^18F-FDG PET/CT显像诊断妇科肿瘤复发、转移的价值 |
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引用本文: | 张敬勉,赵新明,王建方,王颖晨,张召奇,李德志,戴春暖,孙莉,江志华. ^18F-FDG PET/CT显像诊断妇科肿瘤复发、转移的价值[J]. 中华核医学杂志, 2009, 29(4): 234-237. DOI: 10.3760/cma.j.issn.0253-9780.2009.04.006 |
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作者姓名: | 张敬勉 赵新明 王建方 王颖晨 张召奇 李德志 戴春暖 孙莉 江志华 |
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作者单位: | 河北医科大学第四医院核医学科、PET/CT中心,石家庄,050011 |
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基金项目: | 河北省普通高等学校强势特色学科肿瘤学组课题,河北省卫生厅科研课题 |
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摘 要: | 目的探讨^18F-脱氧葡萄糖(FDG)PET/CT显像诊断妇科肿瘤复发、转移的价值,并评价其对临床再分期及治疗决策的影响。方法对47例临床可疑复发、转移的妇科肿瘤患者行^18F—FDG PET/CT显像,对PET、CT及PET/CT图像进行对比分析。采用SPSS12.0软件,对数据行∥检验、校正的,检验及确切概率法分析。结果47例患者中共发现病灶158处,其中恶性病灶149处,良性病灶9处。^18F-FDG PET/CT诊断妇科肿瘤复发、转移的灵敏度、特异性、准确性、阳性预测值及阴性预测值分别为95.97%(143/149),6/9,94.30%(149/158),97.95%(143/146)及50.00%(6/12)。PET/CT在诊断妇科肿瘤复发、转移的灵敏度、准确性及阴性预测值方面明显优于单纯CT(χ^2=18.198,18.890,6.825,P均〈0.05);^18F-FDG PET/CT和单纯PET在各项诊断效能指标间差异无统计学意义(χ^2=0.632,0.000,0.459,0.000,0.150,P均〉0.05),但PET/CT使33.54%(53/158)的单纯PET无法准确定位的病灶得到了准确定位。同单纯CT及PET相比,PET/CT分别使44.68%(21/47)和31.91%(15/47)的患者TNM分期改变,对T分期的影响最明显;共有19.15%(9/47)的患者临床分期改变,并改变相应的治疗决策。结论^18F—FDG PET/CT显像诊断妇科肿瘤复发、转移准确而全面,对临床再分期及治疗决策有重要影响。
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关 键 词: | 生殖器肿瘤,女性 体层摄影术,发射型计算机 体层摄影术,X线计算机 脱氧葡萄糖 |
Value of18F-FDG PET/CT in diagnosing suspected recurrence and metastasis in gynecological malignancies |
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Affiliation: | ZHANG Jing-mian, ZHAO Xin-ming, WANG Jian-fang, et al.( Department of Nuclear Medicine and PET/CT Center, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China) |
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Abstract: | Objective Recurrence and metastasis are significant prognostic factors in patients with gynecological malignancies. The purpose of the study was to evaluate the value of 18F-fluorodeoxyglucose (FDG) PET/CT in diagnosing suspected recurrence and metastasis in gynecological malignancies, and to investigate the influence of PET/CT on clinical restaging and treatment decision. Methods Forty-seven patients with gynecological malignancies clinically suspected of recurrence or metastasis underwent 18 F-FDG PET/CT imaging. The images of 18F-FDG PET/CT, PET and CT were compared respectively. X2-test with SPSS 12.0 was used for data analysis. Results One hundred and forty-nine malignant lesions and 9 benign lesions were found in 47 patients. The sensitivity, specificity, accuracy, positive predictive value and nega-tive predictive value of 18 F-FDG PET/CT in detecting recurrence and metastasis of gynecological malignan-cies were 95.97% ( 143/149), 6/9, 94.30% ( 149/158), 97.95% (143/146) and 50.00% ( 6/12), respectively. The difference was significant between ,18 F-FDG PET/CT image and CT alone in sensitivity, ac-curacy and negative predictive value (X2 = 18.198,18.890, 6.825, all P <0.05). Compared with 18F-FDG PET/CT image, PET alone had no difference in the qualitative diagnostic accuracy (X2 = 0.632, 0.000, 0.459, 0.000, 0.150, all P>0.05), but 18F-FDG PET/CT had a clear advantage in determining the location of the lesions [33.54% (53/158)]. PET/CT changed the TN M staging in 44.68% ( 21/47 ) and 31.91% (15/47) patients, respectively, comparing with CT or PET alone. Furthermore, 19.15% ( 9/47 ) had change in their clinical staging and treatment decision based on the results of PET/CT. Conclu-sion 18F-FDG PET/CT is valuable in the detection, restaging and management decision in recurrent and metastatic gynecological malignancies. |
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Keywords: | Genital neoplasms,female Tomography,emission-computed Tomography,X-ray computed Deoxyglucose |
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