^(18)F-FDG PET(PET/CT)肾癌显像特点分析

Characteristics of ^(18)F-FDG PET for space occupying renal cancer

目的评价肾占位全身18F-FDG PET(PET/CT)显像的应用价值。方法对78例肾占位的18F-FDGPET(PET/CT)显像特点进行分析。其中影像学检查发现肾实性占位28例;肾癌术后复查41例;既往有肾癌手术史后发现肺内占位病变9例。按5.55MBq/kg体质量注入18F-FDG后50min,使用SEIMENS Ecat exact HR+或GE Discovery VCT进行三维模式采集。PET判读:在观察到的肾病灶部位设感兴趣区(ROI),以SUVmax≥2.5为阳性(恶性),SUVmax<2.5为阴性(良性)。PET/CT判读:PET图像标准同上,结合CT影像及融合图像进行诊断。结果病理证实为肾癌的21例中PET阳性11例;7例良性病变中5例错构瘤及1例囊肿PET显示为阴性;11例肾癌为PET/CT显像,9例阳性;13例转移及术后复发者PET阳性10例。结论 18F-FDGPET对肾癌原发灶的诊断价值有限,对转移以及术后局部复发的诊断有较高价值。

Objective To evaluate the value of whole body 18F-FDG PET（PET/CT） for space occupying renal cancer. Methods Characteristics of whole-body 18F-FDG PET imaging for 78 patients with space occupying solid renal cancer were analyzed, which showed space occupying solid renal lesions in 28, 41, 9 patients, respectively. Fifty minutes after injection with 18F-FDG PET （5.55MBq/kg）, Ecat exact HR or GE discovery VCT was used to collect the 3-dimensional images. ROI was set at the renal foci observed. SUVmax ≥ 2.5 was judged as positive PET（malignant） and SUVmax〈2.5 was judged as negative PET（benign）.The disease was diagnosed following the CT and fusion images in PET/CT. Results Pathological examination showed renal cancer and positive PET in 21 and 11 patients, respectively. Of the 7 patients with benign lesions, 5 were found to be hamartoma and 1 was found to have cyst which was positive for PET. Of the 11 patients who were found to have renal cancer by 18F-FDG PET/CT, 5 were positive for PET. Of the 13 patients with metastasis or relapse after operation, 10 were positive for PET. Conclusion 18F-FDG PET has a limited value for the diagnosis of primary renal cancer but has a rather high value for the diagnosis of metastasis or relapse of renal cancer after operation.