上尿路尿路上皮癌的^(18)F-FDG PET/CT诊断及评价

^(18)F-fluorodeoxyglucose positron emission tomography/computed tomography in the diagnosis and evaluation of upper-tract urothelial carcinoma

目的探讨18F-FDG PET/CT在上尿路尿路上皮癌诊断中的应用价值。方法回顾性分析我中心自2000年4月至2010年12月间29例可疑上尿路尿路上皮癌患者的资料,29例患者在介入、手术及其他治疗前均行静脉尿路造影(IVU)、螺旋CT及18F-FDG PET/CT检查。分析3种影像学检查方法的诊断准确性。结果 29例中,18F-FDG PET/CT检查诊断上尿路尿路上皮癌26例(89.7%),26例均经手术病理证实为上尿路尿路上皮癌。对照手术病理结果,IVU的敏感性和特异性分别为64.0%和75.0%;螺旋CT的敏感性和特异性分别为75.0%和80.0%;而18F-FDGPET/CT的敏感性和特异性分别为92.9%和100%。18F-FDG PET/CT的敏感性高于IVU和螺旋CT(P=0.041vsCT,P=0.036vs IVU),同时特异性也高于IVU和螺旋CT(P=0.041vs CT,P=0.036vs IVU)。结论 18F-FDG PET/CT在上尿路尿路上皮癌的诊断中其敏感性和特异性均高于IVU和螺旋CT,为一种有用的临床诊断方法。上尿路尿路上皮癌的最后诊断需经手术病理证实。

Objective To retrospectively evaluate the diagnosis of upper-tract urothelial carcinoma （UTUC） by using 18F-fluorodeoxyglucose positron emission tomography/computed tomography （18 F- FDG-PET/CT）. Methods We retrospectively analyzed 29 patients with UTUC suspected undergoing in- travenous urography （IVU）, helical computerized tomography （CT） and ＇SF-FDG-PET/CT before any surgery, intervention or treatment from April 2000 to December 2010. Final diagnosis of UTUC was con- firmed by surgical pathology results. Relationships between the diagnostic accuracy and various diagnostic tools, including 18F-FDG-PET/CT were analyzed. Results 26 patients （89. 7%） had a positive lSF- FDG-PET/CT study, which were confirmed by surgical pathology for UTUC. The sensitivity and specific- ity of IVU were 64.0M, 75.0%, respectively, and 75.0%, 80.0% for helical CT. The sensitivity and specificity of 18 F-FDG-PET/CT were 92.9 %, 100~~, respectively. The sensitivity of ~8 F-FDG-PET/CT was significantly to CT and IVU in 29 patients （P=0. 041 vs CT, P=0. 036 vs IVU）. And the specificity of 18F-FDG-PET/CT was significantly higher compared to CT and IVU in 29 patients （P=0. 041 vs CT, P=0. 036 vs IVU）. Conclusions 18 F-FDG-PET/CT is more sensitive and specific than IVU and helical CT in the diagnosis of UTUC. The 18 F-FDG-PET/CT is a useful modality for the diagnosis of UTUC.