18F-FDG PET/CT显像在胃癌分期及治疗方案制定中的应用价值

目的探讨18F-FDG PET/CT显像在胃癌分期及治疗方案制定中的应用价值。方法回顾性分析46例临床疑诊胃癌患者的18F-FDG PET/CT图像，采用目测法和半定量法对患者PET/CT图像进行分析，即测定SUV_max与最大胃壁厚度（T_max），以胃镜或手术后取得的病理结果作为“金标准”，评估18F-FDG PET/CT显像对病灶的诊断效能，并采用Pearson相关分析法分析SUV_max与T_max的相关性。结果18F-FDG PET/CT诊断原发病灶的灵敏度、特异度和准确率分别为94.4%、40.0%和82.6%；原发灶SUV_max与T_max呈正相关（r=0.922，P=0.001）；18F-FDG PET/CT诊断淋巴结转移及远处转移的灵敏度、特异度和准确率分别为76.9%、90.0%、82.6%和92.9%、96.9%、95.7%。结论18F-FDG PET/CT在检测胃癌的原发病灶、淋巴结转移灶和远处转移灶时有较高的特异度和灵敏度，在评估临床分期、指导临床制定正确的治疗方案中具有重要的应用价值。

Value of 18F-FDG PET/CT imaging on the staging of gastric carcinoma and its influence on therapeutic schedule formulation

ObjectiveTo explore the value of the 18F-FDG PET/CT imaging on the staging of gastric carcinoma and its influence on therapeutic schedule formulation.MethodsA retrospective analysis on the 18F-FDG PET/CT images of 46 patients with suspected clinical diagnosis of gastric cancer was performed through visual and semiquantitative evaluation by detecting the SUV_max and the maximum gastric wall thickness (T_max). Subsequently, the diagnostic efficiency of the 18F-FDG PET/CT imaging for lesions was assessed by comparing with the pathology obtained from gastroscopy or postoperative pathology. Pearson correlation analysis was used to analyze the correlation between SUV_max and T_max.ResultsThe sensitivity, specificity, and accuracy of 18F-FDG PET/CT imaging in detecting primary lesions were 94.4%, 40.0%, and 82.6%, respectively. The SUV_max of the primary lesions was positively correlated with the T_max (r=0.922, P=0.001). The sensitivity, specificity, and accuracy of 18F-FDG PET/CT imaging were 76.9%, 90.0%, and 82.6% in detecting lymph node metastasis and 92.9%, 96.9%, and 95.7%, respectively, in recognizing distant metastasis.Conclusions18F-FDG PET/CT imaging showed high specificity and sensitivity in detecting primary foci, lymph node metastasis, and distant metastasis of gastric cancer. This technique is also remarkably important in accurate assessment of the clinical stage and therapeutic schedule formulation.