^(18)F-FDG PET/CT显像在上皮性卵巢癌术后随访中的应用价值及对临床决策的影响

Value of ^(18)F-FDG PET/CT in the follow-up and clinical-decision of postoperation patients with epithelial ovarian cancer

目的探讨PET/CT显像在上皮性卵巢癌术后和(或)综合治疗后随访中的应用价值及对临床治疗决策影响。方法回顾性分析52例上皮性卵巢癌术后,接受18F-FDG PET/CT显像及常规影像学方法检查患者的随访及临床评价资料,与临床随访的金标准[再次术后病理和(或)长期随访观察]进行对比,并分析PET/CT显像对临床决策的影响。结果 52例患者中,33例经临床随访确诊为复发和(或)转移,19例无明显复发和(或)转移。PET/CT显像以视觉分析法结合标准摄取值(SUVmax≥2.5作为阳性诊断标准),34例诊断为复发和(或)转移(真阳性30例,假阳性4例),阴性结果18例(其中3例为假阴性)。PET/CT在随访中诊断复发和(或)转移的灵敏度、特异度、准确率、阳性预测值、阴性预测值分别为90.91%(30/33)、78.95%(15/19)、86.54%(45/52)、88.24%(30/34)和83.33%(15/18);而常规影像学分别为70.00%(28/40)、58.33%(7/12)、67.31%(35/52)、84.85%(28/33)和36.84%(7/19)。基于PET/CT结果,16例(16/52,30.77%)患者的治疗方案发生改变。结论应用18F-FDG PET/CT检查对卵巢癌综合治疗后患者进行随访,在监测复发和(或)转移的诊断价值明显高于常规影像学检查。

Objective To investigate the role of PET/CT imaging on the follow-up and therapeutic decision-making in epithelial ovarian cancer patients after surgery and（or） combined therapies.Methods Fifty-two patients were enrolled,all underwent surgical operation,radiotherapy and（or） chemotherapy before PET/CT scans.PET/CT images were retrospectively observed,and compared with the conventional imaging and clinical golden standard（postoperative pathology and long-term clinical follow-up）.The role of PET/CT in therapeutic decision-making was then investigated.Results In 52 patients,33 were final diagnosed as recurrence and（or） metastasis,the other 19 as disease-free survival after long-term clinical follow-up.According to PET/CT,34 patients were diagnosed as metastasis and（or） recurrence（including 30 true-positive and 4 false-positive）,and 18 were negative（including 3 false-negative）.Compared with the golden standard,the diagnostic sensitivity,specificity,accuracy,positive predictive value and negative predictive value of PET/CT was 90.91%（30/33）,78.95%（15/19）,86.54%（45/52）,88.24%（30/34） and 83.33%（15/18） for PET/CT imaging,respectively,while was 70.00%（28/40）,58.33%（7/12）,67.31%（35/52）,84.85%（28/33） and 36.84%（7/19） respectively of conventional imaging.The therapeutic decision changed in 16 patients（16/52,30.77%） based on PET/CT results.Conclusion 18F-FDG PET/CT imaging could be used for the follow-up of ovarian cancer patients after treatment.The diagnostic value of PET/CT in monitoring metastasis and（or） recurrence was much higher than that of conventional imaging.