Department of PET Diagnosis, Institute of Biomedical Research and Innovation, 2-2 Minatojima-Nakamachi, Chuo-ku, Kobe 650-0047, Japan.
Eur J Nucl Med Mol Imaging. 2010 Aug;37(8):1490-8. doi: 10.1007/s00259-010-1440-2. Epub 2010 Apr 13.
To evaluate low-dose non-enhanced CT (ldCT) and full-dose contrast-enhanced CT (ceCT) in integrated (18)F-fluorodeoxyglucose (FDG) PET/CT studies for restaging of uterine cancer.
A group of 100 women who had undergone treatment for uterine cervical (n=55) or endometrial cancer (n=45) underwent a conventional PET/CT scans with ldCT, and then a ceCT scan. Two observers retrospectively reviewed and interpreted the PET/ldCT and PET/ceCT images in consensus using a three-point grading scale (negative, equivocal, or positive) per patient and per lesion. Final diagnoses were obtained by histopathological examination, or clinical follow-up for at least 6 months.
Patient-based analysis showed that the sensitivity, specificity and accuracy of PET/ceCT were 90% (27/30), 97% (68/70) and 95% (95/100), respectively, whereas those of PET/ldCT were 83% (25/30), 94% (66/70) and 91% (91/100), respectively. Sensitivity, specificity and accuracy did not significantly differ between two methods (McNemar test, p=0.48, p=0.48, and p=0.13, respectively). There were 52 sites of lesion recurrence: 12 pelvic lymph node (LN), 11 local recurrence, 8 peritoneum, 7 abdominal LN, 5 lung, 3 supraclavicular LN, 3 liver, 2 mediastinal LN, and 1 muscle and bone. The grading results for the 52 sites of recurrence were: negative 5, equivocal 0 and positive 47 for PET/ceCT, and negative 5, equivocal 4 and positive 43 for PET/ldCT, respectively. Four equivocal regions by PET/ldCT (local recurrence, pelvic LN metastasis, liver metastasis and muscle metastasis) were correctly interpreted as positive by PET/ceCT.
PET/ceCT is an accurate imaging modality for the assessment of uterine cancer recurrence. Its use reduces the frequency of equivocal interpretations.
评估低剂量非增强 CT（ldCT）和全剂量对比增强 CT（ceCT）在整合 18F-氟脱氧葡萄糖（FDG）正电子发射断层扫描/计算机断层扫描（PET/CT）研究中用于子宫癌的分期。
一组 100 名接受子宫颈（n=55）或子宫内膜癌（n=45）治疗的女性接受了常规的 PET/CT 扫描，包括 ldCT，然后进行 ceCT 扫描。两位观察者回顾性地使用三分制评分标准（阴性、不确定或阳性）对每位患者和每个病变进行共识性的 PET/ldCT 和 PET/ceCT 图像回顾和解释。最终诊断通过组织病理学检查或至少 6 个月的临床随访获得。
基于患者的分析表明，PET/ceCT 的敏感性、特异性和准确性分别为 90%（27/30）、97%（68/70）和 95%（95/100），而 PET/ldCT 的敏感性、特异性和准确性分别为 83%（25/30）、94%（66/70）和 91%（91/100）。两种方法之间的敏感性、特异性和准确性差异无统计学意义（McNemar 检验，p=0.48，p=0.48，p=0.13）。有 52 个病变复发部位：12 个盆腔淋巴结（LN）、11 个局部复发、8 个腹膜、7 个腹部 LN、5 个肺、3 个锁骨上 LN、3 个肝、2 个纵隔 LN 和 1 个肌肉和骨骼。52 个复发部位的分级结果为：PET/ceCT 为阴性 5 个，不确定 0 个，阳性 47 个，PET/ldCT 为阴性 5 个，不确定 4 个，阳性 43 个。PET/ldCT 中 4 个不确定的区域（局部复发、盆腔 LN 转移、肝转移和肌肉转移）被正确解释为 PET/ceCT 的阳性。
PET/ceCT 是一种评估子宫癌复发的准确成像方式。它的使用减少了不确定解释的频率。
