Usmanij Edwin A, de Geus-Oei Lioe-Fee, Bussink Jan, Oyen Wim J G
aDepartment of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen bDepartment of Nuclear Medicine, Leiden University Medical Center, Leiden cMIRA Institute, University of Twente, Enschede dDepartment of Radiation Oncology, Radboud University Medical Center, Nijmegen, The Netherlands.
Curr Opin Pulm Med. 2015 Jul;21(4):314-21. doi: 10.1097/MCP.0000000000000182.
The aim of this review is to provide an outline of current evidence for the use of F-18-fluoro-deoxy-glucose PET computed tomography (FDG-PET/CT) in nonsmall cell lung cancer (NSCLC) for diagnosis, staging, radiotherapy planning, response assessment and response monitoring.
Management of patients with NSCLC requires a multimodality approach to accurately diagnose and stage patients. In this approach, FDG-PET/CT has become a standard staging instrument in lung cancer. FDG-PET/CT is, in addition to staging, also valuable for the characterization of the solitary pulmonary nodule. An increased uptake in the nodule as compared with mediastinal blood pool is suspected for malignancy. In radiotherapy planning, FDG-PET/CT can assist the radiation oncologist for optimal dose delivery to the tumour, while sparing healthy tissues. Evidence of the prognostic and predictive implications of FDG-PET/CT is accumulating. Volumetric parameters of PET, such as metabolic active tumour volume and total lesion glycolysis, are promising predictive and prognostic biomarkers. However, for implementation of metabolic response parameters in clinical practice, more randomized, PET-based, multicentre trials are necessary. The introduction of integrated PET and MRI scanners did not change the pivotal role of standard FDG-PET/CT yet, as with current technology, PET/MRI did not show superior performance in thoracic staging.
The role of PET is described for diagnosis, staging and response assessment.
本综述旨在概述目前关于F-18-氟脱氧葡萄糖PET计算机断层扫描（FDG-PET/CT）在非小细胞肺癌（NSCLC）诊断、分期、放射治疗计划、疗效评估及疗效监测方面应用的证据。
NSCLC患者的管理需要采用多模式方法来准确诊断和分期。在这种方法中，FDG-PET/CT已成为肺癌的标准分期工具。除分期外，FDG-PET/CT对孤立性肺结节的特征性诊断也很有价值。若结节摄取高于纵隔血池，则怀疑为恶性。在放射治疗计划中，FDG-PET/CT可协助放射肿瘤学家将最佳剂量输送至肿瘤，同时保护健康组织。关于FDG-PET/CT预后及预测意义的证据正在积累。PET的体积参数，如代谢活性肿瘤体积和总病变糖酵解，是很有前景的预测和预后生物标志物。然而，为了在临床实践中应用代谢反应参数，则需要更多基于PET的随机多中心试验。目前，集成PET和MRI扫描仪的引入尚未改变标准FDG-PET/CT的关键作用，因为就现有技术而言，PET/MRI在胸部分期中并未显示出更优的性能。
描述了PET在诊断、分期及疗效评估中的作用。
