Ramdave S, Thomas G W, Berlangieri S U, Bolton D M, Davis I, Danguy H T, Macgregor D, Scott A M
Department of Nuclear Medicine and Centre for PET, Department of Nephrology, Oncology Unit, Ludwig Institute for Cancer Research, Austin & Repatriation Medical Centre, Heidelberg, Australia.
J Urol. 2001 Sep;166(3):825-30.
We evaluate the accuracy of F-18 fluorodeoxyglucose (FDG)-positron emission tomography (PET) for staging and management of renal cell carcinoma.
FDG-PET was performed in 25 patients with known or suspected primary renal tumors and/or metastatic disease and compared with conventional imaging techniques, including computerized tomography (CT). Histopathological confirmation was obtained in 18 patients and confirmation of the disease was by followup in the remainder. The impact of FDG-PET on disease management was also assessed.
Of the 17 patients with known or suspected primary tumors FDG-PET was true positive in 15, true negative in 1 and false-negative in 1. Comparative CT was true positive in 16 patients and false-positive in 1. The accuracy of FDG-PET and CT was similar (94%). All patients would have undergone radical nephrectomy after conventional imaging findings but FDG-PET results altered treatment decisions for 6 (35%), of whom 3 underwent partial nephrectomy and 3 avoided surgery due to confirmation of benign pathology or detection of unsuspected metastatic disease. Of the 8 cases referred for evaluation of local recurrence and/or metastatic disease FDG-PET changed treatment decisions in 4 (50%), with disease up staged in 3 and recurrence excluded in 1. Compared with CT, FDG-PET was able to detect local recurrence and distant metastases more accurately and differentiated recurrence from radiation necrosis.
FDG-PET accurately detected local disease spread and metastatic disease in patients with renal cell carcinoma and altered treatment in 40%. FDG-PET may have a role in the diagnostic evaluation of patients with renal cell carcinoma preoperatively and staging of metastatic disease.
我们评估F-18氟脱氧葡萄糖（FDG）-正电子发射断层扫描（PET）在肾细胞癌分期及治疗管理中的准确性。
对25例已知或疑似原发性肾肿瘤和/或转移性疾病的患者进行了FDG-PET检查，并与包括计算机断层扫描（CT）在内的传统成像技术进行比较。18例患者获得了组织病理学确诊，其余患者通过随访确诊疾病。还评估了FDG-PET对疾病治疗管理的影响。
在17例已知或疑似原发性肿瘤的患者中，FDG-PET真阳性15例，真阴性1例，假阴性1例。对比CT真阳性16例，假阳性1例。FDG-PET和CT的准确性相似（94%）。所有患者在传统成像检查结果出来后都本会接受根治性肾切除术，但FDG-PET结果改变了6例（35%）患者的治疗决策，其中3例接受了部分肾切除术，3例因病理结果为良性或检测到意外转移性疾病而避免了手术。在8例因评估局部复发和/或转移性疾病而转诊的病例中，FDG-PET改变了4例（50%）患者的治疗决策，其中3例疾病分期上调，1例排除了复发。与CT相比，FDG-PET能够更准确地检测局部复发和远处转移，并区分复发与放射性坏死。
FDG-PET准确检测了肾细胞癌患者的局部疾病扩散和转移性疾病，并使40%的患者治疗方案发生改变。FDG-PET在肾细胞癌患者术前诊断评估及转移性疾病分期中可能具有一定作用。
