^(18)F-FDG PET显像在原发性胃癌中的应用

Evaluation of ^(18)F-FDG PET in primary gastric carcinoma

目的 探讨1 8F 脱氧葡萄糖 (FDG)PET显像在原发性胃癌中的应用价值。方法 2 2例经组织病理学证实的原发性胃癌患者行1 8F FDGPET显像。图像分析采用视觉及半定量方法 [标准摄取值 (SUV) ],其中 2 1例与近期CT结果比较。结果 ①PET检出原发性胃癌的灵敏度为 91% (2 0 2 2例 ) ,2例假阴性均为印戒细胞癌 ,原发肿瘤直径 <1cm (T1 期 )。② 17例手术患者中 ,胃局部淋巴结转移 10例 ,PET检出 6例 ,其灵敏度、特异性和准确性分别为 6 0 %、10 0 %和 75 % ,CT仅检出 1例。③PET检出远处转移 9例 ,CT仅检出 5例。结论 1 8F FDGPET诊断原发性胃癌较为灵敏 ,检出胃癌局部淋巴结及远处转移可能优于CT。

Objective To evaluate the role of 18 F-fluorodeoxyglucose (FDG) PET in primary gastric carcinoma detection. Methods Twenty-two patients with histopathology proven gastric carcinoma underwent whole body PET imaging. Visual and semiquantitative analysis and standardized uptake value (SUV) were used to analyze the images. The results of PET study were compared with those of CT in 21 patients. Results ①The sensitivity of PET in primary gastric carcinoma detection was 91%(20/22);two cases of signet ring cell carcinoma gave false negative results,and the the primary lesions were small (<1 cm in diameter) and of T 1 stage. ②Among the 17 patients underwent gastrectomy,10 had regional lymph node involvement,PET detected six of them,and CT did only one,the sensitivity,specificity and accuracy of FDG PET was 60%,100% and 75%,respectively. ③PET identified distant metastases in 9 patients,and CT only did in 5. Conclusions ① 18 F- FDG PET is a sensitive method for detecting primary gastric carcinoma,but the small and early stage lesions,especially of signet ring cell carcinoma,may give false negative results. ② 18 F-FDG PET is probably more sensitive than CT in detecting peri-gastric lymph node involvement and distant metastasis, and that is important for guiding the tumour staging before operation.