Division of Nuclear Medicine, Department of Radiology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY.
Division of Nuclear Medicine, Department of Radiology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY.
Semin Nucl Med. 2017 Nov;47(6):579-594. doi: 10.1053/j.semnuclmed.2017.07.005. Epub 2017 Jul 24.
FDG-PET/CT as a modality is increasingly used for detection of recurrence and for restaging in patients with clinical suspicion of malignancy, as well as in patients with elevated tumor markers. However, there are many pitfalls in the interpretation of these scans when the studies are performed after some treatment. Some of these are attributed to normal physiological distribution and are compounded when there are inflammatory changes occurring after surgery. The body's inherent response to the surgical insult results in this inflammation. In addition, there are also complications that can happen following surgery, causing increased FDG uptake. Despite various fallacies, FDG-PET/CT provides valuable information in evaluation of residual and recurrent malignant disease. In this article, we aim to describe some of these postsurgical changes secondary to inflammation, common surgical complications, and finally, the utility of FDG-PET/CT in these patients to detect recurrent disease, even in the background of postsurgical changes.
FDG-PET/CT 作为一种检查方式,越来越多地用于检测疑似恶性肿瘤的患者的复发和再分期,以及肿瘤标志物升高的患者。然而,当这些检查在治疗后进行时,在解释这些扫描结果时存在许多陷阱。其中一些归因于正常的生理分布,并且在手术后发生炎症变化时会更加复杂。身体对手术创伤的固有反应导致这种炎症。此外,手术后还可能发生一些并发症,导致 FDG 摄取增加。尽管存在各种谬论,但 FDG-PET/CT 在评估残留和复发性恶性疾病方面提供了有价值的信息。在本文中,我们旨在描述一些继发于炎症的手术后变化、常见的手术并发症,最后是 FDG-PET/CT 在这些患者中的应用,以检测即使在手术后变化的背景下也存在的复发性疾病。