PET-CT进行癌症早期筛查的初步研究

Cancer Screening with Whole-body PET-CT:a Preliminary Report

目的评价18F-PET-CT进行肿瘤筛查的价值。方法2006年9月～2008年11月在我院行PET-CT检查进行肿瘤筛查者72例,男性50人,女性22人,年龄30～80岁(中位46岁)。吸烟者及曾经吸烟者20人,吸烟量10～40包/年,承认二手吸烟者23人。所有受检者行全身PET-CT显像,范围为头顶至双大腿上段。PET-CT扫描后行屏气低剂量胸部螺旋CT扫描(扫描参数为120KV,32mAs,1.25mm层厚)。对所有图像进行分析记录。结果发现恶性肿瘤2例(2.7%),均有局部放射性摄取增高:肺癌1例(T1N0M0),甲状腺癌1例(T1N1M0)。发现良性肿瘤1例(甲状腺腺瘤)。发现肺非钙化性结节28例(38.3%,多发14例,单发14例,直径5mm～21mm),除1例外均无明显放射性摄取增高。6例纵隔及肺门淋巴结出现放射性摄取增高(最大SUV1.1～7.1),其中含钙化1例。头部及腹部未见重要异常发现。电话随诊41例(时间3～15个月)均无异常发现。结论全身PET-CT可检出多种早期肿瘤。

Objective To evaluate the whole body PET-CT in screening cancer. Methods Between September 2006 and November 2008, a total of 72 asymptomatic subjects （50 male and 22 female; age range 30-80; mean age, 46 years） undergone the whole-body ^18FPET/CT studies in our PET-CT center. There were 20 smokers or ex-smokers （10-40 pack-years）, and 23 second-hand smokers. Firstly, the whole-body PET-CT was done from the head to the thigh. And then, the CT examination of the entire thorax was performed at low-dose CT settings （breath hold, 32mAs, 1. 25mm collimation, all images transferred to PACS）. All scanning imaging data of 72 subjects were retrospectively studied and analyzed qualitatively. Results The primary malignant tumors were identified by FDG-PET-CT in 2 patients （2.7%）, one with lung cancer （n=1, T1N0M0）, one with thyroid cancer （n=1, T1N1M0）. A benign tumor was noted in 1 patient with thyroid adenoma. Pulmonary noncalcified nodules were identified in 28 participants （38.3%, multiple nodules in 14, solitary pulmonary nodules in 14）. The diameters were 5mm-21mm. All pulmonary nodules but one had no focal FDG-avid foci. ^18F-FDG avid diseases in lymph nodes in mediastinal and hilar regions were noted in 6 participants, with maximal SUV of 1.1-7.1. Calcification was found in one case. Follow-up with telephone calls were done in 41 cases, 3-15 months later, with no complaints or positive findings. No important abnormality was found in brain or abdomen in all subjects. Conclusion PET-CT has the potential to detect a wide variety of cancer at potentially curative stages.