Division of Medical Oncology, Department of Internal Medicine, University Hopsital Ghent, De Pintelaan 185 B, 9000, Ghent, Belgium.
Ann Nucl Med. 2013 Feb;27(2):97-104. doi: 10.1007/s12149-012-0664-6. Epub 2012 Dec 4.
When confronted with a suspicious rise in CA 15.3 in asymptomatic breast cancer patients following primary treatment and negative or equivocal conventional imaging findings, FDG PET/CT allows assessment of the site and extent of the recurring disease with an accuracy of 83%. Both FDG PET and FDG PET/CT are superior when compared to CT alone for the purpose of recurrence detection in patients suffering from ovarian carcinoma who have completed primary therapy but demonstrate a rising serum CA-125 level. As the global accuracy of CT alone for detection of recurrence of ovarian cancer approximates 80%, CT scan should be performed upfront to identify the site of recurrence. When confronted with negative or equivocal CT findings, FDG PET alone or FDG PET/CT should be added. In patients with rising serum CEA levels that have undergone primary treatment for a colorectal carcinoma, both FDG PET and FDG PET/CT allow detection of tumor recurrence with an accuracy of 95%, well above that of CT and MRI. Available studies further suggest that FDG/PET findings will affect treatment management in 28-50% of these patients. The detection rate of both 11C-choline and 18F-choline PET and PET/CT for local, regional, and distant recurrence in prostate carcinoma patients with a biochemical recurrence increases with rising PSA value at the time of imaging and reaches about 75% in patients with PSA > 3 ng/mL. Furthermore, PET and PET/CT with [11C]- and [18F]-choline derivates may be helpful in the clinical setting for optimization of individualized treatment.
当原发性治疗后无症状乳腺癌患者的 CA 15.3 水平可疑升高，且常规影像学检查阴性或不确定时，FDG PET/CT 可评估疾病复发的部位和范围，其准确性为 83%。与 CT 相比，FDG PET 和 FDG PET/CT 更有助于检测完成初始治疗但血清 CA-125 水平升高的卵巢癌患者的复发。由于 CT 单独用于检测卵巢癌复发的全球准确性约为 80%，因此应首先进行 CT 扫描以确定复发部位。当 CT 检查结果阴性或不确定时，可单独行 FDG PET 或 FDG PET/CT。在接受结直肠癌初始治疗后血清 CEA 水平升高的患者中，FDG PET 和 FDG PET/CT 均可检测到肿瘤复发，准确性为 95%，远高于 CT 和 MRI。现有研究进一步表明，FDG/PET 检查结果将影响这些患者中 28-50%的治疗管理。在影像学检查时 PSA 值升高的前列腺癌患者中，11C-胆碱和 18F-胆碱 PET 和 PET/CT 对局部、区域和远处复发的检测率随着 PSA 值的升高而增加，在 PSA > 3ng/mL 的患者中达到约 75%。此外，[11C]-和[18F]-胆碱衍生物的 PET 和 PET/CT 可能有助于临床优化个体化治疗。
