Ottenhof Sarah R, Vegt Erik
Department of Urology, Netherlands Cancer Institute, Amsterdam, the Netherlands.
Department of Nuclear Medicine, Netherlands Cancer Institute, Amsterdam, the Netherlands.
Transl Androl Urol. 2017 Oct;6(5):833-838. doi: 10.21037/tau.2017.04.36.
Positron emission tomography (PET) imaging with F-fluorodeoxyglucose (FDG) combined with computed tomography (CT) provides functional imaging combined with anatomic information, improving diagnostic accuracy and confidence. Although virtually all primary penile tumors are FDG-avid, PET/CT is not recommended for primary tumor staging as it has limited spatial resolution and is hampered by urinary FDG excretion. The accuracy of PET/CT for lymph node staging seems to improve with the pretest likelihood of metastatic nodes. In groins with normal physical examination, sensitivity is only 57%. In groins with palpably enlarged lymph nodes, sensitivity of PET/CT reaches 96%. For pelvic lymph nodes and distant metastases, PET/CT is more accurate if inguinal metastases are present. However, these results are based on a very limited number of studies. Overall, the role of PET/CT imaging in penile cancer remains ambiguous, especially in inguinal lymph nodes. During staging and follow-up, it may be particularly useful in detecting pelvic lymph node metastases and occult distant metastases prior to systemic chemotherapy and/or extensive surgery, improving selection of patients that are most likely to benefit from such therapies.
正电子发射断层扫描（PET）与氟脱氧葡萄糖（FDG）联合计算机断层扫描（CT）成像可提供结合解剖信息的功能成像，提高诊断准确性和可信度。尽管几乎所有原发性阴茎肿瘤都摄取FDG，但不推荐将PET/CT用于原发性肿瘤分期，因为其空间分辨率有限且受尿液中FDG排泄的影响。PET/CT对淋巴结分期的准确性似乎随着转移淋巴结的预检可能性而提高。在体格检查正常的腹股沟区，敏感性仅为57%。在可触及淋巴结肿大的腹股沟区，PET/CT的敏感性达到96%。对于盆腔淋巴结和远处转移，如果存在腹股沟转移，PET/CT更准确。然而，这些结果基于非常有限的研究数量。总体而言，PET/CT成像在阴茎癌中的作用仍不明确，尤其是在腹股沟淋巴结方面。在分期和随访期间，它可能在全身化疗和/或广泛手术前检测盆腔淋巴结转移和隐匿性远处转移方面特别有用，有助于更好地选择最可能从这些治疗中获益的患者。
