Arulampalam T H A, Francis D L, Visvikis D, Taylor I, Ell P J
Department of Surgery, Royal Free and University College Medical School, Charles Bell House, 67-73, Riding House Street, London W1W 7EJ, UK.
Eur J Surg Oncol. 2004 Apr;30(3):286-91. doi: 10.1016/j.ejso.2003.10.023.
This study assesses the accuracy of routine whole body fluorodeoxyglucose-positron emission tomography (FDG-PET) in the pre-operative staging of patients with colorectal liver metastases (CLM).
A prospective study of patients referred for hepatic resection was undertaken. Patients were staged by spiral CT and FDG-PET. The results of these investigations were considered independently.
Twenty-eight patients had confirmed CLM. Eleven patients had solitary CLM; 10 of whom were correctly identified by both modalities. In the remaining 17 patients, 10 had multiple CLM and seven had extrahepatic disease. FDG-PET detected all lesions (sensitivity 100%, specificity 91%). CT incorrectly diagnosed solitary CLM in five patients and failed to detect extrahepatic disease in four patients (sensitivity 47%, specificity 91%). FDG-PET resulted in altered management for 12 patients of whom seven avoided inappropriate surgery.
FDG-PET is more sensitive and specific for pre-operative staging of CLM. FDG-PET confers clinical benefit through altered patient management.
本研究评估了常规全身氟脱氧葡萄糖-正电子发射断层扫描（FDG-PET）在结直肠癌肝转移（CLM）患者术前分期中的准确性。
对转诊接受肝切除术的患者进行了一项前瞻性研究。患者通过螺旋CT和FDG-PET进行分期。这些检查结果被独立评估。
28例患者确诊为CLM。11例患者为孤立性CLM；其中10例通过两种检查方式均被正确识别。在其余17例患者中，10例有多发性CLM，7例有肝外疾病。FDG-PET检测到了所有病变（敏感性100%，特异性91%）。CT在5例患者中错误诊断为孤立性CLM，在4例患者中未能检测到肝外疾病（敏感性47%，特异性91%）。FDG-PET使12例患者的治疗方案发生了改变，其中7例避免了不适当的手术。
FDG-PET在CLM术前分期中更敏感、更具特异性。FDG-PET通过改变患者的治疗方案带来了临床益处。
