18F-FDG PET对原发性食管癌和复发性食管癌的诊断价值

食管癌的预后较差,手术的致死率和致残率均较高,术前正确分期对确定治疗方案显得尤为重要.PET是继CT、MRI、食管镜等常规检查的有益补充.受分辨率的影响,PET较难确定肿瘤的局部浸润程度,在局部淋巴结转移方面其价值有待于进一步的研究,但对远处转移灶的诊断明显优于CT、MRI等常规检查,诊断复发性食管癌准确率较高,能有效鉴别手术疤痕和复发,有效评价放化疗的疗效.结合传统影像学检查,18F-FDG能较为准确地进行术前分期,纠正不正确的治疗方案,改善食管癌的预后.

The value of 18F-FDG PET in the staging of paimary and recurent esophageal cancer

Because of the poor prognosis for patients with esophageal cancer and the risks associat-ed with surgical intervention,accurate staging is essential for optimal treatment planning.Positron emis-sion tomography(PET)with 18 F-fluoro deoxy-d-glucose(FDG)is a useful adjunct to more conventional imaging modalities in this setting.18 F-FDG PET is not an appropriate first-line diagnostic procedure in the detection of esophageal cancer and is not helpful in detecting local invasion by the primary tumor,and further studies are required to determine its efficacy in the detection of local nodal metastases.Howev-er,18 F-FDG PET is superior to anatomic imaging modalities in the ability to detect distant metastases.Metastases to the liver,lungs,and skeleton can readily be identified at 18 F-FDG PET.In addition,18 F-FDG PET has proved valuable in determining the resectability of disease and allows scan-ning of a larger volume,which is possible with computed tomography.Recurrent disease is readily di-agnosed and differentiat-ed from scar tissue with 18 F-FDG PET.In addition,18 F-FDG PET may play a valuable role in the follow-up of patients who undergo chemotherapy and radiation therapy,allowing early changes in treatment for unre-sponsive tumors.The management of most patients with esophageal cancer can be improved with the use of 18 F-FDG PET.