Sharma Punit, Jain Sachin, Karunanithi Sellam, Pal Sujoy, Julka Pramod Kumar, Thulkar Sanjay, Malhotra Arun, Bal Chandrasekhar, Kumar Rakesh
Department of Nuclear Medicine, All India Institute of Medical Sciences, E-81, Ansari Nagar (East) AIIMS Campus, New Delhi, 110029, India.
Eur J Nucl Med Mol Imaging. 2014 Jun;41(6):1084-92. doi: 10.1007/s00259-013-2664-8. Epub 2014 Jan 17.
To evaluate the role of (18)F-FDG PET/CT in the detection of recurrence in patients with oesophageal carcinoma, suspected clinically or following conventional investigations.
This was a retrospective study. Data from 180 patients (age 56.3 ± 10.4 years; 126 men, 54 women) with histopathologically proven oesophageal carcinoma (squamous cell 115, adenocarcinoma 59, neuroendocrine carcinoma 4, small cell 1, poorly differentiated 1) who had undergone 227 (18)F-FDG PET/CT studies for suspected recurrence were analysed. Recurrence was suspected clinically or following conventional investigations. PET/CT images were revaluated by two nuclear medicine physicians in consensus. Findings were grouped into local, nodal and distant recurrence. Results were compared to those from contrast-enhanced (CE) CT when available (109 patients). Clinical/imaging follow-up (minimum 6 months) with histopathology (when available) was taken as the reference standard.
Of the 227 (18)F-FDG PET/CT studies,166 were positive and 61 were negative for recurrent disease. PET/CT showed local recurrence in 134, nodal recurrence in 115 and distant recurrence in 47, with more than one site of recurrence in 34. The PET/CT findings were true-positive in 153 studies, true-negative in 54, false-positive in 13 and false-negative in 7. The sensitivity of (18)F-FDG PET/CT was 96%, the specificity was 81%, the positive and negative predictive values were 92% and 89%, respectively, and the accuracy was 91%. PET/CT showed similar accuracy in patients with squamous cell carcinoma and in those with adenocarcinoma (P = 0.181).(18)F-FDG PET/CT was more specific than CECT (67% vs. 21%; P < 0.0001). PET/CT was superior to CECT for the detection of nodal recurrence (P < 0.0001), but not local recurrence (P = 0.093) or distant metastases (P = 0.441).
(18)F-FDG PET/CT shows high accuracy in the detection of suspected recurrence in patients with oesophageal carcinoma. It is more specific than and is superior to CECT in the detection of nodal recurrence.
评估（18）F-FDG PET/CT在检测临床上怀疑或经传统检查后疑似复发的食管癌患者复发情况中的作用。
这是一项回顾性研究。分析了180例（年龄56.3±10.4岁；男性126例，女性54例）经组织病理学证实为食管癌（鳞状细胞癌115例，腺癌59例，神经内分泌癌4例，小细胞癌1例，低分化癌1例）的患者的227次（18）F-FDG PET/CT检查数据，这些患者因疑似复发而接受了检查。临床上或经传统检查后怀疑复发。PET/CT图像由两名核医学医师共同重新评估。结果分为局部、淋巴结和远处复发。将结果与有对比增强（CE）CT检查结果的患者（109例）进行比较。以临床/影像随访（至少6个月）及组织病理学检查（如有）作为参考标准。
在227次（18）F-FDG PET/CT检查中，166次检查发现复发病灶呈阳性，61次检查呈阴性。PET/CT显示局部复发134例，淋巴结复发115例，远处复发47例，34例有多个复发部位。PET/CT检查结果在153次检查中为真阳性，54次检查中为真阴性，13次检查中为假阳性，7次检查中为假阴性。（18）F-FDG PET/CT的敏感性为96%，特异性为81%，阳性预测值和阴性预测值分别为92%和89%，准确性为91%。PET/CT在鳞状细胞癌患者和腺癌患者中的准确性相似（P=0.181）。（18）F-FDG PET/CT比CECT更具特异性（67%对21%；P<0.0001）。PET/CT在检测淋巴结复发方面优于CECT（P<0.0001），但在检测局部复发（P=0.093）或远处转移（P=0.441）方面并不优于CECT。
（18）F-FDG PET/CT在检测食管癌患者疑似复发方面具有较高的准确性。在检测淋巴结复发方面，它比CECT更具特异性且优于CECT。
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