^18FDG—PET在诊断头颈部鳞状细胞癌复发中的价值

目的了解18FDG-PET在诊断头颈部鳞状细胞癌复发中的价值,确定标准吸收值(SUV)来鉴别放疗后的炎症与肿瘤复发.材料和方法头颈部鳞状细胞癌患者43例,在放疗后至少4个月(平均11个月)进行18FDG-PET检查.计算感兴趣区的SUV值.肿瘤复发诊断依赖组织病理学检查或6个月以上的临床随访.结果43例患者中,FDG-PET阳性23例,其中3例为假阳性;20例为阴性,其中假阴性2例.FDG-PET的诊断准确性是88%(38/43),而CT/MRI的诊断准确性则为66%(25/38).肿瘤复发病灶和炎症病灶的SUV有部分重叠,无统计学上差异(p=0.31).结论18FDG-PET检测头颈部鳞状细胞癌复发中肉眼分析更有价值;18FDG-PET较CT/MRI更为准确.

Evaluation of Recurrent Squamous Cell Carcinoma at Head and Neck with FDG PET

Purpose: To evaluate 18 FDG PET study in assessing recurrent squamous cell carcinoma at head and neck and to determine the optimal standardized uptake values (SUV) to distinguish recurrent neoplasm from inflammatory lesions. Materials and Method: Forty three patients with head and neck cancer were studied with 18 FDG PET at least 4 mos after their last course of radiation therapy (mean: 11 mos). SUVs were measured in regions of interest (ROIs). The final diagnosis of recurrence was made based on biopsy or at least 6 months clinical follow up. Results: FDG PET correctly detected recurrence in 20/22 patients. There were 2 false negatives and 3 false positive patients. The accuracy of FDG PET was 88% (38/43), compared to 66% (25/38) for CT/MRI. The SUV of recurent lesions and inflammatory lesions were partially overlap and there was no statistical difference between them (p=0.31). It is difficulty to define optimal cut off SUV to distinguish them. Conclusion: Visual analysis of FDG PET study is more useful than SUV measurement and FDG PET study has more accurate than CT/MR in evaluating recurrent squamous cell cancer of the head and neck.