^(18)氟标记脱氧葡萄糖正电子发射计算机断层摄影术在非小细胞肺癌分期中的应用价值

Value of ^(18) F-fluorodeoxyglucose positron emission tomography imaging in staging of non-small cell lung cancer

目的 探讨18F 氟代脱氧葡萄糖正电子发射计算机断层摄影术 (FDGPET)对非小细胞肺癌 (NSCLC)术前分期的准确性及其应用价值。方法 对 82例经病理证实的NSCLC患者胸部CT扫描、全身FDGPET显像和病理检查资料进行回顾性分析。结果 82例NSCLC患者肺部病灶及转移灶部位FDG摄取均增高。FDGPET对预测NSCLC纵隔淋巴结转移的敏感性为 94.4% ,特异性为 10 0 % ;对探测胸外转移灶的敏感性明显高于CT。 42例患者手术治疗的结果证实 ,FDGPET对NSCLC的分期准确性达 95 .2 %。经全身FDGPET显像 ,82例患者中 37例 (45 .1% )的CT分期得到改变 ,为患者治疗方案的选择提供了重要依据。结论 FDGPET在NSCLC的术前分期方面优于CT等常规检查 ,但在精确定位方面仍然需要结合解剖显像技术。

Objective To evaluate the accuracy and value of fluorine desoxy glucose Positron emission tomography (FDG PET) imaging in the staging of non small cell lung cancer (NSCLC). Methods A retrospective analysis of 82 patients with NSCLC confirmed by pathological examination was made to study the staging of whole body FDG PET scanning compared with computerized tomography (CT). Results The intake of FDG increased in the lung and metastatic foci among all 82 NSCLC patients. Whole body PET scanning showed concentrated FDG in the 41 NSCLC patients with extrathoracic metastasis. The sensitivity and specificity of FDG PET in prediction of metastasis of mediastinal lymph nodes in patients with lung cancer were 94.4% and 100% respectively. The accuracy of PET scanning in staging of NSCLC was 95.2% in 42 patients who underwent operation after PET imaging. 37 NSCLC patients (45.1%) were restaged after the whole body FDG PET scanning and their treatment programs were changed. Conclusion PET is more advantageous in pre operational staging of NSCLC than other conventional imaging techniques, such as CT. For accurate positioning, PET should be combined with anatomical imaging techniques.