Department of Radiology, Mayo Clinic, Rochester, MN, USA.
J Nucl Med. 2012 Aug;53(8):1200-6. doi: 10.2967/jnumed.112.102897. Epub 2012 Jun 22.
The purpose of this study was to evaluate the clinical utility of (18)F-FDG PET/CT in esthesioneuroblastoma staging and restaging and quantify the additional benefit of PET/CT to conventional imaging.
A retrospective review was performed with institutional review board approval for patients with a diagnosis of esthesioneuroblastoma who underwent PET/CT from 2000 to 2010. PET/CT results were retrospectively reviewed by 2 radiologists who were unaware of the clinical and imaging data. Positive imaging findings were classified into 3 categories: local disease, cervical nodal spread, and distant metastasis. All conventional imaging performed in the 6 mo preceding PET/CT, and the medical records, were reviewed to determine the potential added value.
Twenty-eight patients (mean age, 52.3 ± 10 y; range, 23-81 y) were identified who underwent a total of 77 PET/CT examinations. Maximum standardized uptake value (SUVmax) was 8.68 ± 4.75 (range, 3.6-23.3) for the primary tumor and 8.57 ± 6.46 (range, 1.9-27.2) for the metastatic site. There was no clear association between primary tumor SUVmax and tumor grade (P = 0.30). Compared with conventional imaging, PET/CT changed disease stage or altered clinical management in 11 (39%) of 28 esthesioneuroblastoma patients. Of these, 10 (36%) of 28 were upstaged on the basis of their PET/CT studies. Cervical nodal metastases were found in 5 (18%) of 28, local recurrence in 2 (7%) of 28, cervical nodal and distant metastases in 2 (7%) of 28, and distant metastases in 1 (4%) of 28. One patient (4%) was downstaged after negative findings on PET/CT.
PET/CT is a useful adjunct to conventional imaging in the initial staging and restaging of esthesioneuroblastoma by detecting nodal and distant metastatic disease not demonstrated by conventional imaging and identifying local recurrence hidden by treatment changes on conventional imaging.
本研究旨在评估（18）F-FDG PET/CT 在嗅神经母细胞瘤分期和再分期中的临床应用，并定量评估 PET/CT 对常规影像学检查的额外获益。
本研究经机构审查委员会批准，回顾性分析了 2000 年至 2010 年期间接受 PET/CT 检查的嗅神经母细胞瘤患者。2 名放射科医生对 PET/CT 结果进行了回顾性分析，他们对临床和影像学数据并不知情。阳性影像学发现分为 3 类：局部疾病、颈部淋巴结转移和远处转移。所有在 PET/CT 检查前 6 个月内进行的常规影像学检查和病历均进行了回顾，以确定潜在的附加价值。
共确定了 28 例患者（平均年龄 52.3±10 岁；范围，23-81 岁），共进行了 77 次 PET/CT 检查。原发肿瘤的最大标准化摄取值（SUVmax）为 8.68±4.75（范围，3.6-23.3），转移灶的 SUVmax 为 8.57±6.46（范围，1.9-27.2）。原发肿瘤 SUVmax 与肿瘤分级之间无明显相关性（P=0.30）。与常规影像学检查相比，PET/CT 改变了 28 例嗅神经母细胞瘤患者的疾病分期或改变了临床管理策略，其中 11 例（39%）患者的分期得到了提高。这 28 例患者中，有 10 例（36%）患者的 PET/CT 研究发现颈部淋巴结转移。28 例患者中，2 例（7%）患者发现局部复发，2 例（7%）患者发现颈部淋巴结和远处转移，1 例（4%）患者发现远处转移。1 例（4%）患者在 PET/CT 检查未见远处转移后降级。
PET/CT 通过检测常规影像学检查未显示的淋巴结和远处转移病灶，并识别常规影像学检查因治疗改变而隐藏的局部复发，在嗅神经母细胞瘤的初始分期和再分期中是常规影像学检查的有用补充。
