[18F-FDG PET/CT在鼻咽癌分期及治疗疗效监测中的临床应用]

[Clinical application of (18)F-FDG PET/CT to staging and treatment effectiveness monitoring of nasopharyngeal carcinoma].

作者信息

Wang Guo-Hui, Lau Eddie W F, Shakher Ramdave, Binns David S, Hogg Annette, Drummond Elizabeth, Hicks Rodney J

机构信息

State Key Laboratory of Oncology in South China, Guangzhou, Guangdong, 510060, P. R. China.

出版信息

Ai Zheng. 2007 Jun;26(6):638-42.

PMID:17562272

Abstract

BACKGROUND & OBJECTIVE: Fluorine-18 fluorodeoxyglucose ((18)F-FDG) PET/CT could increase the accuracy of diagnosis, staging, and treatment effectiveness monitoring of many malignant diseases, such as lung cancer and esophageal cancer. This study was to evaluate the clinical application of (18)F-FDG PET/CT to the staging, restaging, and treatment effectiveness monitoring of nasopharyngeal carcinoma (NPC).

METHODS

The reports of whole body (18)F-FDG PET/CT scans, performed from Feb. 2002 to Dec. 2005 on 43 NPC patients (26 men and 17 women with median age of 52 years) in Peter MacCallum Cancer Center, were reviewed. The final diagnoses were made according to medical records, pathologic reports and follow-up information. The accuracy, specificity, sensitivity, positive predictive value (PPV), and negative predictive value (NPV) of (18)F-FDG PET/CT, CT and MRI were calculated and analyzed.

RESULTS

The accuracy, specificity, sensitivity, PPV, and NPV of (18)F-FDG PET/CT were 95.3%, 100.0%, 85.7%, 93.8%, and 100.0%, respectively; those of CT and MRI were 65.5%, 79.4%, 64.7%, 81.8%, and 57.9%, respectively. The results of (18)F-FDG PET/CT led to changes in the medical management of 2 staged patients, and 7 restaged patients and 5 patients in monitoring group. (18)F-FDG PET/CT scan affected the therapy plan of 3 restaged patients and 11 patients in monitoring group. Two cases of second primary malignancies(1 case of thyroid carcinoma and 1 case of low grade gastric carcinoma) were detected by (18)F-FDG PET/CT scan.

CONCLUSION

(18)F-FDG PET/CT is better than conventional imaging in N and M staging and treatment effectiveness monitoring of NPC.

摘要

背景与目的

氟-18氟脱氧葡萄糖（(18)F-FDG）PET/CT可提高许多恶性疾病如肺癌和食管癌的诊断、分期及治疗效果监测的准确性。本研究旨在评估(18)F-FDG PET/CT在鼻咽癌（NPC）分期、再分期及治疗效果监测中的临床应用。

方法

回顾了2002年2月至2005年12月在彼得·麦卡勒姆癌症中心对43例NPC患者（26例男性和17例女性，中位年龄52岁）进行的全身(18)F-FDG PET/CT扫描报告。最终诊断根据病历、病理报告及随访信息做出。计算并分析了(18)F-FDG PET/CT、CT和MRI的准确性、特异性、敏感性、阳性预测值（PPV）和阴性预测值（NPV）。

结果

(18)F-FDG PET/CT的准确性、特异性、敏感性、PPV和NPV分别为95.3%、100.0%、85.7%、93.8%和100.0%；CT和MRI的分别为65.5%、79.4%、64.7%、81.8%和57.9%。(18)F-FDG PET/CT的结果导致2例分期患者、7例再分期患者和监测组5例患者的治疗管理发生改变。(18)F-FDG PET/CT扫描影响了3例再分期患者和监测组11例患者的治疗方案。(18)F-FDG PET/CT扫描检测到2例第二原发性恶性肿瘤（1例甲状腺癌和1例低级别胃癌）。