Nishiyama Yoshihiro, Yamamoto Yuka, Yokoe Koiku, Miyabe Kazunori, Ogawa Takaaki, Toyama Yoshihiro, Satoh Katashi, Ohkawa Motoomi
Department of Radiology, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa 761-0793, Japan.
Nucl Med Commun. 2005 Mar;26(3):239-44. doi: 10.1097/00006231-200503000-00008.
The presence of simultaneous primary tumours in other regions affects the prognosis and management decisions of head and neck cancer patients. Therefore, early detection of these tumours is necessary. Recent improvements in positron emission tomography (PET) have made it possible to examine the patient's whole body. The present study was undertaken to evaluate the clinical contribution of whole-body PET using fluorodeoxyglucose (FDG) for head and neck cancer patients.
Fifty-three consecutive patients with previously untreated head and neck cancer were examined. Whole-body FDG PET imaging was performed at 1 h after injection of (18)F-FDG. A 3-D acquisition was undertaken and iterative reconstruction was performed. The final diagnosis of simultaneous primary tumour was established by histological findings or clinical follow-up.
Of 53 patients, six (11%) had evidence of simultaneous primary tumour. In five of these six patients, simultaneous primary tumours (two gastric cancer; one colon cancer; one pancreatic cancer; one thyroid cancer) were found by FDG PET. One more patient was found to have prostate cancer on the basis of blood test but this was not detected by FDG PET. In none of the remaining 47 patients, were additional simultaneous primary tumours found by FDG PET or any of the other routine examinations or during follow-up.
The results of this study show a high rate of simultaneous primary tumour in patients with primary head and neck cancer. FDG PET appears to be a promising imaging modality for the detection of simultaneous tumours in head and neck cancer patients.
其他部位同时存在原发性肿瘤会影响头颈癌患者的预后和治疗决策。因此，早期检测这些肿瘤很有必要。正电子发射断层扫描（PET）技术的最新进展使得对患者进行全身检查成为可能。本研究旨在评估使用氟脱氧葡萄糖（FDG）的全身PET对头颈癌患者的临床贡献。
对53例连续的未经治疗的头颈癌患者进行检查。在注射（18）F-FDG后1小时进行全身FDG PET成像。进行三维采集并进行迭代重建。同时原发性肿瘤的最终诊断通过组织学检查结果或临床随访确定。
53例患者中，6例（11%）有同时原发性肿瘤的证据。在这6例患者中的5例中，FDG PET发现了同时原发性肿瘤（2例胃癌；1例结肠癌；1例胰腺癌；1例甲状腺癌）。另外1例患者根据血液检查发现患有前列腺癌，但FDG PET未检测到。在其余47例患者中，FDG PET或任何其他常规检查以及随访期间均未发现额外的同时原发性肿瘤。
本研究结果显示原发性头颈癌患者同时原发性肿瘤的发生率较高。FDG PET似乎是检测头颈癌患者同时性肿瘤的一种有前景的成像方式。
