Mangili Giorgia, Bergamini Alice, Giorgione Veronica, Picchio Maria, Petrone Micaela, Mapelli Paola, Rabaiotti Emanuela, Incerti Elena, Candiani Massimo
Obstetrics and Gynaecology Unit, Vita-Salute San Raffaele University and IRCCS San Raffaele Hospital, Milan, Italy -
Q J Nucl Med Mol Imaging. 2016 Jun;60(2):103-16. Epub 2016 Feb 11.
Gestational trophoblastic disease (GTD) is a group of different pregnancy-related diseases that includes hydatidiform mole (HM), invasive mole, gestational choriocarcinoma (CC), placental site trophoblastic tumor (PSTT) and epithelioid trophoblastic tumor (ETT). The potential role of 18F-2-fluoro-2-deoxy-D-glucose ([18F]FDG) positron emission tomography (PET) in diagnostic setting and follow up phase of GTD is still largely debated.
The aim of this review is to examine the role of [18F]FDG PET/computed tomography (CT) in diagnosis, treatment and follow up of different disease subtypes. A systematic computerized search of the literature, from 1996 until December 2015 was performed in PubMed and MEDLINE to identify relevant papers to be included for this purpose. All pertinent articles and their reference lists were systematically reviewed in order to identify other studies for potential inclusion.
Regarding HM a potential prognostic relevance of maximum standardized uptake value (SUV max) of molar tissue within the uterus before evacuation has been suggested. Considering CC staging, most [18F]FDG PET evaluations confirmed the results of conventional imaging. However [18F]FDG PET played a key role in discriminating ambiguous lesions on routine imaging work-up. [18F]FDG PET was particularly useful in evaluating disease recurrence and chemo-resistance, thanks to the possibility of an early identification of the active tumor site. Since the main treatment of PSTT is surgery, the contribution of [18F]FDG PET in differential diagnosis and in providing a more precise mapping of resectable metastasis or the complete response to treatment is advisable.
Since the role of [18F]FDG PET and PET/CT in diagnostic setting and follow up of GTN is still controversial, further studies are required to clarify this issue.
妊娠滋养细胞疾病（GTD）是一组与妊娠相关的不同疾病，包括葡萄胎（HM）、侵蚀性葡萄胎、妊娠绒毛膜癌（CC）、胎盘部位滋养细胞肿瘤（PSTT）和上皮样滋养细胞肿瘤（ETT）。18F-2-氟-2-脱氧-D-葡萄糖（[18F]FDG）正电子发射断层扫描（PET）在GTD诊断及随访阶段的潜在作用仍存在很大争议。
本综述旨在探讨[18F]FDG PET/计算机断层扫描（CT）在不同疾病亚型诊断、治疗及随访中的作用。在PubMed和MEDLINE数据库中对1996年至2015年12月的文献进行了系统的计算机检索，以确定纳入本研究的相关论文。对所有相关文章及其参考文献列表进行了系统回顾，以确定其他可能纳入的研究。
关于葡萄胎，已提出清宫术前子宫内葡萄胎组织最大标准化摄取值（SUV max）具有潜在的预后相关性。考虑到绒毛膜癌的分期，大多数[18F]FDG PET评估证实了传统影像学检查的结果。然而，[18F]FDG PET在鉴别常规影像学检查中不明确的病变方面发挥了关键作用。由于能够早期识别活跃的肿瘤部位，[18F]FDG PET在评估疾病复发和化疗耐药性方面特别有用。由于PSTT的主要治疗方法是手术，[18F]FDG PET在鉴别诊断以及更精确地定位可切除转移灶或治疗的完全缓解情况方面的作用是可取的。
由于[18F]FDG PET和PET/CT在妊娠滋养细胞肿瘤（GTN）诊断及随访中的作用仍存在争议，需要进一步研究来阐明这一问题。
