^18F-FDG PET／CT显像诊断妇科肿瘤复发、转移的价值

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。

Value of18F-FDG PET/CT in diagnosing suspected recurrence and metastasis in gynecological malignancies

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.