Nishizawa Sadahiko, Inubushi Masayuki, Ozawa Fukujiro, Kido Aki, Okada Hiroyuki
Hamamatsu Medical Imaging Center, Hamamatsu Medical Photonics Foundation, 5000 Hirakuchi, Hamamatsu 434-0041, Japan.
Ann Nucl Med. 2007 Aug;21(6):345-8. doi: 10.1007/s12149-007-0029-8. Epub 2007 Aug 27.
It is known that focal 18F-fluorodeoxyglucose (FDG) uptake is physiologically seen in the ovaries and uterus of premenopausal women in correlation with the menstrual cycle, which may cause false-positive diagnoses on the images of FDG positron emission tomography (PET). The objective of this study was to clarify whether women of reproductive age after hysterectomy whose ovaries were preserved, also showed physiological ovarian FDG uptake.
We reviewed 26 women after hysterectomy (age 51.1 +/- 5.0 years), who underwent annual cancer screening, including FDG-PET and pelvic magnetic resonance (MR) imaging, three times.
Seven women (age 45.9 +/- 5.8 years, range 34-52 years) had at least one ovary, showing changes in its appearance including the size and number of follicles on MR images each year, which suggested that the ovary was functioning. Four of the seven women showed focal FDG uptake (standardized uptake value 4.2 +/- 1.1) that corresponded to the normal ovaries on five PET examinations. Another group of 19 women (age 53.1 +/- 3.1 years, range 47-59 years) who had small ovaries without changes on MR images each year did not show FDG uptake in the ovaries.
Physiological FDG uptake observed in the ovaries of women of reproductive age even after hysterectomy is reasonably common. As it is not easy to determine the hormonal cycle in these women, it is essential to correlate focal FDG uptake in the pelvis with anatomical and morphological findings on MR images to avoid false-positive diagnoses.
已知绝经前女性的卵巢和子宫在生理状态下会出现局灶性18F-氟脱氧葡萄糖（FDG）摄取，且与月经周期相关，这可能在FDG正电子发射断层扫描（PET）图像上导致假阳性诊断。本研究的目的是阐明子宫切除术后保留卵巢的育龄女性是否也会出现生理性卵巢FDG摄取。
我们回顾性分析了26例子宫切除术后的女性（年龄51.1±5.0岁），她们每年接受包括FDG-PET和盆腔磁共振（MR）成像在内的癌症筛查，共进行了三次。
7名女性（年龄45.9±5.8岁，范围34 - 52岁）至少保留了一侧卵巢，每年的MR图像显示其外观有变化，包括卵泡大小和数量，提示卵巢有功能。这7名女性中有4名在5次PET检查中显示与正常卵巢相对应的局灶性FDG摄取（标准化摄取值4.2±1.1）。另一组19名女性（年龄53.1±3.1岁，范围47 - 59岁），其卵巢较小且每年MR图像无变化，未显示卵巢有FDG摄取。
即使在子宫切除术后，育龄女性卵巢中观察到的生理性FDG摄取相当常见。由于难以确定这些女性的激素周期，将盆腔内局灶性FDG摄取与MR图像上的解剖和形态学表现相关联以避免假阳性诊断至关重要。
