Johnson K, Bakhsh A, Young D, Martin T E, Arnold M
Grant Medical Center, Columbus, Ohio, USA.
Dis Colon Rectum. 2001 Mar;44(3):354-7. doi: 10.1007/BF02234732.
Several studies have been performed comparing computed tomography scan with positron emission tomography scan in clinical decision making. Unfortunately, therapeutic decisions are being made based on positron emission tomography scan data without a clear understanding of how well the diagnostic findings correlate with the clinical findings.
A retrospective review of 41 patients with metastatic colorectal cancer was performed. All patients had both a computed tomography scan and a positron emission tomography scan before surgical exploration. All underwent surgical re-exploration. Findings were divided into hepatic, extrahepatic, and pelvic regions of the abdomen. Computed tomography scan and positron emission tomography scan findings were either confirmed or refuted by the operative findings.
Positron emission tomography scan was found to be more sensitive than computed tomography scan when compared with actual operative findings in the liver (100 vs. 69 percent, P = 0.004), extrahepatic region (90 vs. 52 percent, P = 0.015), and abdomen as a whole (87 vs. 61 percent, P < 0.001). Sensitivities of positron emission tomography scan and computed tomography scan were not significantly different in the pelvic region (87 vs. 61 percent, P = 0.091). In each case, specificity was not significantly different between the two examinations.
Computed tomography scan and positron emission tomography scan are both diagnostic tests useful in the evaluation of metastatic colorectal cancer. However, positron emission tomography scanning is more sensitive than computed tomography scanning and more likely to give the correct result when actual metastatic disease is present.
已经进行了多项研究，比较计算机断层扫描与正电子发射断层扫描在临床决策中的应用。不幸的是，目前基于正电子发射断层扫描数据做出治疗决策时，并未清楚了解诊断结果与临床发现之间的关联程度。
对41例转移性结直肠癌患者进行回顾性研究。所有患者在手术探查前均接受了计算机断层扫描和正电子发射断层扫描。全部患者均接受了再次手术探查。结果分为腹部的肝区、肝外区域和盆腔区域。计算机断层扫描和正电子发射断层扫描的结果通过手术结果进行确认或反驳。
与肝脏实际手术结果相比，正电子发射断层扫描比计算机断层扫描更敏感（100%对69%，P = 0.004），肝外区域（90%对52%，P = 0.015），以及整个腹部（87%对61%，P < 0.001）。正电子发射断层扫描和计算机断层扫描在盆腔区域的敏感性无显著差异（87%对61%，P = 0.091）。在每种情况下，两种检查的特异性无显著差异。
计算机断层扫描和正电子发射断层扫描都是评估转移性结直肠癌的有用诊断检查。然而，正电子发射断层扫描比计算机断层扫描更敏感，在存在实际转移性疾病时更有可能得出正确结果。
