正电子发射断层显像（PET）-计算机断层扫描（CT）与单纯CT用于卵巢癌复发的情况比较

PET-CT vs. CT alone in ovarian cancer recurrence.

作者信息

Sebastian Sunit, Lee Susanna I, Horowitz Neil S, Scott James A, Fischman Alan J, Simeone Joseph F, Fuller Arlan F, Hahn Peter F

机构信息

Department of Radiology, Massachusetts General Hospital, 55 Fruit Street, White 270, Boston, MA 02114, USA.

出版信息

Abdom Imaging. 2008 Jan-Feb;33(1):112-8. doi: 10.1007/s00261-007-9218-0.

DOI:10.1007/s00261-007-9218-0

PMID:17404789

Abstract

BACKGROUND

To compare fusion, positron emission tomography-computed tomography (PET-CT) with CT alone in detecting ovarian carcinoma recurrence.

METHODS

Fifty-one consecutive patients underwent 53 restaging PET-CT scans with a concurrent diagnostic quality CT scan. Two body imaging radiologists independently assessed the CT's; each then teamed with a nuclear medicine specialist to review the PET-CT's. Two teams conferred for consensus on the presence of disease in the chest, abdomen, and body overall with CT alone and with PET-CT, using a six-point reader confidence metric to determine accuracy and receiver operating characteristic (ROC) curves. Reader agreement was compared using kappa. Recurrence was determined by two gynecologic oncologists reviewing clinical records from time of presentation to at least 13 months (mean 22.7) after imaging.

RESULTS

Recurrence was based on histopathology in 17% (9/53). Seventy-two percent (38/53) cases had recurrence, with two cases showing isolated chest recurrence. PET-CT accuracy exceeded CT for body 92% (49/53) vs. 83% (44/53), chest 96% (51/53) vs. 89% (47/53), and abdomen 91% (48/53) vs. 79% (42/53). ROC curves for PET-CT dominated that for CT alone; this difference was statistically significant for abdomen and for body overall (P < 0.01). Interobserver agreement was better for PET-CT than for CT alone.

CONCLUSIONS

PET-CT demonstrates greater accuracy and less interobserver variability than CT alone.

摘要

背景

比较正电子发射断层扫描-计算机断层扫描（PET-CT）与单纯CT在检测卵巢癌复发方面的效果。

方法

51例连续患者接受了53次再分期PET-CT扫描，并同时进行了具有诊断质量的CT扫描。两名身体成像放射科医生独立评估CT图像；然后每人与一名核医学专家合作审查PET-CT图像。两个团队就单纯CT和PET-CT检查时胸部、腹部及全身疾病的存在情况达成共识，使用六点阅片者信心指标来确定准确性和受试者操作特征（ROC）曲线。使用kappa检验比较阅片者之间的一致性。由两名妇科肿瘤学家审查从就诊时到成像后至少13个月（平均22.7个月）的临床记录来确定复发情况。

结果

17%（9/53）的复发基于组织病理学检查。72%（38/53）的病例出现复发，其中两例为孤立性胸部复发。PET-CT在检测全身复发方面的准确性超过CT，分别为92%（49/53）对83%（44/53），胸部为96%（51/53）对89%（47/53），腹部为91%（48/53）对79%（42/53）。PET-CT的ROC曲线优于单纯CT；腹部和全身的这种差异具有统计学意义（P<0.01）。PET-CT的观察者间一致性优于单纯CT。