18F-脱氧葡萄糖正电子发射计算机断层显像CT检查在前列腺癌诊断和分期中的应用价值

目的 评价18F-脱氧葡萄糖(18F-FDG)正电子发射计算机断层显像CT检查(PET/CT)在前列腺癌诊断和分期中的应用价值.方法 经手术或穿刺活检病理证实为前列腺癌患者40例,年龄52 ～ 78岁,平均67岁.其中T24例,T316例,T420例.行18F-FDG PET/CT及99Tcm-MDPECT骨显像检查,统计PET/CT显像对前列腺癌原发灶、淋巴结转移及骨转移诊断的敏感性,对比分析PET/CT显像及99Tcm-MDPECT骨显像对骨转移的诊断效果.结果 40例患者中,18F-FDG PET/CT检查显示前列腺局部结节状放射性浓聚17例,对原发灶诊断敏感性为43％.17例淋巴结转移患者中CT检查发现8例,18F-FDG PET/CT检查发现15例,诊断敏感性为88％,其中5例患者因PET/CT检查改变了临床分期以及治疗方案.18F-FDG PET/CT对骨转移诊断的敏感性与99Tcm-MDP骨显像相近,但特异性(95％)和准确率(96％)均明显高于99Tcm-MDP骨显像,其中6例患者因PET/CT检查改变了临床分期,2例改变了治疗方案.结论 18F-FDG PET/CT对前列腺癌淋巴结转移和骨转移有较高诊断价值,对前列腺的分期具有特殊优势,可为临床医生制定治疗方案提供可靠依据.

Applications value of 18F-FDG PET/CT in the diagnosis and staging of prostate cancer

Objective To evaluate the clinical role of F-18 fluorodeoxyglucose (FDG)-positron emission tomography (PET) for the diagnosis and staging of prostate cancer.Methods 18F-FDG PET/CT and 99Tcm-MDP ECT whole body bone scan were both performed in 40 patients with prostate cancer proved by biopsy or surgery.We then evaluated the diagnostic value of 18F-FDG PET/CT for prostate cancer.Results Of 40 cases,17 cases were detected by 18 F-FDG PET/CT with a sensitivity of 42.5％.Of the 17 cases with lymphoma metastasis,8 cases were detected by CT while 15 cases were detected by 18F-FDG PET/CT.The sensitivity of 18F-FDG PET/CT is 88.2％.Though 18F-FDG PET/CT and 99Tcm-MDP bone scan have a similar sensitivity in detecting bone metastases,18 F-FDG PET/CT has better specificity and accuracy in detecting bone metastases than that of an 99Tcm-MDP bone scan.Conclusions Though the diagnostic value of 18F-FDG PET/CT in detecting primary focus of prostate is limited,it still has an important role in detecting lymph node metastases and bone metastases.18F-FDG PET/CT has its superiority in prostate cancer staging.It can also help clinicians to select the regimen of treatment.