Nguyen Nghi C, Chaar Bassem T, Osman Medhat M
Division of Nuclear Medicine, Department of Radiology, Saint Louis University Hospital, St, Louis, USA.
BMC Med Imaging. 2007 Dec 12;7:8. doi: 10.1186/1471-2342-7-8.
The aim of this retrospective study was to report the prevalence and patterns of soft tissue (ST) metastasis detected with true whole-body (TWB) F-18 FDG PET/CT acquired from the top of the skull through the bottom of the feet and to compare such findings to that of the typically acquired skull-base to upper-thigh, thus limited whole-body (LWB) field of view (FOV).
TWB FDG-PET/CT scans were performed in 500 consecutive cancer patients. Suspected ST metastasis was verified by correlation with surgical pathology, other imaging modalities, or clinical follow-up.
Nine out of 500 patients (1.8 %) had ST metastasis with a prevalence of 4/41 (9.8%) for melanoma, 2/60 (3.3%) for lung carcinoma, 2/88 (2.3%) for lymphoma and 1/13 (77%) for esophageal cancer. Those nine patients had a total of 41 ST lesions: 22 lesions within and 19 outside of LWB FOV. Of those 41 lesions, 19 (46%) were subcutaneous and 22 (54%) were muscular lesions. The presence of ST metastasis neither changed the staging nor the treatment in any of these patients. However, the ST lesions provided a biopsy site in 4 of the 9 patients (44%). Seven out of nine studied patients died of their disease within 1-22 months after ST metastasis was diagnosed.
The detection of ST metastasis may have prognostic implications, provide more accessible biopsy sites and help avoid invasive procedures. A LWB scanning may underestimate the true extent of ST metastasis since a significant percentage of ST metastasis (46%) occurred outside the typical LWB FOV.
本回顾性研究的目的是报告通过从头颅顶部至脚底进行的真正全身（TWB）F-18 FDG PET/CT检测到的软组织（ST）转移的患病率和模式，并将这些结果与典型的从颅底至大腿上部获取的有限全身（LWB）视野（FOV）的结果进行比较。
对500例连续的癌症患者进行了TWB FDG-PET/CT扫描。通过与手术病理、其他成像方式或临床随访相关联来验证疑似ST转移。
500例患者中有9例（1.8%）发生ST转移，其中黑色素瘤的患病率为4/41（9.8%），肺癌为2/60（3.3%），淋巴瘤为2/88（2.3%），食管癌为1/13（7.7%）。这9例患者共有41个ST病变：22个病变在LWB FOV内，19个在LWB FOV外。在这41个病变中，19个（46%）为皮下病变，22个（54%）为肌肉病变。ST转移的存在在这些患者中均未改变分期或治疗。然而，ST病变为9例患者中的4例（44%）提供了活检部位。9例研究患者中有7例在ST转移诊断后的1 - 22个月内死于疾病。
ST转移的检测可能具有预后意义，提供更容易获取的活检部位并有助于避免侵入性操作。由于相当比例的ST转移（46%）发生在典型的LWB FOV之外，LWB扫描可能会低估ST转移的真实范围。
