Lim Joon Seok, Yun Mi Jin, Kim Myeong-Jin, Hyung Woo Jin, Park Mi-Suk, Choi Jin-Young, Kim Tae-Sung, Lee Jong Doo, Noh Sung Hoon, Kim Ki Whang
Department of Diagnostic Radiology, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemoon-ku, Seoul, 120-752, Republic of Korea.
Radiographics. 2006 Jan-Feb;26(1):143-56. doi: 10.1148/rg.261055078.
Stomach cancer is one of the leading causes of cancer mortality worldwide. Complete resection of a gastric tumor and adjacent lymph nodes represents the only potentially curative intervention. Computed tomography (CT) has remained the modality of choice for the preoperative staging of gastric cancer and for follow-up. A recently developed advanced CT technique that makes use of thin sections, optimal contrast material enhancement, and multiplanar reformation allows more accurate staging. However, CT may be limited in the identification of nonenlarged lymph node metastasis, peritoneal dissemination, and small hematogenous metastasis. Positron emission tomography (PET) with 2-[fluorine-18]fluoro-2-deoxy-d-glucose (FDG) has been recognized as a useful diagnostic technique in clinical oncology. FDG PET allows scanning of a larger volume than is possible with CT. Although FDG PET is not an appropriate first-line diagnostic procedure in the detection of stomach cancer and is not helpful in tumor staging, it may play a valuable role in the detection of distant metastases, such as those of the liver, lungs, adrenal glands, ovaries, and skeleton. FDG PET may also be helpful in the follow-up of patients undergoing chemotherapy, as it allows the identification of early response to treatment. Further studies are needed to determine the efficacy of FDG PET in the detection of local nodal metastases and peritoneal dissemination. Nevertheless, the combined use of CT and PET can be helpful in the preoperative staging of stomach cancer and in the therapeutic monitoring of affected patients.
胃癌是全球癌症死亡的主要原因之一。完整切除胃肿瘤及相邻淋巴结是唯一可能治愈的干预措施。计算机断层扫描（CT）一直是胃癌术前分期及随访的首选检查方法。最近开发的一种先进CT技术，利用薄层扫描、优化对比剂增强及多平面重建，能实现更准确的分期。然而，CT在识别未增大的淋巴结转移、腹膜播散及微小血行转移方面可能存在局限性。正电子发射断层扫描（PET）结合2-[氟-18]氟-2-脱氧-D-葡萄糖（FDG）已被公认为临床肿瘤学中一种有用的诊断技术。FDG PET能够扫描比CT更大的范围。尽管FDG PET在胃癌检测中并非合适的一线诊断方法，对肿瘤分期也无帮助，但它在检测远处转移（如肝、肺、肾上腺、卵巢及骨骼转移）方面可能发挥重要作用。FDG PET在接受化疗患者的随访中也可能有用，因为它能识别治疗的早期反应。需要进一步研究来确定FDG PET在检测局部淋巴结转移及腹膜播散方面的疗效。尽管如此，CT与PET联合使用有助于胃癌的术前分期及对患者的治疗监测。
