Ruhlmann J, Schomburg A, Bender H, Oehr P, Robertz-Vaupel G M, Vaupel H, Wolter H, Kozak B, Biersack H J
PET-Center, Friedrich-Wilhelm University, Bonn, Germany.
Dis Colon Rectum. 1997 Oct;40(10):1195-204. doi: 10.1007/BF02055166.
To evaluate the routine clinical value of attenuation-corrected whole-body fluorodeoxyglucose positron emission tomography in colorectal cancer, a total of 59 patients who were referred for evaluation of suspected or proven colorectal cancers were studied.
Positron emission tomography scans were recorded using a Siemens ECAT Exact 921/47.
Median follow-up after the positron emission tomography study was 11 (mean, 12.3; range, 1-21) months. According to computed tomography, coloscopy, and ultrasound, we recorded eight apparently false-positive results. During later follow-up, however, three of those cases, which were negative with computed tomography, magnetic resonance imaging, sonography, or laparoscopy, turned out to be true-positive instead. In 3 patients, a primary colorectal cancer was suspected; in 26 patients, a recurrence of colorectal cancer was suspected. Eight patients were studied for follow-up after the history of colorectal cancer with no suspicion of recurrence. In 12 patients, the rise of serum tumor marker concentrations was the reason for the positron emission tomography study; 12 patients with known metastatic disease were also included ("restaging"). With regard to the entire patient population, we found an overall sensitivity of 100 percent, a specificity of 67 percent, and positive and negative predictive values of 92 and 100 percent, respectively. Being merely confirmative with respect to tumor recurrence or distant metastases in the majority of patients, positron emission tomography revealed a primary tumor in one patient and confirmed metastatic foci in several patients that had not been delineated by other imaging modalities.
A whole-body positron emission tomography scan provides optimum conditions to locate metastatic lesions that might not be seen otherwise. There is a trend showing that positron emission tomography diagnostics as a consequence of early increased tumor markers is a highly sensitive combination, because computed tomography and magnetic resonance imaging were not as sensitive in early recurrences. Positron emission tomography, as performed in daily clinical practice, proved to be a powerful diagnostic tool in our subset of colorectal cancer patients.
为评估衰减校正后的全身氟脱氧葡萄糖正电子发射断层扫描在结直肠癌中的常规临床价值，我们对59例因疑似或确诊结直肠癌而前来评估的患者进行了研究。
使用西门子ECAT Exact 921/47记录正电子发射断层扫描。
正电子发射断层扫描研究后的中位随访时间为11个月（平均12.3个月；范围1 - 21个月）。根据计算机断层扫描、结肠镜检查和超声检查，我们记录到8例明显的假阳性结果。然而，在随后的随访中，其中3例经计算机断层扫描、磁共振成像、超声检查或腹腔镜检查为阴性的病例，最终被证明为真阳性。3例患者疑似原发性结直肠癌；26例患者疑似结直肠癌复发。8例患者在无复发怀疑的情况下因结直肠癌病史接受随访研究。12例患者因血清肿瘤标志物浓度升高而接受正电子发射断层扫描研究；还纳入了12例已知有转移疾病的患者（“再分期”）。对于整个患者群体，我们发现总体敏感性为100%，特异性为67%，阳性预测值和阴性预测值分别为92%和100%。在大多数患者中，正电子发射断层扫描仅用于确认肿瘤复发或远处转移，它在1例患者中发现了原发性肿瘤，并在数例患者中确认了其他成像方式未发现的转移灶。
全身正电子发射断层扫描为定位否则可能无法发现的转移病灶提供了最佳条件。有一种趋势表明，由于肿瘤标志物早期升高而进行的正电子发射断层扫描诊断是一种高度敏感的组合，因为计算机断层扫描和磁共振成像在早期复发时不如其敏感。在日常临床实践中进行的正电子发射断层扫描在我们的结直肠癌患者亚组中被证明是一种强大的诊断工具。
