18F-FDG hPET/CT显像在原发性贲门癌中的应用

背景与目的：dPET／CT检查价格昂贵、而hPET／CT显像检查虽在准确性尚不及dPET，但其性价比较高．有较好的应用前景，本文探讨^18F-脱氧葡萄糖（FDG）双探头hPET／CT显像在原发性贲门癌中的应用价值。方法：26例经组织病理学证实的原发性贲门癌患者进行^18F-FDG双探头hPET／CT显像。图象分析采用视觉及半定量方法，同时与近期CT结果比较。结果：①双探头hPET／CT检出原发性贲门癌的灵敏度为92．3％（24／26例），2例假阴性患者均属印戒细胞癌，原发肿瘤直径〈2cm（T1期）。②19例手术患者中，贲门局部淋巴结转移15例，双探头hPET／CT检出8例，其灵敏度、特异性和准确性分别为71．4％、100％和53．3％，CT检出3例。③双探头hPET／CT检出远处转移7例，CT仅检出3例。结论：^18F-FDG双探头hPET／CT诊断原发性贲门癌较为灵敏，检出贲门局部淋巴结转移和远处转移可能优于CT。因此hPET／CT显像对贲门癌的术前分期和手术方案有一定的指导作用。

Evaluation of 18F-FDG hPET/CT in primary carcinoma of gastric cardia

Background and Purpose:dPET/CT is very expensive,so although the accuracy of hPET/CT is less than dPET/CT,it is better than CT,and is useful for guiding the tumor staging before operation.This paper is evaluate the role of ~(18)F-fluorodeoxyglucose(FDG) hPET/CT in primary carcinoma of gastric cardia detection.Methods:26 patients with histologically proven primary carcinoma of gastric cardia underwent whole body hPET/CT imaging.Visual and semiquantitative analysis and standardized uptake value(SUV) were used to analyze the images.The results of hPET/CT study were compared with those of CT.Results:1.The sensitivity of hPET/CT in primary carcinoma of gastric cardia detection was 92.3%(24/26);two cases of signet ring cell carcinoma gave false negative results,and the primary lesions were small(<2cm in diameter) and of T_(1)stage.2.among the 19 patients underwent surgery,15 had regional lymph node involvement,hPET/CT detected ten of them,and CT only three,the sensitivity,specificity and accuracy of FDG hPET/CT was 78.9%,100% and 53.3%,respectively.3.hPET/CT identified distant metastases in 7 patients,and CT only 3.Conclusions:1.~(18)F-FDG hPET/CT is a sensitive method for detecting primary carcinoma of gastric cardia,but small and early stage lesions,especially signet ring cell carcinoma,may give false negative results.2.~(18)F-FDG hPET/CT is probably more sensitive than CT in detecting peri-cardia lymph node involvement and distant metastasis,and that is important for guiding the tumor staging before operation.