术前 18F-FDG PET/CT 检查在嗜铬细胞瘤和副神经节瘤中可实现精准手术。
Preoperative 18F-FDG PET/CT in Pheochromocytomas and Paragangliomas Allows for Precision Surgery.
机构信息
Endocrine Oncology Branch, National Cancer Institute, National Institutes of Health, 10 Center Drive, Bethesda, MD.
Section on Medical Neuroendocrinology, Eunice Kennedy Shriver National Institute of Child Health & Human Development, National Institutes of Health, Bethesda, MD.
出版信息
Ann Surg. 2019 Apr;269(4):741-747. doi: 10.1097/SLA.0000000000002671.
BACKGROUND
Fluorodeoxyglucose (F-FDG) positron emission tomography/computed tomography (PET/CT) imaging is recommended in patients with metastatic pheochromocytoma (PC) and paraganglioma (PGL). There are no data on whether routine preoperative F-FDG PET/CT in all patients with PC/PGL impacts surgical management.
OBJECTIVE
The aim of this study was to determine whether routine preoperative F-FDG PET/CT imaging affects the surgical management of patients with PC/PGLs.
METHODS
We analyzed clinical, biochemical, genetic, and anatomic imaging data in 93 consecutive patients with PC/PGL who collectively underwent a total of 100 operations and who had preoperative F-FDG PET/CT imaging.
RESULTS
Of 100 operations, preoperative F-FDG PET/CT showed additional lesions compared to anatomic imaging in 15 cases. These patients were more likely to undergo an open surgical approach (P < 0.05). Presence of genetic mutation, redo operations, sex, age, or tumor size had no significant association with finding additional lesions on F-FDG PET/CT.
CONCLUSIONS
Additional lesions detected on preoperative F-FDG-PET/CT imaging have an impact on the surgical approach in patients with PC/PGLs. Therefore, surgeons should routinely obtain F-FDG-PET/CT imaging in patients with PC/PGL to allow for a more precise surgical intervention.
背景
氟代脱氧葡萄糖（F-FDG）正电子发射断层扫描/计算机断层扫描（PET/CT）成像在转移性嗜铬细胞瘤（PC）和副神经节瘤（PGL）患者中被推荐使用。目前尚无数据表明所有 PC/PGL 患者常规进行术前 F-FDG PET/CT 是否会影响手术管理。
目的
本研究旨在确定常规术前 F-FDG PET/CT 成像是否会影响 PC/PGL 患者的手术管理。
方法
我们分析了 93 例连续 PC/PGL 患者的临床、生化、遗传和解剖影像学数据，这些患者总共进行了 100 次手术，并进行了术前 F-FDG PET/CT 成像。
结果
在 100 次手术中，术前 F-FDG PET/CT 与解剖影像学相比，在 15 例中显示出了额外的病变。这些患者更有可能接受开放手术方法（P < 0.05）。遗传突变、再次手术、性别、年龄或肿瘤大小与 F-FDG PET/CT 上发现额外病变无显著相关性。
结论
术前 F-FDG-PET/CT 成像检测到的额外病变会影响 PC/PGL 患者的手术方法。因此，外科医生应常规为 PC/PGL 患者获取 F-FDG-PET/CT 成像，以实现更精确的手术干预。
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