^(18)F-FDG PET显像在胃癌术后复发及转移中的应用

The value of ^(18)F-FDG PET in estimation of recurrence and metastasis of gastric carcinoma

目的 探讨1 8F 脱氧葡萄糖 (FDG)PET显像诊断胃癌术后复发及转移的价值。方法 4 1例临床疑胃癌术后复发患者行1 8F FDGPET全身显像。图像分析采用视觉及半定量方法 (标准摄取值 ,SUV) ,并参考近期病理检查、CT或核素骨显像结果。结果 ① 2 1例复发患者 (经组织病理学、CT、核素骨显像及临床随访证实 ) ,PET检出胃癌术后复发及转移的灵敏度为 90 5 % ,特异性 80 0 % ,阳性预测值、阴性预测值和准确性分别为 82 6 %、88 9%和 85 4 %。② 2 1例术后复发及转移患者中 ,PET与CT均阳性 13例共 16例次 ,PET平均每例次检出病灶数多于CT。③ 12例术后复发及转移患者化疗后共进行 15次PET复查。 5例化疗后PET显像示病情好转 ,随访 17～ 36个月均存活 ,7例化疗后PET显像示化疗效果欠佳 ,存活时间为 6～ 10个月。结论 1 8F FDGPET显像是诊断胃癌术后复发及转移的有用方法 ,并对监测胃癌术后复发的化疗效果有重要意义。

Objective To evaluate the use of 18 F-fluorodeoxyglucose (FDG) PET in recurrence and metastasis of gastric carcinoma. Methods Forty-one patients were referred for 18 F-FDG PET whole body imaging for evaluation of recurrent gastric carcinoma and metastasis. Visual and semiquantitative methods [standardized uptake value (SUV)] were used to analyze the images. The results of PET imaging were compared with those of pathology,CT, or bone imaging. Results ①Recurrences were established in 21 patients, the sensitivity and specificity of FDG PET for the diagnosis of recurrence and metastasis were 90.5% and 80.0%, respectively. Positive and negative predictive values and accuracy were 82.6%, 88.9% and 85.4%, respectively. ②Among the 21 patients with recurrent gastric carcinoma, lesions were demonstrated by both PET and CT in 16 studies,PET detected more lesions than CT. ③Twelve patients with recurrent gastric carcinoma had 15 PET studies after chemotherapy. PET imaging indicated improvement in 5 cases who were survival after 17～36 months, however, the other 7 with lesion aggression finding died within 6～10 months. Conclusions 18 F-FDG PET is a useful diagnostic modality for recurrent gastric carcinoma. 18 F-FDG PET is of great importance in monitoring the response to chemotherapy.