Ucak Semirgin Sibel, Basoglu Tarik, Atmaca Saglik Behiye, Sahin Murathan, Yapici Oktay
aDepartment of Nuclear Medicine, Ondokuzmayis University, Medical School bNuclear Medicine Physician, Samsun Mehmet Aydin Education and Research Hospital, Samsun, Turkey.
Nucl Med Commun. 2016 Dec;37(12):1260-1266. doi: 10.1097/MNM.0000000000000577.
In routine noncontrast-enhanced PET/computed tomography (CT) studies, the female pelvis is one of the most challenging anatomical regions to interpret. In surgically treated patients, it may be more difficult to determine the accurate location of paravaginal hypermetabolic lesions. In this study, the aim was to investigate the contribution of additional PET/CT imaging using a vaginal catheter in patients with pelvic malignant disease.
Forty-seven patients with pelvic malignancies were enrolled in this study. Following routine whole-body fluorine-18 fluorodeoxyglucose (F-FDG) PET/CT scanning, an additional pelvic scan was obtained after placement of a plastic catheter in the vaginal lumen (v-catheter). All suspected foci in vaginal and paravaginal areas were evaluated for both studies. The contribution of additional v-catheter imaging was determined visually by five experienced interpreters.
Pathological F-FDG uptake in various vaginal and/or paravaginal locations was detected in 24 of 47 patients after conventional PET/CT imaging. In 10 of these 24 patients, anatomic relations within the uptake area could not be confidently described and v-catheter imaging provided a significant contribution in all 10 cases. In seven of these 10 sites examined, pathological F-FDG uptake was safely ruled out and three sites were confirmed to be malignant. In total, the final interpretation in 13 of 24 patients (54%) was modified by additional v-catheter imaging. The contribution rate of catheter imaging was 89% in treated patients and 33% in untreated patients with vaginal and/or paravaginal lesions on initial scans.
Additional v-catheter imaging of pelvis may be of diagnostic value in the accurate anatomical definition of hypermetabolic lesions in the vaginal/paravaginal area on noncontrasted PET/CT studies.
在常规非增强正电子发射断层显像/计算机断层扫描（PET/CT）研究中，女性盆腔是最难解释的解剖区域之一。在接受手术治疗的患者中，确定阴道旁代谢增高病变的准确位置可能更加困难。本研究旨在探讨使用阴道导管进行额外PET/CT成像对盆腔恶性疾病患者的作用。
本研究纳入了47例盆腔恶性肿瘤患者。在进行常规全身氟-18氟脱氧葡萄糖（F-FDG）PET/CT扫描后，在阴道腔内放置一根塑料导管（阴道导管）后再进行一次盆腔扫描。对两项研究中阴道和阴道旁区域的所有可疑病灶进行评估。由五名经验丰富的解读人员通过视觉判断额外的阴道导管成像的作用。
在47例患者中，24例在常规PET/CT成像后检测到阴道和/或阴道旁不同位置有病理性F-FDG摄取。在这24例患者中的10例中，摄取区域内的解剖关系无法确切描述，而阴道导管成像在所有10例中都发挥了重要作用。在这10个检查部位中的7个部位，排除了病理性F-FDG摄取，3个部位被确诊为恶性。总体而言，24例患者中有13例（54%）的最终解读因额外的阴道导管成像而改变。对于初始扫描时有阴道和/或阴道旁病变的患者，导管成像在已治疗患者中的贡献率为89%，在未治疗患者中的贡献率为33%。
在非增强PET/CT研究中，盆腔额外的阴道导管成像对于准确界定阴道/阴道旁区域代谢增高病变的解剖结构可能具有诊断价值。
