Nakamoto Y, Saga T, Ishimori T, Mamede M, Togashi K, Higuchi T, Mandai M, Fujii S, Sakahara H, Konishi J
Department of Nuclear Medicine and Diagnostic Imaging, Graduate School of Medicine, Kyoto University Hospital, 54 Shogoin-kawahara-cho, Sakyo-Ku, Kyoto, 606-8507 Japan.
AJR Am J Roentgenol. 2001 Jun;176(6):1449-54. doi: 10.2214/ajr.176.6.1761449.
Recurrence is often a major problem for patients who have undergone surgery for ovarian cancer. This prospective study was undertaken to evaluate the clinical contribution of positron emission tomography (PET) using (18)F-fluorodeoxyglucose (FDG) for recurrent ovarian cancer.
Twenty-four women who had undergone surgery or chemoradiotherapy for histopathologically proven ovarian cancer were enrolled in this study. Ovarian cancer was thought to have recurred in 12 of these women because of evidence on conventional imaging modalities or tumor marker measurements (group A). Clinical findings for the remaining 12 women showed them to be disease-free (group B). PET findings for the women were compared with the final diagnoses obtained by histopathology or by clinical follow-up. The clinical contribution of PET was assessed by evaluating whether PET yielded information complementing the findings of conventional modalities and by examining its impact on treatment.
PET gave valuable information for seven of 12 patients in group A in addition to the information obtained from findings on conventional imaging, and treatment was affected in five patients. On the other hand, in group B, additional information was obtained in only three of 12 patients, and treatment of only one patient was affected. Overall sensitivity, specificity, and accuracy of conventional imaging modalities were 72.7%, 75.0%, and 73.3%, respectively, and these rates improved to 92.3%, 100.0%, and 94.4%, respectively, by considering both conventional imaging modalities and PET findings.
Our preliminary data suggest that whole-body PET with FDG can be a complementary modality for following up patients who have had ovarian cancer, especially patients believed to be at risk for recurrence.
对于接受过卵巢癌手术的患者,复发常常是一个主要问题。本前瞻性研究旨在评估使用(18)F - 氟脱氧葡萄糖(FDG)的正电子发射断层扫描(PET)对复发性卵巢癌的临床贡献。
24名经组织病理学证实患有卵巢癌并接受过手术或放化疗的女性纳入本研究。其中12名女性因传统影像学检查或肿瘤标志物检测有证据表明卵巢癌复发(A组)。其余12名女性的临床检查结果显示无疾病(B组)。将这些女性的PET检查结果与通过组织病理学或临床随访获得的最终诊断结果进行比较。通过评估PET是否能提供补充传统检查方式结果的信息以及检查其对治疗的影响来评估PET的临床贡献。
A组12名患者中,除了从传统影像学检查结果获得的信息外,PET为7名患者提供了有价值的信息,5名患者的治疗受到影响。另一方面,在B组中,12名患者中只有3名获得了额外信息,只有1名患者的治疗受到影响。传统影像学检查方式的总体敏感性、特异性和准确性分别为72.7%、75.0%和73.3%,通过综合考虑传统影像学检查方式和PET检查结果,这些比率分别提高到92.3%、100.0%和94.4%。
我们的初步数据表明,FDG全身PET可作为卵巢癌患者随访的补充检查方式,尤其是对于被认为有复发风险的患者。