Salem Shahenda S, Shahin Mohamed A
Department of Nuclear Medicine, Cairo University, Cairo, Egypt.
Nucl Med Commun. 2012 Mar;33(3):313-21. doi: 10.1097/MNM.0b013e32834ee824.
The increase in tumor markers with negative or equivocal conventional imaging modalities represents a serious dilemma in the follow-up of previously treated cancer patients. Positron emission tomography/computed tomography (PET/CT) has emerged as a useful tool in oncological imaging in staging and restaging of most cancers.
This study explored the potential role of ¹⁸F-fluorodeoxyglucose (FDG) PET/CT in the detection and localization of tumor recurrence in cancer patients with increasing serum tumor markers and negative or equivocal conventional imaging modalities.
This prospective study was conducted on 105 previously diagnosed and treated cancer patients with different pathologies. All patients were referred for ¹⁸F-FDG PET/CT scans because of increasing tumor markers with negative or equivocal conventional imaging modalities. All patients underwent whole-body ¹⁸F-FDG PET/CT scans. The findings were confirmed by clinical and/or radiological follow-up of at least 12 months and histopathologically whenever possible.
PET/CT detected recurrence and/or metastases in 90 patients (85.7%), including 17 recurrences, 50 metastases, and 23 recurrences and metastases. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of PET/CT scans were 95.7, 100, 100, 73.3, and 96.2%, respectively. These parameters were 95, 100, 100, 69, and 95% for PET scans alone and were 91.5, 100, 100, 57.9, and 92.3% for CT scans alone.
¹⁸F-FDG PET/CT is a powerful diagnostic tool in restaging of cancer patients. In most cases, PET/CT provides accurate results and helps resolve the clinical dilemma encountered in oncological patients with increasing serum tumor markers and negative or equivocal findings in conventional imaging modalities.
在既往接受过治疗的癌症患者的随访中，肿瘤标志物升高而传统影像学检查结果为阴性或不明确是一个严重的难题。正电子发射断层扫描/计算机断层扫描（PET/CT）已成为大多数癌症分期和再分期的肿瘤影像学检查的有用工具。
本研究探讨¹⁸F-氟脱氧葡萄糖（FDG）PET/CT在血清肿瘤标志物升高且传统影像学检查结果为阴性或不明确的癌症患者中检测肿瘤复发及定位的潜在作用。
本前瞻性研究纳入了105例既往诊断并接受过治疗的不同病理类型的癌症患者。所有患者因肿瘤标志物升高且传统影像学检查结果为阴性或不明确而被转诊进行¹⁸F-FDG PET/CT扫描。所有患者均接受了全身¹⁸F-FDG PET/CT扫描。结果通过至少12个月的临床和/或放射学随访以及尽可能进行的组织病理学检查得以证实。
PET/CT在90例患者（85.7%）中检测到复发和/或转移，包括17例复发、50例转移以及23例复发兼转移。PET/CT扫描的敏感性、特异性、阳性预测值、阴性预测值和准确性分别为95.7%、100%、100%、73.3%和96.2%。单独PET扫描的这些参数分别为95%、100%、100%、69%和95%，单独CT扫描的这些参数分别为91.5%、100%、100%、57.9%和92.3%。
¹⁸F-FDG PET/CT是癌症患者再分期的有力诊断工具。在大多数情况下，PET/CT能提供准确结果，并有助于解决血清肿瘤标志物升高且传统影像学检查结果为阴性或不明确的肿瘤患者所面临的临床难题。
