Suenaga Yuko, Kitajima Kazuhiro, Ishihara Takeaki, Sasaki Ryohei, Otsuki Naoki, Nibu Ken-Ichi, Minamikawa Tsutomu, Kiyota Naomi, Sugimura Kazuro
Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
Department of Radiology, Division of Radiation Oncology, Kobe University Graduate, School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
Eur Radiol. 2016 Apr;26(4):1018-30. doi: 10.1007/s00330-015-3902-1. Epub 2015 Jul 19.
To evaluate the accuracy of PET/CT using (18)F-fluorodeoxyglucose (FDG) with IV contrast for suspected recurrent head and neck squamous cell carcinoma (HNSCC).
One hundred and seventy patients previously treated for HNSCC underwent PET/CT, consisting of non-contrast-enhanced and contrast-enhanced CT, to investigate suspected recurrence. Diagnostic performance of PET/contrast-enhanced CT (PET/ceCT), PET/non-contrast-enhanced CT (PET/ncCT) and contrast-enhanced CT (ceCT) for local or regional recurrence, distant metastasis, overall recurrence and second primary cancer was evaluated. The reference standard included histopathology, treatment change and imaging follow-up.
The patient-based areas under the receiver operating characteristic curves (AUC) for ceCT, PET/ncCT and PET/ceCT were 0.82, 0.96 and 0.98 for local recurrence, 0.73, 0.86 and 0.86 for regional recurrence, 0.86, 0.91 and 0.92 for distant metastasis, 0.72, 0.86 and 0.87 for overall recurrence, and 0.86, 0.89 and 0.91 for a second primary cancer. Both PET/ceCT and PET/ncCT statistically showed larger AUC than ceCT for recurrence, and the difference between PET/ceCT and PET/ncCT for local recurrence reached a significant level (p = 0.039). The accuracy of PET/ceCT for diagnosing overall recurrence was high, irrespective of the time interval after the last treatment (83.3-94.1 %).
FDG-PET/CT was a more accurate HNSCC restaging tool than ceCT. The added value of ceCT at FDG-PET/CT is minimal.
• FDG-PET/CT is a more accurate post-treatment surveillance tool than ceCT for HNSCC. • FDG-PET/ceCT was useful, irrespective of the time interval after the last treatment. • FDG-PET/ceCT showed high negative predictive value and limited positive predictive value. • The added value of ceCT at FDG-PET/CT is minimal and likely not clinically relevant.
评估使用(18)F-氟脱氧葡萄糖（FDG）并静脉注射造影剂的PET/CT对疑似复发性头颈部鳞状细胞癌（HNSCC）的诊断准确性。
170例既往接受过HNSCC治疗的患者接受了PET/CT检查，包括非增强CT和增强CT，以调查疑似复发情况。评估PET/增强CT（PET/ceCT）、PET/非增强CT（PET/ncCT）和增强CT（ceCT）对局部或区域复发、远处转移、总体复发和第二原发癌的诊断性能。参考标准包括组织病理学、治疗变化和影像学随访。
基于患者的ceCT、PET/ncCT和PET/ceCT在接受者操作特征曲线下的面积（AUC），局部复发分别为0.82、0.96和0.98，区域复发分别为0.73、0.86和0.86，远处转移分别为0.86、0.91和0.92，总体复发分别为0.……
（原文中总体复发处“0.72, 0.86 and 0.87 for overall recurrence”后面内容缺失，翻译到此处中断）
FDG-PET/CT是比ceCT更准确的HNSCC再分期工具。ceCT在FDG-PET/CT中的附加值极小。
• FDG-PET/CT是比ceCT更准确的HNSCC治疗后监测工具。• FDG-PET/ceCT有用，与上次治疗后的时间间隔无关。• FDG-PET/ceCT显示出高阴性预测价值和有限的阳性预测价值。• ceCT在FDG-PET/CT中的附加值极小，可能与临床无关。
