Safaei A, Figlin R, Hoh C K, Silverman D H, Seltzer M, Phelps M E, Czernin J
Ahmanson Biological Imaging Clinic/Nuclear Medicine, Department of Molecular and Medical Pharmacology, UCLA School of Medicine, Los Angeles, CA 90095-6948, USA.
Clin Nephrol. 2002 Jan;57(1):56-62. doi: 10.5414/cnp57056.
The use of whole-body PET for re-staging of renal cell carcinoma has not been investigated. The aim of the current study was to examine the diagnostic accuracy and clinical usefulness of whole-body PET imaging for re-staging of renal cell cancer.
Clinical PET was performed for re-staging in 36 patients with advanced renal cell cancer. Written reports of imaging studies (including CT, MRI, US, plain film and bone scan), patient history, and extensive chart notes were used to define the clinical stage before PET (pre-PET stage). The written PET report was used to define the clinical stage after PET (PET stage). Reports were used to determine the accuracy of PET for re-staging renal cell cancer and for defining biopsy proven lesions. Clinical parameters and biopsy proven lesions served as reference for the accuracy of PET for re-staging renal cell cancer.
PET classified the clinical stage correctly in 32/36 patients (89%) and was incorrect in 4/36 (11%) (sensitivity and specificity: 87% and 100%). In 20 patients, 25 suspicious lesions were biopsied within 3.2 +/- 6.7 months of the PET study. Of these, 17 were malignant and 8 were benign. PET correctly classified 21/25 (84%) of the biopsied lesions (sensitivity and specificity: 88% and 75%).
PET re-stages renal cell cancer with a diagnostic accuracy of 89%. Its diagnostic accuracy for classifying biopsy proven anatomic lesions as malignant or benign was 84%. These findings suggest that PET is useful in characterizing anatomic lesions of unknown significance in patients with renal cell cancer.
尚未对全身PET用于肾细胞癌再分期进行研究。本研究的目的是检验全身PET成像用于肾细胞癌再分期的诊断准确性和临床实用性。
对36例晚期肾细胞癌患者进行临床PET检查以进行再分期。利用影像学研究（包括CT、MRI、超声、平片和骨扫描）的书面报告、患者病史及详细的病历记录来确定PET检查前的临床分期（PET检查前分期）。PET书面报告用于确定PET检查后的临床分期（PET分期）。报告用于确定PET对肾细胞癌再分期及明确活检证实病变的准确性。临床参数和活检证实病变作为PET对肾细胞癌再分期准确性的参考。
PET对32/36例患者（89%）的临床分期分类正确，4/36例（11%）分类错误（敏感性和特异性分别为87%和100%）。20例患者在PET检查后3.2±6.7个月内对25个可疑病变进行了活检。其中，17个为恶性，8个为良性。PET对25个活检病变中的21个（84%）分类正确（敏感性和特异性分别为88%和75%）。
PET对肾细胞癌再分期的诊断准确性为89%。其将活检证实的解剖学病变分类为恶性或良性的诊断准确性为84%。这些结果表明，PET有助于明确肾细胞癌患者中意义不明的解剖学病变的特征。
