Skehan S J, Brown A L, Thompson M, Young J E, Coates G, Nahmias C
Department of Nuclear Medicine and Radiology, McMaster University Medical Centre, 1200 Main St W, Hamilton, Ontario, Canada L8N 3Z5.
Radiographics. 2000 May-Jun;20(3):713-23. doi: 10.1148/radiographics.20.3.g00ma04713.
Because of the poor prognosis for patients with esophageal cancer and the risks associated with surgical intervention, accurate staging is essential for optimal treatment planning. Positron emission tomography (PET) with 2-[fluorine-18]fluoro-2-deoxy-d-glucose (FDG) is a useful adjunct to more conventional imaging modalities in this setting. 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. However, 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 FDG PET. In addition, FDG PET has proved valuable in determining the resectability of disease and allows scanning of a larger volume than is possible with computed tomography. Recurrent disease is readily diagnosed and differentiated from scar tissue with FDG PET. In addition, 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 unresponsive tumors. The management of most patients with esophageal cancer can be improved with use of FDG PET.
由于食管癌患者预后较差且手术干预存在风险，准确分期对于制定最佳治疗方案至关重要。在这种情况下，正电子发射断层扫描（PET）结合2-[氟-18]氟-2-脱氧-D-葡萄糖（FDG）是对更传统成像方式的一种有用辅助手段。FDG PET在食管癌检测中并非合适的一线诊断程序，对检测原发肿瘤的局部侵犯也无帮助，需要进一步研究以确定其在检测局部淋巴结转移方面的疗效。然而，FDG PET在检测远处转移方面优于解剖成像方式。在FDG PET上可轻易识别肝、肺和骨骼的转移。此外，FDG PET在确定疾病的可切除性方面已被证明有价值，并且能够扫描比计算机断层扫描更大的范围。通过FDG PET可轻易诊断复发性疾病并将其与瘢痕组织区分开来。此外，FDG PET在接受化疗和放疗的患者随访中可能发挥重要作用，可针对无反应的肿瘤尽早改变治疗方案。使用FDG PET可改善大多数食管癌患者的管理。
