Department of Nuclear Medicine and Endocrine Oncology, Institute Gustave Roussy and University Paris-Sud XI, 39 rue Camille Desmoulins, 94805 Villejuif, France.
Radiology. 2011 Jan;258(1):270-6. doi: 10.1148/radiol.10092440. Epub 2010 Nov 2.
To compare fluorine 18 fluorodeoxyglucose (FDG) positron emission tomography (PET) combined with computed tomography (PET/CT) and chest CT in the evaluation of the effectiveness of lung radiofrequency (RF) ablation.
Institutional review board approved the study, and all patients gave written informed consent. Thirty-four patients (22 men and 12 women; mean age, 64 years) planned to undergo lung RF ablation were prospectively included and underwent FDG PET/CT and chest CT before (pre-RF ablation PET) and 24 hours, 1 month, and 3 months after RF ablation. Persistent equivocal findings up to 3 months were followed up.
Pre-RF ablation PET led to changes in the treatment strategy in nine patients (26%) by depicting unexpected metastases. Two patients without FDG uptake in lesions to be treated were excluded. Overall, 28 patients (46 lesions: five primary cancer, 41 metastases) were treated and followed up. Within 3 months after RF ablation, incomplete treatment was diagnosed in four of 28 patients (14%, three at 1 month and one at 3 months). Findings of FDG PET/CT were true-positive in four, false-positive in one, and true-negative in 23 patients. Findings of chest CT were true-positive in one, false-positive in one, false-negative in three, and true-negative in 23 patients. Inflammatory FDG uptake in mediastinal lymph nodes and at the needle path puncture site used for RF ablation was observed in 15%, 21%, and 15% of patients and in 19%, 11%, and 15% of patients at 24 hours, 1 month, and 3 months, respectively.
FDG PET/CT can be used for the evaluation of the effectiveness of lung RF ablation. Inflammatory FDG uptake in mediastinal lymph nodes or at the needle path site used for RF ablation may occur.
比较氟 18 氟脱氧葡萄糖（FDG）正电子发射断层扫描（PET）与计算机断层扫描（PET/CT）联合在评估肺部射频（RF）消融疗效中的作用。
本研究经机构审查委员会批准，所有患者均签署书面知情同意书。前瞻性纳入 34 例计划行肺部 RF 消融的患者（22 名男性，12 名女性；平均年龄，64 岁），分别在 RF 消融前（消融前 PET）、消融后 24 小时、1 个月和 3 个月行 FDG PET/CT 和胸部 CT 检查。对 3 个月内持续出现不确定的结果进行随访。
RF 消融前 PET 发现 9 例（26%）患者出现意外转移，改变了治疗策略。有 2 例拟行治疗的病灶无 FDG 摄取而被排除。最终，28 例（46 个病灶：5 个原发性肿瘤，41 个转移瘤）患者接受了治疗并进行了随访。RF 消融后 3 个月内，28 例患者中有 4 例（14%，1 例为 1 个月，3 例为 3 个月）诊断为不完全治疗。FDG PET/CT 的结果为 4 例真阳性、1 例假阳性、23 例真阴性。胸部 CT 的结果为 1 例真阳性、1 例假阳性、3 例假阴性、23 例真阴性。24 小时、1 个月和 3 个月时，分别有 15%、21%和 15%的患者和 19%、11%和 15%的患者出现纵隔淋巴结和 RF 消融针道部位的炎症性 FDG 摄取。
FDG PET/CT 可用于评估肺部 RF 消融的疗效。纵隔淋巴结或 RF 消融针道部位可能出现炎症性 FDG 摄取。
