Whiteford M H, Whiteford H M, Yee L F, Ogunbiyi O A, Dehdashti F, Siegel B A, Birnbaum E H, Fleshman J W, Kodner I J, Read T E
Department of Surgery, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri, USA.
Dis Colon Rectum. 2000 Jun;43(6):759-67; discussion 767-70. doi: 10.1007/BF02238010.
The purpose of this study was to evaluate the clinical efficacy of positron emission tomography with 2-[18F] fluoro-2-deoxy-D-glucose compared with computed tomography plus other conventional diagnostic studies in patients suspected of having metastatic or recurrent colorectal adenocarcinoma.
The records of 105 patients who underwent 101 computed tomography and 109 2-[18F] fluoro-2-deoxy-D-glucose positron emission tomography scans for suspected metastatic or recurrent colorectal adenocarcinoma were reviewed. Clinical correlation was confirmed at time of operation, histopathologically, or by clinical course.
The overall sensitivity and specificity of 2-[18F] fluoro-2-deoxy-D-glucose positron emission tomography in detection of clinically relevant tumor were higher (87 and 68 percent) than for computed tomography plus other conventional diagnostic studies (66 and 59 percent). The sensitivity of 2-[18F] fluoro-2-deoxy-D-glucose positron emission tomography in detecting mucinous cancer was lower (58 percent; n = 16) than for nonmucinous cancer (92 percent; n = 93). The sensitivity of 2-[18F] fluoro-2-deoxy-D-glucose positron emission tomography in detecting locoregional recurrence (n = 70) was higher than for computed tomography plus colonoscopy (90 vs. 71 percent, respectively). The sensitivity of 2-[18F] fluoro-2-deoxy-D-glucose positron emission tomography in detecting hepatic metastasis (n = 101) was higher than for computed tomography (89 vs. 71 percent). The sensitivity of 2-[18F] fluoro-2-deoxy-D-glucose positron emission tomography in detecting extrahepatic metastases exclusive of locoregional recurrence (n = 101) was higher than for computed tomography plus other conventional diagnostic studies (94 vs. 67 percent). 2-[18F] fluoro-2-deoxy-D-glucose positron emission tomography altered clinical management in a beneficial manner in 26 percent of cases (26/101) when compared with evaluation by computed tomography plus other conventional diagnostic studies.
2-[18F] fluoro-2-deoxy-D-glucose positron emission tomography is more sensitive than computed tomography for the detection of metastatic or recurrent colorectal cancer and may improve clinical management in one-quarter of cases. However, 2-[18F] fluoro-2-deoxy-D-glucose positron emission tomography is not as sensitive in detecting mucinous adenocarcinoma, possibly because of the relative hypocellularity of these tumors.
本研究旨在评估2-[18F]氟-2-脱氧-D-葡萄糖正电子发射断层扫描与计算机断层扫描及其他传统诊断研究相比，在疑似转移性或复发性结直肠癌患者中的临床疗效。
回顾了105例因疑似转移性或复发性结直肠癌接受101次计算机断层扫描和109次2-[18F]氟-2-脱氧-D-葡萄糖正电子发射断层扫描的患者记录。通过手术时、组织病理学或临床病程确认临床相关性。
2-[18F]氟-2-脱氧-D-葡萄糖正电子发射断层扫描检测临床相关肿瘤的总体敏感性和特异性（分别为87%和68%）高于计算机断层扫描及其他传统诊断研究（分别为66%和59%）。2-[18F]氟-2-脱氧-D-葡萄糖正电子发射断层扫描检测黏液癌的敏感性（58%；n = 16）低于非黏液癌（92%；n = 93）。2-[18F]氟-2-脱氧-D-葡萄糖正电子发射断层扫描检测局部区域复发（n = 70）的敏感性高于计算机断层扫描加结肠镜检查（分别为90%和71%）。2-[18F]氟-2-脱氧-D-葡萄糖正电子发射断层扫描检测肝转移（n = 101）的敏感性高于计算机断层扫描（分别为89%和71%）。2-[18F]氟-2-脱氧-D-葡萄糖正电子发射断层扫描检测不包括局部区域复发的肝外转移（n = 101）的敏感性高于计算机断层扫描及其他传统诊断研究（分别为94%和67%）。与计算机断层扫描及其他传统诊断研究评估相比，2-[18F]氟-2-脱氧-D-葡萄糖正电子发射断层扫描在26%的病例（26/101）中以有益的方式改变了临床管理。
2-[F]氟-2-脱氧-D-葡萄糖正电子发射断层扫描在检测转移性或复发性结直肠癌方面比计算机断层扫描更敏感，可能在四分之一的病例中改善临床管理。然而，2-[18F]氟-2-脱氧-D-葡萄糖正电子发射断层扫描在检测黏液腺癌方面不那么敏感，可能是因为这些肿瘤相对细胞稀少。
