18F-FDG PETCT在探测卵巢癌术后复发和转移中的价值

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1、18F-FDGPET/CT在探测卵巢癌术后复发和转移中的价值作者：赵军,管一晖,左传涛,华逢春,林祥通单位：复旦大学附属华山医院，上海【摘要】［目的］评价18F-FDGPET/CT显像在探测卵巢癌术后复发病灶中的应用价值。［方法］采用仪器为SiemensBiographSensation16PET/CT，43例卵巢癌术后患者禁食4~6h，静脉注射18F-FDG60min后进行PET/CT检查，采集方式为3D模式。PET/CT图像结果与血清CA125、B超及CT或MRI影像学资料进行比较。并与手术病理或临床随访结果比较判断其诊断的准

2、确性。［结果］FDGPET/CT诊断卵巢癌复发的灵敏度、特异性和准确性分别为92.3%、100%和93.0%。血清CA125水平与FDGPET结果有一定相关性，33例CA125升高患者中31例PET显像阳性，10例CA125正常水平患者中仅有5例PET显像阳性。［结论］当常规影像学检查阴性或可疑时，PET/CT显像对卵巢癌复发的检测具有较高的灵敏度和准确性，特别术后患者CA125升高的情况下，FDGPET/CT有助于探测隐匿性复发或转移病灶，指导进一步的治疗。【关键词】卵巢肿瘤　复发　转移　PET/CT　　Abstract:［Pu

3、rpose］Toevaluatethevalueofintegratedpositronemissiontomography(PET)andcomputedtomography(CT)fordepictionofrecurrenceovariancarcinomaaftersurgery.［Methods］ThemodelofPET/CTscannerweusedisSiemensBiographSensation16.Forty-threewomenwhohadpreviouslyundergonesurgeryforovari

4、ancancerwereincluded.Thepatientsreceived18F-FDGintravenouslyafterfastingfor4to6hours.3DwholebodyPET/CTscanswereacquired60minafterinjection.PET/CTimagingresultswerecomparedwiththeresultsofserumCA125levelsandultrasound,CTorMRIconventionalimaging.PET/CTresultswerecompare

5、dtohistologicexaminationaftersurgeryandclinicalfollow-uptodeterminethediagnosticaccuracyofPET/CTintheevaluationofdiseasestatus.［Results］Theoverallsensitivity,specificity,accuracyofPET/CTwere92.3%,100%,93.0%respectively.TherewasapositivecorrelationbetweenserumCA125andp

6、ositiveresultofFDGPET/CT.PET/CTcoulddetectrecurrentlesionsin31of33patientsinwhomincreasedserumCA125level.Amongthe10patientswithserumCA125innormalrange,PET/CTcorrectlydetectedrecurrentfociin5patients.［Conclusion］PET/CTdepictsrecurrentovariancarcinomawithahighsensitivit

7、yandaccuracywhenconventionalimagingisinconclusiveornegative,especiallyinpatientswithincreasedCA125levels.FDGPET/CTimagecanhelptodetectoccultmetastasisanddirectfurthertreatmenttotheprecisesiteoftumorrecurrence.Keywords:ovarianneoplasms;recurrence;neoplasmmetastasis;PET

8、/CT卵巢癌是妇科较常见的恶性肿瘤，死亡率居妇科恶性肿瘤之首。在临床上通常以血清肿瘤标志物（CA125）和B超或CT、MRI检查作为卵巢癌术后的常规随访项目，但是肿瘤标志物灵敏度较低且缺乏定位价值，而B超或CT、MRI诊断的特异性尚不能令人满意，有