默克尔细胞癌：2-脱氧-2-[F-18]氟-D-葡萄糖正电子发射断层扫描/计算机断层扫描有何作用？
Merkel cell carcinoma: Is there a role for 2-deoxy-2-[f-18]fluoro-D-glucose-positron emission tomography/computed tomography?
作者信息
Iagaru A, Quon A, McDougall I R, Gambhir S S
机构信息
Division of Nuclear Medicine, Department of Radiology, Stanford University Medical Center, 300 Pasteur Drive, H-0101, Stanford, CA 94305, USA.
出版信息
Mol Imaging Biol. 2006 Jul-Aug;8(4):212-7. doi: 10.1007/s11307-006-0047-2.
PURPOSE
2-Deoxy-2-[F-18]fluoro-D-glucose (FDG)-positron emission tomography (PET)/computed tomography (CT) is becoming widely available as a powerful imaging modality, combining the ability to detect active metabolic processes and their morphologic features in a single study. The role of FDG-PET/CT is proven in lymphoma, melanoma, colorectal carcinoma, and other cancers. However, there are rare malignancies such as Merkel cell carcinoma that can potentially be evaluated with PET/CT. We were therefore prompted to review our experience with FDG-PET/CT in the management of patients with Merkel cell carcinoma.
PROCEDURES
This is a retrospective case series of six patients with Merkel cell carcinoma, 58-81 years old (average 69 +/- 8.3), who had whole-body PET/CT at our institution from January 1st, 2003 to August 31st, 2005. Two patients were women and four were men. Reinterpretation of the imaging studies for accuracy and data analysis from medical records were performed.
RESULTS
Twelve examinations were acquired for the six patients (one patient had six PET/CT, one patient had two PET/CT, and four patients had one PET/CT). The injected FDG doses ranged 381.1-669.7 MBq (average 573.5 +/- 70.3). Four patients had the PET/CT as part of initial staging, and two patients had the exam for restaging (after surgery and XRT). A total of six Merkel lesions (pancreas, adrenal, lip, submandibular lymph nodes, cervical lymph nodes, and parapharyngeal soft tissue) were identified in three patients and confirmed on histopathological examination. The FDG uptake in these areas was intense, with maximum standardized uptake value (SUVmax) values of 5-14 (average 10.4 +/- 3.8). In one patient, the PET/CT scan identified abnormal focal distal sigmoid uptake that was biopsied and diagnosed as adenocarcinoma. Two patients had negative scans and had no clinical evidence of disease on follow-up office visits (up to one year after PET/CT).
CONCLUSIONS
This case series suggests that FDG-PET/CT may have a promising role in the management of patients with Merkel cell carcinoma.
目的
2-脱氧-2-[F-18]氟-D-葡萄糖（FDG）-正电子发射断层扫描（PET）/计算机断层扫描（CT）作为一种强大的成像方式正变得广泛可用，它能够在一项研究中同时检测活跃的代谢过程及其形态特征。FDG-PET/CT在淋巴瘤、黑色素瘤、结直肠癌及其他癌症中的作用已得到证实。然而，像默克尔细胞癌这样的罕见恶性肿瘤也有可能通过PET/CT进行评估。因此，我们促使回顾我们在默克尔细胞癌患者管理中使用FDG-PET/CT的经验。
方法
这是一个回顾性病例系列，包括6例默克尔细胞癌患者，年龄58 - 81岁（平均69±8.3岁），于2003年1月1日至2005年8月31日在我们机构接受了全身PET/CT检查。2例为女性，4例为男性。对影像学研究进行重新解读以确保准确性，并对病历进行数据分析。
结果
6例患者共进行了12次检查（1例患者进行了6次PET/CT，1例患者进行了2次PET/CT，4例患者进行了1次PET/CT）。注射的FDG剂量范围为381.1 - 669.7 MBq（平均573.5±70.3）。4例患者将PET/CT作为初始分期的一部分，2例患者进行该检查用于再分期（手术后及放疗后）。3例患者共发现6个默克尔病灶（胰腺、肾上腺、唇部、颌下淋巴结、颈部淋巴结及咽旁软组织），并经组织病理学检查证实。这些区域的FDG摄取强烈，最大标准化摄取值（SUVmax）为5 - 14（平均10.4±3.8）。1例患者的PET/CT扫描发现乙状结肠远端异常局灶性摄取，经活检诊断为腺癌。2例患者扫描结果为阴性，随访门诊（PET/CT后长达1年）无疾病临床证据。
结论
该病例系列表明FDG-PET/CT在默克尔细胞癌患者的管理中可能具有广阔前景。
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