Orlacchio A, Schillaci O, Fusco N, Broccoli P, Maurici M, Yamgoue M, Danieli R, D'Urso S, Simonetti G
Dipartimento di Diagnostica per Immagini, Imaging Molecolare, Radiologia Interventistica e Radioterapia, Policlinico Universitario Tor Vergata, Viale Oxford 81, 00133, Roma, Italy.
Radiol Med. 2009 Jun;114(4):571-85. doi: 10.1007/s11547-009-0393-7. Epub 2009 May 14.
The aim of this study was to compare the diagnostic accuracy of 2-[fluorine-18] fluoro-2-deoxy-D-glucose positron emission tomography (18F-FDG-PET) and computed tomography (CT) with PET/CT in the detection of liver metastases during tumour staging in patients suffering from colorectal carcinoma for the purposes of correct surgical planning and follow-up.
A total of 467 patients underwent a PET/CT scan using an iodinated contrast medium. We compared images obtained by the single PET scan, the single CT scan and by the fusion of the two procedures (PET/CT). The final diagnosis was obtained by histological examination and/or by the follow-up of all patients, including those who did not undergo surgery or biopsy.
The PET scan had 94.05% sensitivity, 91.60% specificity and 93.36% accuracy; the CT scan had 91.07% sensitivity, 95.42% specificity and 92.29% accuracy. The combined procedures (PET/CT) had the following values: sensitivity 97.92%, specificity 97.71% and accuracy 97.86%.
This study indicates that PET/CT is very useful in staging and restaging patients suffering from colorectal cancer. It was particularly useful when recurrences could not be visualised either clinically or by imaging despite increasing tumour markers, as it guaranteed an earlier diagnosis. PET/CT not only provides high diagnostic performance in terms of sensitivity and specificity, enabling modification of patient treatment, but it is also a unique, high-profile procedure that can produce cost savings.
本研究旨在比较2-[氟-18]氟-2-脱氧-D-葡萄糖正电子发射断层扫描（18F-FDG-PET）和计算机断层扫描（CT）联合PET/CT在结直肠癌患者肿瘤分期时检测肝转移灶的诊断准确性，以进行正确的手术规划和随访。
共有467例患者接受了使用碘化造影剂的PET/CT扫描。我们比较了单次PET扫描、单次CT扫描以及两种检查方法融合（PET/CT）所获得的图像。最终诊断通过组织学检查和/或对所有患者进行随访获得，包括那些未接受手术或活检的患者。
PET扫描的灵敏度为94.05%，特异度为91.60%，准确度为93.36%；CT扫描的灵敏度为91.07%，特异度为95.42%，准确度为92.29%。联合检查方法（PET/CT）的相应数值为：灵敏度97.92%，特异度97.71%，准确度97.86%。
本研究表明PET/CT在结直肠癌患者的分期及再分期中非常有用。当尽管肿瘤标志物升高但临床或影像学均无法发现复发时，PET/CT尤其有用，因为它能保证更早的诊断。PET/CT不仅在灵敏度和特异度方面具有很高的诊断性能，能够改变患者的治疗方案，而且它还是一种独特的、备受瞩目的检查方法，可节省成本。
