^(18)F-FDG SPECT/CT显像在鼻咽癌治疗后EBV-DNA升高患者中的应用

The application of ^(18)F-FDG coincidence SPECT in patients with rising serum EBV-DNA after management of nasopharyngeal carcinoma

目的:探讨18F-FDG SPECT/CT显像在检测鼻咽癌治疗后血清EBV-DNA升高患者,肿瘤复发和(或)转移病灶的价值。方法:鼻咽癌治疗后血清EBV-DNA升高患者45例,皆行全身18 F-FDG SPECT/CT显像。所有图像经图像融合后,进行18F-FDG显像图像和CT图像帧对帧对比分析。肿瘤复发和(或)转移病灶根据病理检查结果、多种影像学诊断及临床随访而确诊。随访时间均>6个月。采用SPSS 11.5软件进行统计学处理,进行2检验。结果:45例患者中,明确诊断肿瘤复发和(或)转移者35例,单纯CT诊断肿瘤复发和(或)转移28例,其灵敏度为80.0%(28/35);符合线路18 F-FDG CT同机融合显像诊断肿瘤复发和(或)转移32例,灵敏度提高至91.4%(32/35)。结论:18F-FDG SPECT/CT在检测鼻咽癌治疗后EBV-DNA升高患者肿瘤复发和(或)转移病灶中有较好的应用价值,但角化型鼻咽癌可能出现假阴性。

Objective：The aim of this study was to evaluate the clinical role of 18F-FDG SPECT/CT for the detection of recurrent and（or）metastatic tumor in patients with rising serum EBV-DNA after the management of nasopharyngeal carcinoma（NPC）.Methods：The whole body 18F-FDG SPECT/CT scans were performed in 45patients with rising serum EBV-DNA on routine follow-up examinations after the management of NPC.All PET and CT images of one patient were fused by the specific software on workstation.PET images,CT images and 18F-FDG SPECT/CT fused images were analyzed by frame to frame.All patients were followed up for more than six months.The final diagnosis was obtained by pathologic finding from surgery or biopsy,and（or）multi-modalities of imaging and clinical follow-up.Chi-square test for statistics was used with SSPS 11.5software.Results：There were 35patients proved to be suffered with recurrent and（or） metastatic tumor.Intrahepatic lesions were found in 45patients,extrahepatic lesions were found in 32patients.The overall sensitivity of18F-FDG SPECT/CT for tumor detection was 88.5%（32/35）and it was obviously higher than 80.0%（28/35）of CT alone（x2=9.744,P=0.002）.Conclusion：18F-FDG SPECT/CT is a valuable imaging tool to detect the recurrent and（or）metastatic tumor in patients with rising serum EBV-DNA after NPC treatment.Nevertheless,apitfall of false-negative could be happened in patients with well-differentiated NPC.