18F-FDG PET/CT在探测卵巢癌术后复发和转移中的价值

目的]评价^18F-FDG PET/CT显像在探测卵巢癌术后复发病灶中的应用价值。方法]采用仪器为Siemens Biograph Sensation 16 PET/CT，43例卵巢癌术后患者禁食4～6h，静脉注射^18F-FDG60min后进行PET/CT检查，采集方式为3D模式。PET/CT图像结果与血清CA125、B超及CT或MRI影像学资料进行比较。并与手术病理或临床随访结果比较判断其诊断的准确性。结果]FDG PET/CT诊断卵巢癌复发的灵敏度、特异性和准确性分别为92.3%、100%和93.0%。血清CA125水平与FDG PET结果有一定相关性，33例CA125升高患者中31例PET显像阳性，10例CA125正常水平患者中仅有5例PET显像阳性。结论]当常规影像学检查阴性或可疑时，PET/CT显像对卵巢癌复发的检测具有较高的灵敏度和准确性，特别术后患者CA125升高的情况下，FDG PET/CT有助于探测隐匿性复发或转移病灶，指导进一步的治疗。

Value of 18F-FDG PET/CT Imaging in Detection of Postoperative Recurrent or Metastasis of Ovarian Cancer

Purpose] To evaluate the value of integrated positron emission tomography(PET)and computed tomography(CT)for depiction of recurrence ovarian carcinoma after surgery.Methods] The model of PET/CT scanner we used is Siemens Biograph Sensation 16.Forty-three women who had previously undergone surgery for ovarian cancer were included.The patients received 18F-FDG intravenously after fasting for 4 to 6 hours.3D whole body PET/CT scans were acquired 60 min after injection.PET/CT imaging results were compared with the results of serum CA125 levels and ultrasound,CT or MRI conventional imaging.PET/CT results were compared to histologic examination after surgery and clinical follow-up to determine the diagnostic accuracy of PET/CT in the evaluation of disease status.Results] The overall sensitivity,specificity,accuracy of PET/CT were 92.3%,100%,93.0% respectively.There was a positive correlation between serum CA125 and positive result of FDG PET/CT.PET/CT could detect recurrent lesions in 31 of 33 patients in whom increased serum CA125 level.Among the 10 patients with serum CA125 in normal range,PET/CT correctly detected recurrent foci in 5 patients.Conclusion] PET/CT depicts recurrent ovarian carcinoma with a high sensitivity and accuracy when conventional imaging is inconclusive or negative,especially in patients with increased CA125 levels.FDG PET/CT image can help to detect occult metastasis and direct further treatment to the precise site of tumor recurrence.