
Received 19 October and in revised form 18 December 1998 相似文献
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