Torizuka Tatsuo, Nobezawa Shuji, Kanno Toshihiko, Futatsubashi Masami, Yoshikawa Etsuji, Okada Hiroyuki, Takekuma Munetaka, Maeda Makoto, Ouchi Yasuomi
Positron Medical Center, Hamamatsu Medical Center, 5000, Hirakuchi, Hamakita, Shizuoka, 434-0041, Japan.
Eur J Nucl Med Mol Imaging. 2002 Jun;29(6):797-803. doi: 10.1007/s00259-001-0750-9. Epub 2002 Mar 19.
This study was designed to assess the value of whole-body positron emission tomography (PET) using 2-[fluorine-18]-fluoro-2-deoxy- D-glucose (FDG) for the diagnosis of recurrent ovarian cancer. Twenty-five patients who had previously undergone surgery for ovarian cancer were imaged using whole-body FDG-PET. During the 4 weeks preceding the PET study, conventional imaging, comprising computed tomography (CT) and magnetic resonance (MR) imaging of the abdomen and/or pelvis, was performed and serum CA125 levels were measured. PET imaging was commenced at 60 min after the intravenous administration of FDG in all patients. PET results were compared with the results of conventional imaging and CA125 levels, and related to pathological findings and clinical follow-up for more than 6 months. FDG-PET showed a sensitivity of 80% (16/20), a specificity of 100% (5/5) and an accuracy of 84% accuracy (21/25) for the diagnosis of recurrent ovarian cancer. The sensitivity, specificity and accuracy of conventional imaging were 55% (11/20), 100% (5/5) and 64% (16/25), respectively. PET could detect recurrent lesions in seven of nine patients in whom conventional imaging was falsely normal, while conventional imaging was true positive in two of four patients with false-negative PET results. The CA125 results showed a sensitivity of 75% (15/20), a specificity of 100% (5/5) and an accuracy of 80% accuracy (20/25). Among the 15 patients with true-positive CA125 results, PET correctly detected abnormal foci of recurrence in 13 patients (86.7%) whereas conventional imaging showed recurrent lesions in only eight patients (53.3%). In conclusion, our preliminary study demonstrates that FDG-PET may be accurate and useful for the detection of tumour recurrence when conventional imaging is inconclusive or negative, especially in patients with abnormal CA125 levels.
本研究旨在评估使用2-[氟-18]-氟-2-脱氧-D-葡萄糖（FDG）的全身正电子发射断层扫描（PET）对复发性卵巢癌的诊断价值。对25例先前接受过卵巢癌手术的患者进行了全身FDG-PET成像。在PET研究前的4周内，进行了包括腹部和/或盆腔计算机断层扫描（CT）和磁共振（MR）成像的传统成像，并测量了血清CA125水平。所有患者在静脉注射FDG 60分钟后开始PET成像。将PET结果与传统成像结果和CA125水平进行比较，并与病理结果及超过6个月的临床随访结果相关联。FDG-PET对复发性卵巢癌诊断的敏感性为80%（16/20），特异性为100%（5/5），准确性为84%（21/25）。传统成像的敏感性、特异性和准确性分别为55%（11/20）、100%（5/5）和64%（16/25）。PET能够在9例传统成像结果为假阴性的患者中的7例中检测到复发病变，而在4例假阴性PET结果的患者中，有2例传统成像结果为真阳性。CA125结果显示敏感性为75%（15/20），特异性为100%（5/5），准确性为80%（20/25）。在15例CA125结果为真阳性的患者中，PET正确检测出13例患者（86.7%）的复发异常病灶，而传统成像仅显示8例患者（53.3%）有复发病变。总之，我们的初步研究表明，当传统成像结果不明确或为阴性时，尤其是CA125水平异常的患者，FDG-PET可能对肿瘤复发的检测准确且有用。
