^18F-FDG PET/CT在结直肠癌诊断和治疗中的价值

结直肠癌在我国是常见的恶性肿瘤,发病率逐年上升,但近30年的治疗效果进步不大,因而,术前早期正确的诊断和分期、术后检测复发转移以及判断治疗效果,对于个体化的治疗意义重大.集解剖和功能显像优势于一身的^18F-FDG PET/CT显像在结直肠癌诊断和治疗上具有广泛的应用前景和价值.大多数结直肠癌病变在PET上表现为高度的浓聚灶,^18F-FDG PET/CT对于结直肠原发灶诊断准确率一般在92.7%～95%之间,其敏感度高,假阴性率低.18F-FDG PET/CT可以早期发现转移病灶,是目前最好的术前分期手段;对结直肠癌复发及转移诊断的灵敏度、特异性及准确性分别为89%～94.6%、83.3%～100%、90%～98.3%,显著优于传统的检查方式,可以发现更多微小或隐匿的复发和转移灶.此外,PET/CT可以通过病灶代谢的变化先于超声、CT、MRI等形态学手段早期判定化疗效果,指导临床及时更改治疗方案以及进行术前再分期.总之,PET/CT为结直肠癌的诊断、术前分期、监测术后复发转移、评估疗效提供了一种安全无创的功能影像方法.

The value of 18F-FDG PET / CT in the diagnosis and treatment of colorectal carcinoma

Colorectal cancer is one of the most common kinds of carcinoma in China and the morbidity has been increasing continually. Although much effect has been made in the field of treatment of coloreetal cancer, the progress is not significant. So the prompt and accurate preoperative diagnosis, staging and restaging are very important clinical concerns for individual treatment;^18F - FDG PET/CT, which combines the anatomical and func- tional imaging information, has been widely applied in these aspects and showed significantly clinical value. Most lesions of colorectal carcinoma demonstrate highly increased FDG uptake. The diagnostic accuracy of 18F - FDG PET/CT for primary lesions commonly ranges from 92.7% - 95.0% , with a high. sensitivity and specificity. ~SF - FDG PET/CT can earlier detect metastasis and is considered the best method, of＇choice for preoperative staging. The diagnostic sensitivity, specificity and accuracy for the recurrence and metastasis ranges from 89% -94.6%, 83.3% - 100% ,90% - 98.3%, respectively. Comparing with the conventional imaging modalities,^18F - FDG PET/CT can found more small and occult recurrent and metastatic lesions. Additionally, the metabolic changes of lesions can be earlier detected by ^18F- FDG PET/CT than by other methods such as CT, MRI, and uhrasonogra-characteristics. Therefore, F- FDG PET/CT can play an important role phy,which are based on morphological . ^18F in the evaluation of therapeutic effects and can provide evidence for further clinical decisions. In short, PET/CT is a safe, noninvasive functional imaging method of diagnosis, staging and restaging for colorectal carcinoma.