Karlan B Y, Hawkins R, Hoh C, Lee M, Tse N, Cane P, Glaspy J
Division of Gynecologic-Oncology, Cedars-Sinai Medical Center, Los Angeles, California.
Gynecol Oncol. 1993 Nov;51(2):175-81. doi: 10.1006/gyno.1993.1268.
The existing means of detecting recurrent ovarian carcinoma are notoriously poor. Positron emission tomography (PET) is a form of computer-assisted imaging which produces images reflective of the biochemistry of the tissues rather than their physical characteristics. PET imaging with the positron emitting glucose analog 2-[18F]-fluoro-2-deoxy-D-glucose (FDG) exploits the accelerated rate of glycolysis characteristic of malignant tissue to image tumors. To begin to study PET's ability to diagnose recurrent ovarian cancer, whole-body PET FDG scanning was performed on 13 patients prior to planned surgical exploration. Seven patients were suspected of having recurrence based upon clinical findings, and 6 patients were clinically free of disease. In all 6 of the patients with suspected recurrence who subsequently underwent surgery, PET images demonstrated increased FDG uptake in a distribution that correlated with surgical-pathologic findings. Both intraperitoneal and extraperitoneal lesions were detected by PET. All 6 patients judged clinically free of disease had negative PET scans, but in 5 of these microscopic foci of residual tumor were found at surgery. Although PET FDG cannot replace surgery in the detection of microscopic recurrence, it can accurately detect tumors greater than 1.0 cm in diameter.
现有的复发性卵巢癌检测手段 notoriously 较差。正电子发射断层扫描（PET）是一种计算机辅助成像形式，它生成的图像反映的是组织的生物化学特性而非其物理特征。使用发射正电子的葡萄糖类似物2-[18F]-氟-2-脱氧-D-葡萄糖（FDG）进行PET成像利用了恶性组织特有的糖酵解加速速率来对肿瘤进行成像。为了开始研究PET诊断复发性卵巢癌的能力，在计划进行手术探查前，对13例患者进行了全身PET FDG扫描。7例患者根据临床发现怀疑有复发，6例患者临床上无疾病。在随后接受手术的所有6例疑似复发患者中，PET图像显示FDG摄取增加，其分布与手术病理结果相关。PET检测到了腹膜内和腹膜外病变。所有6例临床上判断无疾病的患者PET扫描均为阴性，但其中5例在手术中发现了残留肿瘤的微小病灶。虽然PET FDG在检测微小复发方面不能替代手术，但它能准确检测直径大于1.0厘米的肿瘤。
