胃癌PET-CT显像的临床应用

Clinic practice of PET-CT in diagnosis of gastnic canler

目的：评价^18F-脱氧葡萄糖（FDG）PET-CT显像在胃癌诊断中的价值。方法：26例临床可疑胃癌及胃癌术后吻合口复发患者（男20例，女6例，年龄48～82岁）行全身^18F-FDG PET-CT扫描。患者于左手臂静脉注入^18F-FDG前行胃肠道喝水低张准备，患者行^18F-FDG PET-CT扫描前再次喝水充盈胃肠道。图像有2位核医学医师及2位影像学医师共同阅片。结果与病理结果及临床随访结果相对照。结果：^18F-FDG PET-CT扫描可同时得到PET、CT及PET-CT图像。PET图像发现病灶19例，PET-CT图像发现病灶20例，病理结果及临床随访结果证实原发性胃癌16例，胃癌术后吻合口复发3例，胃癌术后改变3例，胃炎4例。PET图像诊断胃癌及胃癌术后吻合口复发的灵敏性为89％，特异性为71％，准确性为85％，阳性预测值为89％，阴性预测值为71％；PET-CT图像诊断胃癌及胃癌术后吻合口复发的灵敏性为100％，特异性为86％，准确性为96％，阳性预测值为95％，阴性预测值为100％。结论：PET-CT在诊断胃癌及胃癌吻合口复发方面优越于PET图像。

Objective：To investigate the value of PET-CT in diagnosis of gastric cancer.Methods：All patients（20M/6F;age48-82） were entrolled for whole body PET-CT scan. All patients gastric wall were distend by orally ingesting water befor intravenous injection of FDG and whole hady PET-CT scan. Images were reviewed by two nuclear medicine physicians and two radiologist. Results： Were compared with histological confirmation and clinic follow-up. Results Once PET-CT scaning can get PET image, CT image and PET-CT image. 19 cases positive image in PET image. 20 cases positive image in PET-CT image. Histological confirmation and follow-up confirm that there were 16 eases with primary gastric cancer,3 eases with local anastomotie recurrence,3 eases with no local anastomofie recurrence,4 cases with gastricism, this translates to a sensitivity of 89%, specificity of 71%, accurary of 85% ,positive predictive value of 89% and negative predictive value of 71% for PET image in diagnosis of gastric cancer and translates to a sensitivity of 100%, specificity of 86%, accunuy of 96%,pasifive predictive value of 95% and negative predictive value of 96% for PET-CF image in diagnosis of gastric cancer. Conclusion： PET-CT is obviously superior to PET alone for diagnosis of gastric cancer.