^18F-FDG符合线路显像在结直肠癌术后复发和（或）转移监测中的应用

The application of ^18F-FDG coincidence imaging in detecting recurrent colorectal cancer

目的评价^18F-脱氧葡萄糖（FDG）符合线路显像在结直肠癌术后复发和（或）转移监测中的价值。方法对56例结直肠癌术后6个月以上患者行^18F-FDG符合线路显像，经迭代法处理和重建，获得衰减校正后的断层图像，并与同期CT和癌胚抗原（CEA）检查结果进行对比。结果经再次手术病理、肠镜检查和随访观察56例患者中有33例发生复发和（或）转移，^18F-FDG符合线路显像诊断结直肠癌术后复发和（或）转移的灵敏度、特异性、阳性预测值、阴性预测值和准确性分别为81．8％（27／33），87．0％（20／23），90．0％（27／30），76．9％（20／26）和83．9％（47／56）；CT分别为69．7％（23／33），82．6％（19／23），85．2％（23／27），65．5％（19／29）和75．0％（42／56）；CEA的诊断效能分别为66．7％（22／33），43．5％（10／23），62．9％（22／35），47．6％（10／21）和57．1％（32／56）。结论^18F-FDG符合线路显像监测结直肠癌术后复发和（或）转移有较大的临床应用价值，尤其在术后CEA水平升高的患者中，其诊断准确性较CT为高。

Objective The aim of this study was to evaluate the value of lS F-fluorodeoxyglueose （FDG） coincidence imaging in detecting recurrent colorectal cancer. Methods FDG coincidence imaging were performed in 56 patients with colorectal cancer. All had FDG coincidence imaging after their radical surgeries for at least six months. Imaging data was acquired and was reconstructed using iterative algorithm. 133 Ba was used for attenuation correction. Results of FDG coincidence images were compared with CT scans and serum tumor marker carcinoembryonic antigen （CEA） during the corresponding period. Results Of the 56 patients, 33 （58.9%） had recurrent disease, confirmed or endorsed by post-operation pathology, enteroscope, and（or） clinical follow-up. The sensitivity, specificity, positive predictive value （PPV）, negative predictive value （NPV）, and accuracy of ^18F-FDG coincidence imaging were 81.8% （27/33）, 87.0% （20/23）, 90.0% （27/30）, 76.9% （20/26） and 83.9% （47/56）, those of CT were 69.7% （23/ 33 ）, 82.6% （ 19/23 ）, 85.2% （23/27）, 65.5 % （19/29） and 75.0% （42/56）, and those of CEA were 66.7% （22/33）, 43.5% （ 10/23）, 62.9% （22/35）, 47.6% （ 10/21 ） and 57.1% （32/56） respectively. Conclusion FDG coincidence imaging has the highest clinical value among FDG coincidence imaging, CT, and CEA in detecting recurrent colorectal cancer.