García Velloso M J, Boán García J F, Villar Luque L M, Aramendía Beitia J M, López García G, Richter Echeverría J A
Servicio de Medicina Nuclear. Clínica Universitaria. Facultad de Medicina. Universidad de Navarra. Pamplona. Spain.
Rev Esp Med Nucl. 2003 Jul-Aug;22(4):217-23. doi: 10.1016/s0212-6982(03)72189-2.
The aim of this study was to evaluate the clinical utility of FDG-PET for detecting recurrent disease in patients with ovarian cancer.
Twenty-one FDG-PET studies performed in 19 patients who had previously undergone surgery and chemotherapy for ovarian cancer were reviewed retrospectively. In a maximum interval of one week regarding the FDG-PET study, computed tomography (CT) was performed and CA-125 levels were measured. In 16 cases the relapse suspicion was due to elevation of the tumor marker CA125 and in 5 cases it was due to CT. PET images were obtained at 45 min after the intravenous injection of 370 MBq of FDG. The results of the visual interpretation were compared with the CA125 levels and the images of the CT, and related to the definitive diagnosis. Recurrence was confirmed in 19/21 cases, by means of pathological findings (11 cases) and clinical follow-up for a median of 11 months in the others.
Recurrence was confirmed in 16 cases with increased CA-125 and the tumor marker was true-negative in 2 disease free cases, but there were 3 false-negative results (sensitivity of 84 % and accuracy of 86 %). CT correctly identified 9 cases with recurrence, but it was false-negative in 10 cases and false-positive in 2 disease free patients (sensitivity of 47 % and accuracy of 43 %). FDG-PET correctly detected the 19 cases with recurrence but it was false-positive in 2 cases with a sensitivity of 100 % and accuracy of 90 %. In 3 patients with CA125 false-negative and 10 patients with false-negative CT, FDG-PET was positive and recurrence was confirmed.
These preliminary results suggest that in the follow-up of patients with ovarian cancer FDG-PET could detect recurrence with higher accuracy than CT, and even with higher sensitivity than the tumor marker CA125, being useful at the same time to locate the recurrence when the tumor marker is positive.
本研究旨在评估氟代脱氧葡萄糖正电子发射断层扫描（FDG-PET）在检测卵巢癌患者复发疾病方面的临床应用价值。
回顾性分析了19例曾接受过卵巢癌手术及化疗患者的21次FDG-PET检查。在进行FDG-PET检查的最长一周间隔内，进行了计算机断层扫描（CT）并检测了CA-125水平。16例复发怀疑是由于肿瘤标志物CA125升高，5例是由于CT检查。在静脉注射370 MBq FDG后45分钟获得PET图像。将视觉解读结果与CA125水平和CT图像进行比较，并与最终诊断结果相关联。19/21例患者经病理检查（11例）及其他患者中位11个月的临床随访确诊复发。
16例CA-125升高患者确诊复发，2例无病患者肿瘤标志物为真阴性，但有3例假阴性结果（敏感性84%，准确性86%）。CT正确识别出9例复发患者，但有10例假阴性结果，2例无病患者为假阳性结果（敏感性47%，准确性43%）。FDG-PET正确检测出19例复发患者，但有2例假阳性结果，敏感性为100%，准确性为90%。在3例CA125假阴性和10例CT假阴性的患者中，FDG-PET呈阳性且复发得到确诊。
这些初步结果表明，在卵巢癌患者的随访中，FDG-PET检测复发的准确性高于CT，甚至比肿瘤标志物CA125的敏感性更高，同时在肿瘤标志物呈阳性时有助于定位复发部位。
