FLT-PET/CT 诊断胃癌原发灶和转移性淋巴结病变：与 FDG-PET/CT 的比较

FLT-PET/CT diagnosis of primary and metastatic nodal lesions of gastric cancer: comparison with FDG-PET/CT.

机构信息

Department of Radiology, Kagoshima University, Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan.

Department of Radiology, Nanpuh Hospital, 14-3 Nagata, Kagoshima, 892-8512, Japan.

出版信息

Abdom Radiol (NY). 2016 Oct;41(10):1891-8. doi: 10.1007/s00261-016-0788-6.

DOI:10.1007/s00261-016-0788-6

PMID:27255652

Abstract

PURPOSE

To examine the diagnostic performance of (18)F-fluorothymidine (FLT)-PET/CT of primary and metastatic nodal lesions of gastric cancer by comparing with (18)F-fluorodeoxyglucose (FDG)-PET/CT.

METHODS

The enrolled study population comprised 17 patients with 17 newly diagnosed gastric cancers who underwent surgery of the primary lesion and regional nodes after both FDG- and FLT-PET/CT scans. Visual detectability of the primary gastric lesions was correlated with pathological factors using the Fisher exact or Mann-Whitney U test. The sensitivity, specificity, and accuracy in detecting nodal lesions were compared between both PET/CT scans using the McNemar exact or χ (2) test.

RESULTS

Fourteen of 17 (82.4%) primary cancers were visualized by both FDG- and FLT-PET/CT scans. Although FDG or FLT visibility was not significantly associated with tumor size (p = 0.16) or histological type (p = 1.00), the 3 nonvisible lesions were pathologically early (T1) cancers. The sensitivity, specificity, and accuracy for detecting nodal metastasis were 44.8% (13/29), 98.7% (164/166), and 90.8% (177/195) for FDG-PET/CT, and 31.0% (9/29), 100% (166/166), and 89.7% (175/195) for FLT-PET/CT, respectively. No significant difference was found between the two scans in sensitivity (p = 0.13), specificity (p = 0.48), or accuracy (p = 1.00).

CONCLUSION

FLT-PET/CT may have the same diagnostic value as FDG-PET/CT for detection of primary and nodal lesions of gastric cancer.

摘要

目的

通过比较（18）F-氟代胸腺嘧啶（FLT）-PET/CT 与（18）F-氟代脱氧葡萄糖（FDG）-PET/CT，研究原发性和转移性胃癌淋巴结病变的（18）F-FLT-PET/CT 诊断性能。

方法

本研究纳入了 17 例新诊断为胃癌的患者，这些患者在接受 FDG 和 FLT-PET/CT 扫描后均进行了原发性病变和区域淋巴结的手术。使用 Fisher 确切检验或 Mann-Whitney U 检验，将原发性胃病变的视觉检测结果与病理因素相关联。使用 McNemar 确切检验或 χ²检验比较两种 PET/CT 扫描在检测淋巴结病变时的敏感性、特异性和准确性。

结果

17 例原发性肿瘤中有 14 例（82.4%）在 FDG 和 FLT-PET/CT 扫描中均可见。尽管 FDG 或 FLT 的可见性与肿瘤大小（p=0.16）或组织学类型（p=1.00）无显著相关性，但 3 例不可见病变为病理早期（T1）癌症。FDG-PET/CT 检测淋巴结转移的敏感性、特异性和准确性分别为 44.8%（13/29）、98.7%（164/166）和 90.8%（177/195），FLT-PET/CT 检测淋巴结转移的敏感性、特异性和准确性分别为 31.0%（9/29）、100%（166/166）和 89.7%（175/195）。两种扫描在敏感性（p=0.13）、特异性（p=0.48）或准确性（p=1.00）方面均无显著差异。