Chung Hyun Hoon, Jo Hoenil, Kang Won Jun, Kim Jae Weon, Park Noh-Hyun, Song Yong-Sang, Chung June-Key, Kang Soon-Beom, Lee Hyo-Pyo
Department of Obstetrics and Gynecology, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul 110-744, South Korea.
Gynecol Oncol. 2007 Mar;104(3):529-34. doi: 10.1016/j.ygyno.2006.09.009. Epub 2006 Oct 16.
To assess the value and clinical impact of integrated PET/CT using (18)F-FDG in the diagnosis and management of women with suspected cervical cancer recurrence.
Fifty-two patients with cervical cancer with suspected recurrence because of clinical, cytological, biochemical and radiological findings were retrospectively evaluated. A final diagnosis of recurrence was confirmed by histologic tissue biopsy or by further clinical or radiological evidence. The clinical impact of information provided by PET/CT on patient management was assessed on the basis of clinical follow-up data concerning further diagnostic or therapeutic approach.
Twenty-eight of 32 positive PET/CT scans (87.5%) were proven to have recurrent disease. Seventeen of 20 negative PET/CT scans (85.0%) had no evidence of disease. The sensitivity, specificity, and accuracy of PET/CT for detecting recurrence were 90.3%, 81.0%, and 86.5% respectively. PET/CT changed the management of 12 patients (23.1%) by changing treatment plan (5 patients), by initiating unplanned treatment strategy (4 patients), or by obviating the need for planned diagnostic procedures (3 patients). Median duration after performing PET/CT and last follow-up was 12 (range: 6-27) months, and the 2-year disease-free survival rate of patients with negative PET/CT scan for recurrence was significantly better than that of patients with positive PET/CT (85.0% vs. 10.9%, P=0002).
In patients with a suspected recurrence of cervical cancer, integrated PET/CT using (18)F-FDG provides good anatomic and functional localization of suspicious lesions, and the better diagnostic interpretation has an impact not only on clinical management and treatment planning of patients, but also on disease-free survival.
评估采用（18）F-FDG的PET/CT融合成像在疑似宫颈癌复发患者诊断及管理中的价值和临床影响。
对52例因临床、细胞学、生化及影像学检查结果而疑似复发的宫颈癌患者进行回顾性评估。复发的最终诊断通过组织学活检或进一步的临床或影像学证据得以证实。基于关于进一步诊断或治疗方法的临床随访数据，评估PET/CT所提供信息对患者管理的临床影响。
32例PET/CT扫描阳性的患者中，28例（87.5%）被证实患有复发性疾病。20例PET/CT扫描阴性的患者中，17例（85.0%）未发现疾病证据。PET/CT检测复发的敏感性、特异性和准确性分别为90.3%、81.0%和86.5%。PET/CT改变了12例患者（23.1%）的管理方式，包括改变治疗方案（5例）、启动非计划治疗策略（4例）或避免进行计划中的诊断程序（3例）。进行PET/CT检查至最后一次随访的中位时间为12个月（范围：6 - 27个月），PET/CT扫描复发阴性患者的2年无病生存率显著高于PET/CT扫描阳性患者（85.0%对10.9%，P = 0.002）。
在疑似宫颈癌复发的患者中，采用（18）F-FDG的PET/CT融合成像能对可疑病变提供良好的解剖和功能定位，更好的诊断解读不仅对患者的临床管理和治疗计划有影响，而且对无病生存也有影响。
