Rege S, Maass A, Chaiken L, Hoh C K, Choi Y, Lufkin R, Anzai Y, Juillard G, Maddahi J, Phelps M E
Department of Molecular and Medical Pharmacology, UCLA School of Medicine.
Cancer. 1994 Jun 15;73(12):3047-58. doi: 10.1002/1097-0142(19940615)73:12<3047::aid-cncr2820731225>3.0.co;2-#.
The purpose of this study was to evaluate the utility of positron emission tomography- (PET) 2-[18F]-fluoro-2-deoxy-D-glucose (FDG) imaging in extracranial head and neck cancers.
Sixty patients with biopsy-proven cancers were studied using PET-FDG. Thirty-four patients were studied before therapy (staging), of which 15 patients received primary radiotherapy and serial PET-FDG imaging (monitoring). Seven patients with advanced disease had laser excision (monitoring), and 19 patients were evaluated for recurrent disease (recurrence).
Four patients had unknown primary lesions. PET-FDG imaging located the primary tumor in two of four patients, and magnetic resonance imaging (MRI) in none of four. In the remaining patients (staging), PET-FDG imaging detected the primary tumor in 29 of 30 patients, and MRI in 23 of 30. In the staging group, PET-FDG imaging identified the presence or absence of lymph node involvement in 32 of 34 patients, and MRI in 31 of 34. PET-FDG imaging was helpful in evaluating tumor response to radiation therapy or laser excision. Ten patients evaluated for recurrent disease had biopsy-confirmed recurrences, and 7 had no recurrence. PET-FDG imaging results were positive for primary tumor recurrence in 9 of 10 patients, and MRI results were positive in 6 of 10. MRI results were negative for lymph node disease in one of these patients with recurrent primary tumor where PET-FDG imaging and biopsy demonstrated nodal involvement. PET-FDG results were negative for recurrent disease in seven of seven patients, and MRI results were negative for recurrent disease in in four of seven.
In this series, the authors found that PET-FDG is a useful diagnostic modality for evaluating the patient with an unknown primary, monitoring response to therapy, and in detecting recurrent tumors.
本研究的目的是评估正电子发射断层扫描（PET）-2-[18F]-氟-2-脱氧-D-葡萄糖（FDG）成像在颅外头颈部癌症中的应用价值。
对60例经活检证实患有癌症的患者进行PET-FDG研究。34例患者在治疗前进行研究（分期），其中15例患者接受了原发灶放疗及系列PET-FDG成像（监测）。7例晚期疾病患者接受了激光切除（监测），19例患者接受了复发疾病评估（复发）。
4例患者原发灶不明。PET-FDG成像在4例患者中的2例中定位到了原发肿瘤，而磁共振成像（MRI）在4例中均未定位到。在其余患者（分期）中，PET-FDG成像在30例患者中的29例中检测到了原发肿瘤，MRI在30例中的23例中检测到。在分期组中，PET-FDG成像在34例患者中的32例中确定了有无淋巴结受累，MRI在34例中的31例中确定了有无淋巴结受累。PET-FDG成像有助于评估肿瘤对放射治疗或激光切除的反应。19例接受复发疾病评估的患者中，10例经活检证实复发，7例未复发。PET-FDG成像结果在10例患者中的9例中显示原发肿瘤复发呈阳性，MRI结果在10例中的6例中呈阳性。在这例原发肿瘤复发且PET-FDG成像和活检显示有淋巴结受累的患者中，MRI结果显示淋巴结疾病为阴性。PET-FDG结果在7例患者中的7例中显示复发疾病为阴性，MRI结果在7例中的4例中显示复发疾病为阴性。
在本系列研究中，作者发现PET-FDG是一种用于评估原发灶不明患者、监测治疗反应及检测复发肿瘤的有用诊断方法。
