Betancourt Cuellar Sonia L, Palacio Diana P, Wu Carol C, Carter Brett W, Correa Arlene M, Hofstetter Wayne L, Marom Edith M
1 Department of Diagnostic Radiology,The University of Texas, Anderson Cancer Center , The University of Texas, Anderson Cancer Center , Houston, TX , USA.
2 Department of Diagnostic Radiology,University of Arizona, Medical Center , University of Arizona, Medical Center , Chicago, IL , USA.
Br J Radiol. 2018 Feb;91(1082):20170341. doi: 10.1259/bjr.20170341. Epub 2017 Nov 28.
The purpose of this study was to evaluate fludeoxyglucose-positron emission ;tomography/CT's (FDG-PET/CT) performance in the follow ;up of patients with surgically treated oesophageal adenocarcinoma.
The follow-up FDG-PET/CT scans of 162 consecutive patients with surgically treated oesophageal adenocarcinoma were retrospectively reviewed. Histopathological and/or imaging examinations confirmed recurrent disease. The accuracy, sensitivity, specificity and negative and positive predictive values were calculated.
Recurrence occurred in 71 (43%) patients, usually within the first year following surgery (60%) and in more than one site (76%). The sensitivity, specificity, positive-predictive value, negative-predictive value and accuracy of FDG-PET/CT for anastomotic recurrence were 77, 76, 16, 98 and 76%; for regional nodal recurrence were 88, 85, 43, 97 and 86%; and for distant metastatic recurrence were: 97, 96, 91, 99 and 96%. In 5 of the 42 patients (12%) with distant metastases, the metastatic sites were outside the area covered by a conventional follow-up chest-abdomen CT and in 4 patients (9%) metastases were barely perceptible on the CT component of the FDG-PET/CT and consequently were unlikely to be detected without the aid of the FDG uptake.
FDG PET/CT is accurate in detecting oesophageal adenocarcinoma recurrence, especially within the first post-operative year when most recurrences occur, and is useful in identifying patients with a solitary metastasis. Advances in knowledge: FDG-PET/CT should be considered as a valuable tool in the routine follow ;up of surgically treated oesophageal cancer patients within the first 2 years after surgery.
本研究旨在评估氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（FDG-PET/CT）在手术治疗的食管腺癌患者随访中的性能。
回顾性分析162例连续接受手术治疗的食管腺癌患者的随访FDG-PET/CT扫描结果。组织病理学和/或影像学检查证实疾病复发。计算准确性、敏感性、特异性以及阴性和阳性预测值。
71例（43%）患者出现复发，通常在术后第一年（60%），且复发部位不止一处（76%）。FDG-PET/CT对吻合口复发的敏感性、特异性、阳性预测值、阴性预测值和准确性分别为77%、76%、16%、98%和76%；对区域淋巴结复发分别为88%、85%、43%、97%和86%；对远处转移复发分别为97%、96%、91%、99%和96%。在42例有远处转移的患者中，5例（12%）转移部位在传统胸部-腹部CT覆盖区域之外，4例（9%）转移灶在FDG-PET/CT的CT部分几乎无法察觉，因此若无FDG摄取则不太可能被检测到。
FDG-PET/CT在检测食管腺癌复发方面准确，尤其是在术后第一年大多数复发发生时，并且有助于识别孤立转移患者。知识进展：FDG-PET/CT应被视为手术治疗的食管癌患者术后2年内常规随访的有价值工具。
