Greven K M, Williams D W, McGuirt W F, Harkness B A, D'Agostino R B, Keyes J W, Watson N E
Department of Radiation Oncology, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, North Carolina 27157, USA.
Head Neck. 2001 Nov;23(11):942-6. doi: 10.1002/hed.1136.
A single institution study was undertaken to evaluate the role of positron emission tomography (PET) scans with fluorodeoxyglucose (FDG) prior to radiation and following radiation.
Forty-five patients with head and neck cancers were evaluated with FDG-PET scans as well as either CT or MRI prior to treatment with definitive radiation (RT). These same scans were obtained following completion of RT at 1 month (36 patients), 4 months (28 patients), 12 months (19 patients), and 24 months (15 patients). Standard uptake values (SUV) normalized for blood glucose and lean body mass were calculated on the initial and 1-month post-treatment PET scans.
Fifteen patients are alive without evidence of disease at 24 to 52 months following RT. Initial SUVs were calculated on the primary tumor site and ranged from 2.5 to 28.5. These values did not have any correlation with local control when examined for the entire group, primary site, or T stage. One-month post-RT SUV ranged from 1.8 to 6.24. Of the 36 1-month post-RT PET scans, six were interpreted as positive for residual disease and were confirmed by biopsy. Four of the five scans, which were interpreted as equivocal, were positive on biopsy. Seven of the 25 scans, which were interpreted as negative for tumor, were positive on biopsy. Four-month scans were more accurate for disease with disease noted in 0 of 18 negative scans, 6 of 7 positive scans, and 2 of 3 equivocal scans.
PET is useful for initial imaging of head and neck cancers. SUV does not appear to be useful for predicting outcome following treatment with RT. One-month post-RT scans were inaccurate for predicting the presence of cancer. Four-month post-RT scans were a better predictor for the presence of cancer.
开展了一项单机构研究，以评估氟脱氧葡萄糖（FDG）正电子发射断层扫描（PET）在放疗前及放疗后的作用。
45例头颈部癌患者在进行根治性放疗（RT）前接受了FDG-PET扫描以及CT或MRI检查。在放疗完成后1个月（36例患者）、4个月（28例患者）、12个月（19例患者）和24个月（15例患者）时进行了相同的扫描。根据初始及放疗后1个月的PET扫描计算经血糖和去脂体重标准化的标准摄取值（SUV）。
15例患者在放疗后24至52个月存活且无疾病证据。在原发肿瘤部位计算的初始SUV范围为2.5至28.5。对整个组、原发部位或T分期进行检查时，这些值与局部控制均无相关性。放疗后1个月的SUV范围为1.8至6.24。在36例放疗后1个月的PET扫描中，6例被判定为残留疾病阳性并经活检证实。5例判定为可疑的扫描中有4例活检呈阳性。25例判定为肿瘤阴性的扫描中有7例活检呈阳性。4个月时的扫描对疾病的诊断更准确，18例阴性扫描中有0例发现疾病，7例阳性扫描中有6例发现疾病，3例可疑扫描中有2例发现疾病。
PET对头颈部癌的初始成像有用。SUV似乎对预测放疗后的结果无用。放疗后1个月的扫描对癌症存在情况的预测不准确。放疗后4个月的扫描对癌症存在情况是更好的预测指标。
