Heinemann Melina, Ranft Andreas, Jürgens Heribert, Langer Thorsten, Vieth Volker, Timmermann Beate, Weckesser Matthias, Dirksen Uta, Stegger Lars
Nuklearmedizin. 2017;56(6):233-238. doi: 10.3413/Nukmed-0909-17-07. Epub 2018 Jan 11.
To evaluate the performance of a prospectively defined follow-up imaging protocol that includes FDG-PET(/CT) to detect tumour recurrence in Ewing sarcoma (EwS) before becoming symptomatic.
Imaging results and clinical data during follow-up were retrospectively analysed from all patients treated successfully within the EURO E.W.I.N.G. 99 trial at the University Hospital Münster, Germany. All patients received follow-up imaging according to a comprehensive protocol that included regular X-ray, CT, MRI, bone scan and PET(/CT), albeit not all on the same day and with varying intervals for the different modalities.
80 of 105 patients underwent follow-up at our institution after complete remission. 30 patients had recurrent tumour during the follow-up period of 3.6 years on average. 19 recurrences (63%) were detected by scheduled imaging before the advent of clinical symptoms. The majority of these recurrences (8 out of 19; 42%) was detected first by PET/ CT (and confirmed with additional imaging thereafter), even though the total number of PET/CTs was comparatively low (138) and PET/CT was not systematically scheduled before other imaging techniques. Recurrences detected by bone scan were also detectable by PET.
The implemented follow-up protocol was effective in the detection of EwS recurrence before the advent of symptoms. Most cases of those detected before onset of symptoms were detected by PET/CT first. This hybrid imaging modality should therefore be considered in the routine follow-up of EwS patients, as is standard in our hospital. In combination with PET, low-dose chest CT seems to be sufficient in the detection of small pulmonary nodules.
评估一项前瞻性定义的随访成像方案的性能，该方案包括氟代脱氧葡萄糖正电子发射断层显像（/计算机断层扫描）（FDG-PET(/CT)），用于在尤因肉瘤（EwS）出现症状之前检测肿瘤复发。
对德国明斯特大学医院在EURO E.W.I.N.G. 99试验中成功治疗的所有患者的随访期间的成像结果和临床数据进行回顾性分析。所有患者均按照综合方案接受随访成像，该方案包括常规X线、计算机断层扫描（CT）、磁共振成像（MRI）、骨扫描和正电子发射断层显像（/计算机断层扫描）（PET(/CT)），尽管并非所有检查都在同一天进行，且不同检查方式的间隔时间也不同。
105例患者中有80例在完全缓解后在我们机构接受了随访。在平均3.6年的随访期内，30例患者出现肿瘤复发。19例复发（63%）在临床症状出现之前通过定期成像检测到。这些复发中的大多数（19例中的8例；42%）首先通过PET/CT检测到（随后通过其他成像检查予以证实），尽管PET/CT的检查总数相对较少（138次），且PET/CT在其他成像技术之前并未系统安排。骨扫描检测到的复发也可通过PET检测到。
实施的随访方案在症状出现之前检测EwS复发方面是有效的。症状出现之前检测到的大多数病例首先通过PET/CT检测到。因此，在EwS患者的常规随访中应考虑这种混合成像方式，这在我们医院是标准做法。结合PET，低剂量胸部CT似乎足以检测小的肺结节。
