Halpern Benjamin S, Yeom Kristen, Fueger Barbara J, Lufkin Robert B, Czernin Johannes, Allen-Auerbach Martin
Department of Molecular and Medical Pharmacology, Ahmanson Biological Imaging Center/Nuclear Medicine, UCLA School of Medicine, Los Angeles, CA 90095-6948, USA.
Eur J Radiol. 2007 May;62(2):199-204. doi: 10.1016/j.ejrad.2006.11.037. Epub 2007 Jan 12.
(18)F-FDG PET has a high accuracy for re-staging of head and neck cancer. The purpose of this study was to determine whether the diagnostic accuracy can be further improved with integrated PET/CT.
Forty-nine patients with a mean age of 59+/-18 years were studied retrospectively. Histo-pathological verification was available either from complete tumor resection with or without lymph node dissection (n=27) or direct endoscopic biopsy (n=16) or ultrasound guided biopsy (n=6). Two reviewers blinded to the pathological findings read all PET images in consensus. An experienced radiologist was added for the interpretation of the PET/CT images.
Tissue verification was available for 110 lesions in 49 patients. Sixty-seven lesions (61%) were biopsy positive and 43 (39%) were negative for malignant disease. PET and PET/CT showed an overall accuracy for cancer detection of 84 and 88% (p=0.06), respectively. Sensitivity and specificity for PET were 78 and 93% versus 84 (p=NS) and 95% (p=NS) with PET/CT. A patient-by-patient analysis yielded a sensitivity, specificity and accuracy for PET of 80, 56 and 76%, compared to 88% (p=NS), 78% (p=NS) and 86% (p=0.06) for PET/CT.
The results of this study indicate that PET/CT does not significantly improve the detection of recurrence of head and neck cancer. However, a trend towards improved accuracy was observed (p=0.06).
（18）F-FDG PET对头颈部癌再分期具有较高的准确性。本研究的目的是确定PET/CT一体机是否能进一步提高诊断准确性。
对49例平均年龄为59±18岁的患者进行回顾性研究。组织病理学验证可通过完整肿瘤切除（伴或不伴淋巴结清扫，n = 27）、直接内镜活检（n = 16）或超声引导下活检（n = 6）获得。两位对病理结果不知情的阅片者共同阅读所有PET图像。另增加一位经验丰富的放射科医生解读PET/CT图像。
49例患者的110个病灶有组织学验证。67个病灶（61%）活检呈阳性，43个（39%）为恶性疾病阴性。PET和PET/CT检测癌症的总体准确率分别为84%和88%（p = 0.06）。PET的敏感性和特异性分别为78%和93%，而PET/CT的敏感性为84%（p =无显著性差异），特异性为95%（p =无显著性差异）。逐例分析得出PET的敏感性、特异性和准确率分别为80%、56%和76%，而PET/CT分别为88%（p =无显著性差异）、78%（p =无显著性差异）和86%（p = 0.06）。
本研究结果表明，PET/CT并不能显著提高头颈部癌复发的检测率。然而，观察到有准确性提高的趋势（p = 0.06）。
