18F-FDG PET/CT监测骨与软组织肉瘤术后复发及转移的价值

目的：评价18 F-FDG PET/CT显像监测骨与软组织肉瘤术后复发和/或转移的临床价值及对临床治疗决策的影响。方法回顾性分析32例骨与软组织肉瘤术后行18 F-FDG PET/CT检查患者的随访及临床资料，将PET/CT检查结果与临床随访（再次手术后病理和长期随访观察）的结果进行对比分析，并分析PET/CT对临床决策的影响。结果32例患者，18 F-FDG PET/CT提示局部复发13例，正确诊断12例，假阳性及假阴性各1例，PET/CT诊断骨与软组织肉瘤局部复发的灵敏度、特异性、准确率、阳性预测值及阴性预测值分别为92.3%（12/13）、94.7%（18/19）、93.7%（30/32）、92.3%和94.7%（18/19）；PET/CT提示远处转移11例，正确诊断10例，假阳性1例，假阴性2例，PET/CT诊断远处转移的灵敏度、特异性、准确率、阳性预测值及阴性预测值分别为83.3%（10/12）、95%（19/20）、90.1%（29/32）、90.9%（10/11）和90.5%（19/21）。基于PET/CT结果，37.5%（12/32）患者的治疗方案发生改变。结论18 F-FDG PET/CT在骨与软组织术后复发和/或转移的诊断中具有重要的临床价值，是一种较理想的监测方法。

Value of 18 F-FDG PET/CT in detecting recurrent and metastatic bone and soft tissue sarcoma

Objective To assess the value of 18 F-FDG PET/CT imaging for detecting recurrent and metastatic bone and soft tissue sarcoma after radical surgery.Methods 18 F-FDG PET/CT of 32 patients after resection of bone and soft tissue sarcomas was retrospectively analyzed and compared with pathology and/or long-term clinical follow-up.Results 18 F-FDG PET/CT showed local recurrence correctly in 12/32 patients with 1 false positive and 1 false negative,92.3%sensitivity,94.7%specificity,93.7%accuracy,92.3%positive predictive value,and 94.7%negative predictive value.10/11 distant metastasis were diagnosed accurately on 18 F-FDG PET/CT with 1 false positive and 2 false negative cases,83.3%sensitivity,95.0%specificity,90.1%accuracy,90.9%positive predictive value and 90.5% negative predictive value.The therapeutic decision was changed in 12/32 patients based on the PET/CT results.Conclusion 18 F-FDG PET/CT is valuable in the detection of recurrent and/or metastatic bone and soft tissue sarcoma.