18F-FDG PET-CT在肾癌诊断中的应用价值

目的评价~(18)F-FDG PET-CT在肾癌诊断中的应用价值。方法回顾性分析了2006年至2011年间27例其他影像学方法发现肾脏肿物患者的~(18)F-FDG PET-CT检查,并与手术/穿刺病理或长期随访结果进行对照。结果对于肾脏肿瘤,~(18)F-FDG PET-CT诊断良恶性的敏感性为60%,特异性为50%,准确率为59.3%。肾癌病灶的常规扫描与延迟扫描的SUV_(max)没有显著差异[(4.0±3.0)vs(4.6±4.4)]。FDG阳性肾癌病灶的最大径显著大于FDG阴性肾癌病灶[(5.6±2.0)cm vs(2.5±1.0)cm]。FDG阳性肾癌病灶的病理分级显著高于FDG阴性肾癌病灶[(3.1±0.8)vs(1.9±0.6)]。合并转移的肾癌原发病灶的SUV_(max)显著高于未合并转移的肾癌原发病灶[(7.7±3.7)vs(3.0±2.3)]。结论 ~(18)F-FDG PET-CT对鉴别肾脏肿物的良恶性作用有限。由于最大径越大、分化越差、存在转移的肾癌越容易被~(18)F-FDG PET-CT发现,因此对于肾脏肿物患者其仍是一项有意义的检查,可以作为常规影像学方法的有效补充。

The efficacy of 18F-FDG PET-CT in the diagnosis of renal cell carcinoma

Objective To evaluate the efficacy of18fluorine fluorodeoxyglucose positron emission tomography-compu- ted tomography （ 18 F-FDG PET-CT） in the diagnosis of renal cell carcinoma （RCC）. Methods Between 2006 and 2011, 27 patients with suspicious primary renal masses detected by conventional imaging underwent18 F-FDG PET-CT imaging. The results were retrospectively analyzed, and the final diagnosis was based on histopathology findings or long-time follow- up. Results For RCC tumors, the sensitivity, specificity and accuracy of18F-FDG PET-CT were 60%, 50%, and 59.3% , respectively. In RCC tumors, the SUVmax between early and delayed imaging was 4. 0±3.0 vs 4. 6±4. 4, and was of no statistically significant difference. The maximum diameters of FDG-positive malignant lesions were （ 5.6±2. 0 ） cm, and was statistically higher than FDG-negative ones of （2. 5±1.0） cm. The Fuhrman grades of FDG-positive malig- nant lesions were statistically higher than FDG-negative ones, which was 3.1±0. 8 vs 1.9±0. 6. The SUV of primary renal tumors of the patients with distant metastasis was 7.7±3.7, compared with the 3.0±2. 3 of those without distant me- tastasis, showing significant difference. Conclusion 18 F-FDG PET-CT has limited efficacy in the differential diagnosis of benign and malignant renal tumors. As18 F-FDG PET-CT is more likely to detected RCC with larger maximum diameters, higher Fuhrman grades and with distant metastasis, it is still helpful for patients with renal tumors, and can be used as a supplementary tool to conventional imaging.