^(18)F-FDG PET/CT对腹部增强CT术前评估胰腺癌远处转移的增益价值

Added value of ^(18)F-FDG PET/CT for preoperative evaluation of distant metastasis of pancreatic cancer by abdominal contrast-enhanced CT

目的研究18F-FDG PET/CT对腹部增强CT术前评估胰腺癌远处转移的增益价值。方法回顾分析51例胰腺癌患者的腹部增强CT和18F-FDG PET/CT资料。通过增强CT、增强CT结合18F-FDG PET/CT评估胰腺癌是否发生远处转移,以病理或随访结果为金标准,分析18F-FDG PET/CT的增益价值。结果增强CT结合18F-FDG PET/CT诊断胰腺癌远处转移的灵敏度、特异度和准确度分别为94.2%(33/35)、100%(16/16)、96.1%(49/51),与单独增强CT的71.4%(25/35)、100%(16/16)、76.5%(41/51)相比,灵敏度和准确度的差异有统计学意义(χ2=6.43,P=0.011;χ2=6.04,P=0.014)。共有26例患者增强CT未检出远处转移,结合18F-FDG PET/CT后,其中6例接近肝包膜直径6.7~9.8 mm的肝转移和2例肺转移被检出。另25例增强CT检出远处转移的患者,结合18F-FDG PET/CT后,评估结果未发生改变。结论18F-FDG PET/CT对于腹部增强CT未检出远处转移的胰腺癌患者有增益价值,尤其是肝内有直径<1 cm且接近肝包膜的微小病灶患者。

Objective To explore the added value of 18F-FDG PET/CT for preoperative evaluation of the distant metastasis of pancreatic cancer by the abdominal contrast-enhanced CT（CE-CT）.Methods Data of abdominal CE-CT and F-FDG PET/CT of 51 patients with pancreatic cancer were retrospectively analyzed.The distant metastasis of pancreatic cancer was diagnosed by the CE-CT and CE-CT combined with 18F-FDG PET/CT.Results of pathological diagnosis or follow-up were adopted as the golden standard and the added value of 18F-FDG PET/CT was analyzed.Results The sensitivity,specificity,and accuracy of CE-CT combined with 18F-FDG PET/CT for diagnosing the distant metastasis of pancreatic cancer were 94.2%（33/35）,100%（16/16）,and 96.1%（49/51）.Compared to 71.4%（25/35）,100%（16/16）,and 76.5%（41/51） of CE-CT,the differences of sensitivity and accuracy were statistically significant（X2=6.43,P=0.Oil;X2=6.04,P=0.014）.A total of 26 patients were diagnosed of no distant metastasis by CE-CT,but 6of them were diagnosed of liver metastasis（close to the liver capsule with diameter between 6.7-9.8 mm） and2 of them were diagnosed of lung metastasis by CE-CT combined with F-FDG PET /CT.Another 25 patients were diagnosed of distant metastasis by CE-CT and confirmed by CE-CT combined with 18F-FDG PET/CT.Conclusion 18F-FDG PET /CT provides added value for patients who are diagnosed of pancreatic cancer with no distant metastasis by CE-CT,especially for patients with small liver lesion（diameter 〈 1 cm） close to the liver capsular.