18F-FDG符合线路显像在不明原发灶肿瘤中的临床价值

目的评价^18F-脱氧葡萄糖(FDG)符合线路显像在不明原发灶肿瘤(UPT)中的临床价值。方法UPT患者36例，在^18F-FDG符合线路显像后4周内进行常规影像学检查。结果^18F-FDG符合线路显像对原发灶的检出灵敏度为42％(15／36例)；1例原发灶仅被^18F-FDG显像发现，3例首先被^18F-FDG显像发现，后在^18F-FDG显像结果的提示下被其他影像学检查发现，11例同时分别被^18F-FDG显像和常规影像学检查发现；14％(5／36例)患者因找到原发灶而改变了治疗方案；53％(19／36例)患者发现新的转移灶。结论^18F-FDG符合线路显像是寻找UPT原发灶的一种有效方法，并可同时评价患者的全身转移情况，可为选择最佳治疗方案和预后评价提供依据。

The clinical value of 18F-FDG coincidence SPECT in unknown primary tumors

Objective To assess the value of 18F-fluorodeoxyglucose (FDG) coincidence SPECT in unknown primary tumors (UPT). Methods A retrospective analysis of 36 patients referred to 18F-FDG coincidence SPECT imaging for metastases from UPT was performed. Metastases were located in bone (n=19), lymph node (n=11), pleura (n=4) and liver (n=2). All of the 36 patients took conventional imaging diagnostic work-up within 4 weeks after 18F-FDG coincidence SPECT. Results Fifteen (42%) primary tumors were found by 18F-FDG coincidence SPECT and were verified by histopathology (n=6) or conventional imaging procedures and clinical follow-up (n=9). The sensitivity of 18F-FDG coincidence SPECT for detecting primary tumors was 42% (15/36). Among the 15 primary tumors identified by 18F-FDG coincidence SPECT, one was only detected by 18F-FDG; three were detected first by 18F-FDG, and then by conventional imaging methods, by oriented imaging; eleven were found by both 18F-FDG and conventional imaging modalities separately. 18F-FDG coincidence SPECT findings affected the therapeutic protocols of 14% (5/36) patients. 18F-FDG coincidence SPECT also identified additional previously unknown metastases in 53% (19/36) patients. Conclusion 18F-FDG coincidence SPECT is an effective method for primary tumor detection and for evaluation of tumor burden in UPT patients, and it is helpful for staging, selecting appropriate treatment protocols and predicting prognosis for these patients.