Sakamoto H, Nakai Y, Ohashi Y, Matsuda M, Sakashita T, Nasako Y, Kitayama H, Kawabe J, Okamura T, Ochi H
Department of Otorhinolaryngology, Osaka City University Medical School, Japan.
Acta Otolaryngol Suppl. 1998;538:254-60.
We examined the usefulness of positron emission tomography (PET) using fluorine-18 deoxyglucose (FDG) in determining the therapeutic effects of irradiation and chemotherapy on head and neck malignant tumors. Twenty-two patients with head and neck lesions who underwent histological examinations were studied. Squamous cell carcinoma was histologically diagnosed in all cases. Sixteen of them underwent radiotherapy with approximately 40 Gy in combination with carboplatin therapy. The remaining 6 patients underwent radiotherapy alone. After these treatments, 11 underwent surgery. For PET study, each patient was injected with intravenous FDG 185-370 MBq. We evaluated the degree of FDG accumulation using scanned images taken 40-55 min after the injection. We measured the standardized uptake value (SUV), a semiquantative evaluation, ROI activity divided by the dosage per weight of each patient. FDG-PET, CT and MRI were performed twice for each patient, before and after treatment. FDG uptake, but not the tumor size in CT or MRI, was significantly reduced in each patient after the treatment. Therefore, our findings have clearly demonstrated that FDG-PET provides for more valuable therapeutic outcomes than conventional imaging such as CT and MRI. FDG-PET should thus provide a new dimension in the management of head and neck malignant tumors.
我们研究了使用氟-18脱氧葡萄糖（FDG）的正电子发射断层扫描（PET）在确定放疗和化疗对头颈部恶性肿瘤治疗效果方面的实用性。对22例接受组织学检查的头颈部病变患者进行了研究。所有病例均经组织学诊断为鳞状细胞癌。其中16例接受了约40 Gy的放疗联合卡铂治疗。其余6例患者仅接受放疗。这些治疗后，11例接受了手术。对于PET研究，每位患者静脉注射185 - 370 MBq的FDG。我们使用注射后40 - 55分钟拍摄的扫描图像评估FDG的积聚程度。我们测量了标准化摄取值（SUV），这是一种半定量评估，即感兴趣区（ROI）活性除以每位患者的体重剂量。每位患者在治疗前后均进行了两次FDG - PET、CT和MRI检查。治疗后每位患者的FDG摄取明显降低，但CT或MRI中的肿瘤大小未明显减小。因此，我们的研究结果清楚地表明，与CT和MRI等传统成像相比，FDG - PET能提供更有价值的治疗效果评估。因此，FDG - PET应为头颈部恶性肿瘤的管理提供一个新的维度。
