F-18氟代脱氧葡萄糖正电子发射断层扫描在考虑对结直肠癌肝转移患者进行根治性切除术前肝脏评估中的作用。

The role of F-18 FDG positron emission tomography in preoperative assessment of the liver in patients being considered for curative resection of hepatic metastases from colorectal cancer.

作者信息

Rohren Eric M, Paulson Erik K, Hagge Rosalie, Wong Terrence Z, Killius James, Clavien Pierre-Alain, Nelson Rendon C

机构信息

Department of Radiology, Duke University Medical Center, Durham, North Carolina 27710, USA.

出版信息

Clin Nucl Med. 2002 Aug;27(8):550-5. doi: 10.1097/00003072-200208000-00002.

DOI:10.1097/00003072-200208000-00002

PMID:12169999

Abstract

PURPOSE

The authors' goal was to determine the sensitivity and specificity of F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) for identifying patients with hepatic metastases from colorectal cancer and the accuracy of PET for determining the number and distribution of lesions within the liver. Intraoperative sonography and surgical inspection and palpation were used as the reference standard.

METHODS

Twenty-three patients being evaluated for surgical resection of hepatic metastases from colorectal carcinoma underwent FDG PET before operation. Findings of the PET studies were reviewed in a blinded, retrospective manner, with the results compared with the findings of intraoperative sonography and surgical exploration. Lesions of all sizes were considered in the analysis.

RESULTS

The FDG-PET results were positive in 21 of the 22 patients ultimately found to have metastatic disease to the liver, and they were negative in the single patient without metastases. Therefore, for identification of patients with hepatic metastatic disease, PET has a sensitivity of 95% and a specificity of 100%. In all, 48 metastatic lesions were identified in these patients, of which 38 (79%) were identified on PET images. The probability of lesion detection by PET was directly correlated with lesion size (P < 0.01). The assessment of lobar disease distribution in the liver was discordant between PET and surgery in 3 of 23 (13%) patients.

CONCLUSIONS

In patients being evaluated for potential curative resection of hepatic metastases from colorectal cancer, FDG PET is accurate for the identification of the presence or absence of metastatic disease to the liver. However, detection of individual lesions depends on their size, and determination of lesion number and distribution within the liver is more accurately accomplished with intraoperative sonography.

摘要

目的

作者的目标是确定F-18氟脱氧葡萄糖（FDG）正电子发射断层扫描（PET）用于识别结直肠癌肝转移患者的敏感性和特异性，以及PET用于确定肝内病变数量和分布的准确性。术中超声检查以及手术探查和触诊被用作参考标准。

方法

23例接受结直肠癌肝转移手术切除评估的患者在术前接受了FDG PET检查。PET研究结果采用盲法进行回顾性审查，并将结果与术中超声检查和手术探查结果进行比较。分析中考虑了所有大小的病变。

结果

最终发现有肝转移的22例患者中，21例的FDG-PET结果为阳性，而无转移的1例患者结果为阴性。因此，对于识别肝转移疾病患者，PET的敏感性为95%，特异性为100%。这些患者共识别出48个转移灶，其中PET图像上识别出38个（79%）。PET检测病变的概率与病变大小直接相关（P<0.01）。23例患者中有3例（13%）PET与手术对肝叶疾病分布的评估不一致。