全身^(18)F-FDG PET/PET-CT在脑转移瘤寻找原发灶中的诊断价值

Detection of the Primary Tumor in Brain Metastasis by Whole Body ^(18)F-FDG PET/PET-CT

背景与目的:恶性肿瘤发生颅内转移十分常见,据统计其发生率约占颅内肿瘤的5%～20%。本文总结因脑转移瘤查原发灶的62例患者的原发灶发现情况及全身转移灶情况,旨在评价全身^(18)F-FDG PET/PET-CT 在脑转移瘤寻找原发灶中的诊断价值。方法:对62例因脑转移瘤查找原发灶为主诉的肿瘤患者进行了回顾性分析。结果:本组62例患者中52例患者的原发灶位置得到了确诊,原发灶的检出率为83.8%(52/62).其中原发性肺癌占55.7%(29/52),所有肺癌中低分化腺癌占44.8%(13/29)。除可检出原发灶外,^(18)F-FDGPET/PET-CT 全身显像还检出肺转移、淋巴结转移、骨转移、肝转移及其它少见部位的转移灶。全身行^(18)F-FDGPET-CT 扫描对肿瘤原发灶的检出率为84.6%;行全身 ^(18)F-FDG PET 扫描对肿瘤原发灶的检出率为82.6%;与^(18)F-FDG PET-CT 相比,~F-FDG PET 图像对肺转移病灶的检出率仅为10.9%。结论:^(18)F-FDG PET/PET-CT 的全身扫描有利于发现原发灶及其他转移灶,对恶性肿瘤发现方面具有重要的临床实用价值,

BACKGROUND & OBJECTIVE:The cerebral metastases are common and account for 5% -20% of all intracranial neoplasms.This is a retrospective study of the sensitivity of using whole body ^(18)F-FDGPET/PET-CT to detect the primary malignancy in 62 patients proven to have cerebral metastasis.More- over,in the same group of patients ^(18)F-FDG PET were compared to ^(18)F-FDG PET-CT in the ability to pick up oth- er metastasis in the body.METHODS:Sixty-two patients whose initial complain were multiple metastatic tumors in the brain were studied retrospectively.^(18)F-FDG PET and ^(18)F-FDG PET-CT images were each retrospectively re- viewed by three independent readers who were blinded to the clinical history and results of the other technique. RESULTS:Fifty-two(83.8%)of the 62 patients had the primary tumor detected using whole body.Among the cases with primary cancer identified,29(55.7%)were found to have the primary located at the lung.And a- mong these 29 patients,the poor differentiation adenocarcinoma was found in 13 cases(44.8%).Additionally the metastasis in bone,lung,and liver were detected simultaneously,and some rare metastasis in the other part of whole body was determined either.By whole body ^(18)F-FDG PET-CT,the sensitivity for detec- tion of primary tumors was 84.6%,while by whole body ^(18)F-FDG the sensitivity for detec- tion of primary tumors was 82.6%.Compari- son to ^(18)F-FDG PET-CT,the sensitivity for detection of lung metastasis by ^(18)F-FDG PET was 10.9%.CONCLU- SION:The sensitivity for detection of primary tumors by the ^(18)F-FDG PET-CT and ^(18)F-FDG PET was similar. Only 10.9% of intrapulmonary metastasis were identified at ^(18)F-FDG PET compared to ^(18)F-FDG PET-CT.Whole body ^(18)F-FDGPET/PET-CT is a useful diagnostic modality to determine the primary malignancy and other metasta- sis.