中国全科医学2013，Vol.16Issue(12)：1360-1365,6.DOI:10.3969/j.issn.1007-9572.2013.04.088
18F-FDG PET/CT显像对胃癌治疗后临床再分期及治疗决策的影响
Impact of 18F-FDG PET/CT on the Clinical Restaging and Therapeutic Regimens in Post-Treatment Patients with Gastric Carcinoma
摘要
Abstract
Objective To investigate the value of 18F - fluorodeoxyglucose positron emission tomography/computed tomography (18F - FDG PET/CT ) in the follow - up of post - treatment patients with gastrie cancer and to investigate the impact of 18F - FDG PET/CT on the clinical restaging and therapeutic regimens. Methods A retrospective study was conducted in 55 post - treatment patients with gastric cancer. 18F - FDG PET/CT scan was performed at 60 min ( early phase ) and 120 min ( delayed phase ) after 18F - FDG administration. 18F - FDG PET/CT of delayed phase was undertaken after gastric filling with moderate water. If necessary, enhanced CT was also performed. The value of 18F - FDG PET/CT in the follow - up of post - treatment patients with gastric cancer was evaluated hased on recurrence, lymph node metastases and lymph node external metastases respectively, and it was compared with CT. Meanwhile, the impact of 18F - FDG PET/CT on the restaging and treatment decision was also analyzed in this study. Additionally, the maximum of standardized uptake value ( SUVmax ) of early and delayed phases in the anastomotic stoma was measured, and the percentage change of SUVmax ( △ SUVmax% ) was also calculated in this stud-y. Tumor recurrence and/or metastases were finally confirmed by pathology. Data was analyzed with SAS 9. 13. Results ( 1 ) The accuracy of 18F - FDG PET/CT in the diagnosis of gastric recurrence was 96. 4% ( 53/55 ), which was significantly higher than CT(85.5%) .In the detection of lymph node metastases, the sensitivity, accuracy and negative predictive value ( NPV ) of 18F - FDG PET/CT ( 92. 0% , 96. 4% and 93. 8% ) showed statistically significant differences compared with CT ( 60. 0% , 81. 8% and 75. 0% ) . In addition, the sensitivity and accuracy of 18F - FDG PET/CT in detecting lymph node external metasta-ses were 81. 8% and 90. 9% , significantly higher than CT ( 45. 5% , 76. 4% ) . ( 2 )18F - FDG PET/CT changed the TNM stage in 34. 5% ( 19/55 ) cases, and the therapeutic strategies of 21. 8% ( 12/55 ) cases were changed due to PET/CT findings. ( 3 ) ASUVmax% was ( 22. 8 ±9. 8 )% and ( 8. 6 ± 13. 3 )% in gastric recurrence and the anastomotic inflammation with statistically significant differences between the two groups ( P <0. 05 ) . Conclusion 18F - FDG PET/CT is a superior post -operative surveillance modality in the diagnosis of recurrence and metastases in post - treatment patients with gastric cancer compared with CT. 18F - FDG PET/CT has great impact on the clinical restaging and proper re - treatment regimens. 18F - FDG PET/ CT of delayed phase after gastric filling with water may be one of the best ways in discriminating the recurrence from the inflammation in anastomotic stoma.关键词
胃肿瘤/肿瘤复发,局部/肿瘤转移/正电子发射断层显像术/体层摄影术,螺旋计算机/氟脱氧葡萄糖F18Key words
Stomach neoplasms/ Neoplasm recurrence, local/ Neoplasm metastasis/ Positron - emission tomography/ Tomography, spiral computed/ Fluorodexyglucose F18分类
医药卫生引用本文复制引用
张敬勉,赵新明,王建方,王颖晨,张召奇,赵秀娟..18F-FDG PET/CT显像对胃癌治疗后临床再分期及治疗决策的影响[J].中国全科医学,2013,16(12):1360-1365,6.基金项目
河北省普通高等学校强势特色学科肿瘤学组(冀教高2005[52]) （冀教高2005[52]）
河北省卫生厅科研项目(20110499) （20110499）
