~(18)F-脱氧葡萄糖正电子发射计算机断层摄影对胰腺癌的诊断价值

目的分析18F-脱氧葡萄糖(18F-FDG)正电子发射计算机断层摄影(PET-CT)显像对胰腺癌的诊断价值及临床应用。方法选择2011年4月至2013年12月间沈阳军区总医院核医学科收治的18F-FDG PET-CT显像的胰腺肿物患者96例,结合手术病理及其他临床结果,评估18F-FDG PET-CT对胰腺病变定性诊断的准确率、灵敏度及特异度。结果 96例胰腺病变患者中,胰腺恶性肿瘤63例,良性病变33例。18F-FDG PET-CT显像对胰腺癌诊断的准确率、灵敏度、特异度分别为89.6%、90.8%和87.1%,阳性似然比和阴性似然比分别为7.04和0.11。结论18F-FDG PET-CT显像对胰腺癌诊断具有较高的临床诊断价值。     

18F-氟脱氧葡萄糖PET-CT显像预测Ⅲ期非小细胞肺癌的预后

目的 探讨18F-氟脱氧葡萄糖(FDG)PET-CT显像在Ⅲ期非小细胞肺癌(NSCLC)疗效评价及预后判断中的价值.方法 46例NSCLC患者分别在放疗前1周及放疗剂量达到40～50 Gy时进行18F-FDG PET-CT显像检查,以最大标准摄取值(SUVmax)的变化百分率为50%为分割点,将46例患者分为治疗有反应组(A组)和无反应组(B组),对比分析两组治疗前和治疗中的SUVmax值及其变化率与疗效和预后的关系.结果 A组25例,B组21例.A组和B组治疗前的SUVmax值分别为7.59±3.14和14.72±4.67,治疗中的SUVmax值分别为2.89±1.39和9.82±3.31,两组差异均有统计学意义(均P＜0.05).A组和B组SUVmax值变化百分率分别为61.9%±8.7%和33.6%±9.0%,差异有统计学意义(P=0.007).A组和B组患者的1年生存率分别为68.0%和38.1%,2年生存率分别为64.0%和33.3%,两组差异均有统计学意义(均P＜0.05).Logistic回归分析显示,治疗前和治疗中的SUVmax以及两者的变化百分率与NSCLC患者的预后有关.结论 治疗前和治疗中的SUVmax以及两者的变化百分率可作为Ⅲ期NSCLC患者早期疗效评价和预后判断的重要参考指标.     

^18氟-脱氧葡萄糖正电子发射计算机断层显像寻找未知原发灶肿瘤原发灶的临床价值

目的研究”氟一脱氧葡萄糖正电子发射计算机断层显像（^18F－FDGPET－CT）在寻找原发灶不明转移癌（CUP）患者原发灶中的临床价值。方法回顾性分析为寻找原发灶而行^18F-FDGPET．CT扫描的CUP患者48例,其中男28例,女20例;年龄41-82岁,平均（57±16）岁。依据转移癌部位不同将患者分为颈部淋巴结转移组（28例）及非颈部淋巴结转移组（20例）,计算并比较^18F-FDGPET-CT诊断各组原发灶的灵敏度。结果^18F-FDGPET-CT寻找CUP患者原发病灶的灵敏度为66．7％（32／48）,寻找颈部淋巴结转移CUP患者的灵敏度为78．6％（22／28）,非颈部淋巴结转移CUP患者的灵敏度为50．0％（10／20）;^18F-FDGPET-CT诊断颈部淋巴结转移组CUP患者原发灶的灵敏度与非颈部淋巴结转移组相比,差异有统计学意义（x。4．286,P〈0．05）。结论^18F-FDGPET-CT诊断CUP患者原发灶灵敏度较高,尤其适用于颈部淋巴结转移的CUP患者。、     

18F-脱氧葡萄糖-正电子发射型计算机断层显像与CT同机融合图像对氩氦刀治疗肺癌近期疗效的

 【摘要】　目的　观察肺癌经氩氦刀治疗后18F-脱氧葡萄糖-正电子发射型计算机断层显像与CT同机融合图像（18F-FDG PET-CT）显像的变化,寻找氩氦刀治疗后近期疗效评价的方法。方法　对15例肺癌患者19个病灶进行氩氦刀治疗,在治疗后1～6个月内完成18F-FDG PET-CT检查。其中7例患者治疗前后进行了18F-FDG PET-CT检查,8例仅治疗后进行了18F-FDG PET-CT检查,但可自身比较。冷冻治疗组织和对照组织最大标准化摄取值（SUVmax）的比较采用配对资料的t检验,冷冻治疗后PET-CT时间间隔与SUVmax检测采用重复测量方差分析。结果　术后18F-FDG PET-CT检查显示19个氩氦刀冷冻病灶,13个未见放射性核素的浓聚,在随访过程中未见肿瘤生长。2例纵隔型肺癌周边残留,表现为边界清楚的“梨形”放射性缺损,随访4个月左右发现肿瘤开始向周围扩展;4例冷冻的肿瘤组织内表现为放射性核素浓聚,均在半年内复发。肺内单发肿瘤氩氦刀治疗前后SUVmax定性和定量检测结果显示,差异有统计学意义（t＝3.784,P＜0.05）;但是对于冷冻治疗与PET-CT检查间隔时间对SUVmax变化的影响差异无统计学意义（F＝0.106,P＞0.05）。结论　18F-FDG PET-CT图像真实地反映了氩氦刀冷冻治疗的范围及效果,是氩氦刀冷冻治疗后近期效果评价较理想的方法。     

18F-脱氧葡萄糖正电子发射体层摄影术在头颈部肿瘤中的临床应用

18 F 脱氧葡萄糖 (18F fluorodeoxyglucose ,18F FDG )为葡萄糖类似物 ,静脉注入后参与体内葡萄糖代谢过程 ,被己糖激酶磷酸化成 6 磷酸 脱氧葡萄糖。与正常组织相比 ,恶性肿瘤组织细胞增殖快 ,糖代谢旺盛 ,恶性肿瘤细胞葡萄糖转运蛋白、己糖激酶水平增高 ,6 磷酸葡萄糖酶表达水平下降[1] ,被磷酸化的18F FDG既不能参与下一步代谢 ,又不能返回到细胞外 ,因而“滞留”在肿瘤细胞内 ,在18F 脱氧葡萄糖正电子发射体层摄影 (18F FDGPET)表现为高摄取灶。18F FDGPET在肿瘤临床上得到越来越广泛的应用 ,在头颈部肿瘤中主要应用于以下方…     

18F-氟代脱氧葡萄糖正电子发射计算机断层显像/计算机断层扫描代谢体积参数在非小细胞肺癌中的应用进展

18F-氟代脱氧葡萄糖正电子发射计算机断层显像/计算机断层扫描(18F-FDG PET/CT)是能够提供病灶解剖及功能信息的核医学设备,其可以提供一些代谢参数,对病灶进行定量、半定量分析,且与病灶的部分生物学特征相关.非小细胞肺癌(NSCLC)是较为常见的肿瘤,18F-FDG PET/CT代谢参数广泛地应用于NSCLC...     

~(18)F-氟代脱氧葡萄糖-正电子发射断层扫描技术在恶性淋巴瘤诊治中的临床研究

 目的　研究PET对恶性淋巴瘤分期和治疗后评估的临床价值。方法　在初诊时或复发治疗前对 35例恶性淋巴瘤 ,包括霍奇金式淋巴瘤和非何杰金式淋巴瘤进行PET检查 ,部分病例尚进行全身CT扫描 ,WHO分类标准进行诊断。结果　PET对初诊淋巴瘤患者的敏感性为 93.5 % (2 9/ 31) ,PET与CT的一致性为 70 % (12 / 17) ;另有 5例患者的分期结果不一致 ,不一致性为 2 9%。追踪检查发现 ,PET检测复发或微小残留病的敏感率 88% (8/ 9) ,准确性 75 % (6 / 8)。在经过 6～ 8个周期的CHOP方案化疗后 ,5 0 % (4/ 8)的进展期NHL患者仍有残留病灶。结论　PET在恶性淋巴瘤的诊断 ,分期和治疗后评估比CT敏感 ,尤其是在微小残留病方面     

18F-脱氧葡萄糖-正电子发射断层显像在肺癌中的应用价值

肺癌的发病率在我国逐年上升,而传统影像检查对肺癌的诊断、分期、疗效评价及预后评估存在一定局限性。^18F-脱氧葡萄糖-正电子发射断层显像（FDG-PET）作为一种功能影像已较广泛地应用于临床,在一定程度上弥补了传统影像学的不足。现就其在肺癌诊断和治疗中的应用价值进行综述。     

18氟-脱氧葡萄糖PET在儿童恶性淋巴瘤分期、疗效评估及随诊中的意义

 目的　探讨18氟-脱氧葡萄糖（18F-FDG）正电子发射计算机断层显像（PET）在儿童恶性淋巴瘤分期、疗效评估及随诊中的意义。方法　回顾性分析了88例儿童恶性淋巴瘤初诊时、化疗中期以及停药后随诊过程中18F-FDG-PET扫描结果,并与同期的CT扫描相比较。结果　67例初诊儿童淋巴瘤患者,化疗前共评估了1072个解剖部位,PET和CT均提示瘤灶阳性及阴性部位分别为11.10 %和77.52 %,PET阳性CT阴性的部位占6.81 %,而PET阴性CT阳性的占4.57 %,PET在化疗前受累部位的诊断方面优于CT扫描。对26例随诊患者,在治疗中期、停药时及停药后进行了35次PET检查,32例患儿瘤灶为阴性,PET扫描瘤灶真阴性为28例（87.50 %）,CT为16例（57.14 %）,在假阳性方面,CT比较高,为16例（50%）,而PET仅为4例（14.29 %）,临床吻合度PET大于CT。结论　PET对于儿童恶性淋巴瘤的临床分期、鉴别残余病灶的性质以避免不必要的过度治疗或二次活检,以及发现肿瘤的早期复发具有一定的意义。     

The role of Fluorine-18-Fluorodeoxyglucose positron emission tomography in staging and restaging of patients with osteosarcoma

Background

The objective of this study is to systematically review the role of positron emission tomography (PET) and PET/computed tomography (PET/CT) with Fluorine-18-Fluorodeoxyglucose (FDG) in patients with osteosarcoma (OS).

Methods

A comprehensive literature search of published studies through October 10^th, 2012 in PubMed/MEDLINE, Embase and Scopus databases regarding whole-body FDG-PET and FDG-PET/CT in patients with OS was performed.

Results

We identified 13 studies including 289 patients with OS. With regard to the staging and restaging of OS, the diagnostic performance of FDG-PET and PET/CT seem to be high; FDG-PET and PET/CT seem to be superior to bone scintigraphy and conventional imaging methods in detecting bone metastases; conversely, spiral CT seems to be superior to FDG-PET in detecting pulmonary metastases from OS

Conclusions

Metabolic imaging may provide additional information in the evaluation of OS patients. The combination of FDG-PET or FDG-PET/CT with conventional imaging methods seems to be a valuable tool in the staging and restaging of OS and may have a relevant impact on the treatment planning.     

Differential diagnosis of gallbladder cancer using positron emission tomography with fluorine-18-labeled fluoro-deoxyglucose (FDG-PET)

BACKGROUND AND OBJECTIVES: The purpose of this paper is to evaluate the utility of positron emission tomography (PET) with fluorine-18-labeled fluoro-deoxyglucose (FDG) in the preoperative differential diagnosis of gallbladder tumors. We performed PET studies of gallbladder tumors in order to predict the malignancy of these tumors preoperatively. METHODS: Sixteen patients who had protuberant lesions in the gallbladder and who were scheduled to undergo surgery were studied with PET using FDG. Focally increased FDG uptake in the gallbladder region was considered malignant. The FDG-PET findings were compared with the histological findings of surgical pathology. RESULTS: Sensitivity of FDG-PET was 75% (6/8 patients). One of two false-negative cases suffered from diabetes mellitus, and in the other case, the lesion was small. Specificity was 87.5% (7/8 patients). A case with xanthogranulomatous cholecystitis (XGC) was the only false-positive case. CONCLUSIONS: FDG-PET may be able to provide important information for evaluating the malignancy of gallbladder tumors.     

18 F-脱氧葡萄糖PET显像在原发灶不明转移癌中的应用

目的：探讨^18F-脱氧葡萄糖（FDG）正电子发射型体层摄影术（PET）全身显像在原发灶不明转移癌中的作用。方法：对29例原发灶不明转移癌患者行EDG PET全身显像，并与临床随诊、组织活检和手术病理结果对照。结果：29例原发灶不明转移癌患者，FDG PET发现可疑原发灶15例，其中13例为病理结果所证实，2例病理结果为阴性，FDG PET对原发灶的检出率为44．8％（13／29）。FDG PET全身显像另外检检出淋巴结转移和远地转移灶26个，CT和MRI只检出13个。14例FDG PET未确定原发灶者，经随访3－13个月,死亡率42．9％（6／14）。13例FDG PET确定原发灶者，经过有针对性的治疗，经随访2－13个月，死亡率为15．4％（2／13）。结论：FDG PET全身显像对原发灶不明转移癌原发灶的确定、临床分期、治疗方案的制定以及预后的改善均有一定的价值。     

Positron emission tomography (PET) with 18F-fluorodeoxyglucose (18F-FDG) for the staging of low-grade non-Hodgkin's lymphoma (NHL).

Background:Although PET has been shown to be highlysensitive in the primary staging of lymphoma, previous studies withsmall numbers of patients indicated that low-grade NHL may not always beadequately detected by PET. We undertook this study to determine factorsinfluencing the detection of lesions by PET in low-grade NHL and toevaluate the utility of PET in this indication. Patients and methods:Forty-two patients underwentconventional staging procedures (clinical examination,oto-rhino-laryngologic examination, computed tomography of the chest,abdomen and pelvis, gastroscopy and bone marrow biopsy as well aswhole-body non-attenuation corrected ¹⁸F-FDG-PET. Results:PET detected 40% more abnormal lymph nodeareas than conventional staging in follicular lymphoma but wasinappropriate for the staging of small lymphocytic lymphoma where itdetected less than 58% of abnormal lymph node areas. PET showedmore lesions than conventional staging for peripheral (34% morelymph node areas detected) and thoracic lymph node (39% more)areas but not for abdominal or pelvic lymph nodes (26% fewerareas detected). The sensitivity to detect bone marrow infiltration wasunacceptably low for PET. In contrast, PET was as effective as standardprocedures for the detection of other extranodal localizations, althougha few localizations were detected only by PET and a few others only byconventional procedures. Conclusions:PET may contribute to the management ofpatients with low-grade follicular NHL. For the other low-grade lymphomasubtypes, the role of PET is less evident. Further studies using PET toevaluate the results of treatment or to diagnose disease recurrence arewarranted in low-grade follicular NHL.     

The impact of pre- and post-transplantation positron emission tomography using 18-fluorodeoxyglucose on poor-prognosis lymphoma patients undergoing autologous stem cell transplantation

BACKGROUND: In patients with lymphoma who had a poor prognosis, pretransplantation 18-fluorodeoxyglucose (FDG)-positron-emission tomography (PET) was important for the evaluation of response and outcome. However, little is known about the correlation of FDG-PET with post-transplantation PET. The current study was designed to ascertain whether positive pretransplantation PET images are modified by the conditioning regimen. METHODS: Sixty consecutive patients who had achieved remission and underwent consolidation by autologous stem cell transplantation (ASCT) had PET images obtained before ASCT (after 3 or 4 chemotherapy cycles) and 100 days after ASCT. The correlation was explored between the presence of abnormal 18-FDG uptake (PET positive) or its absence (PET negative) and patient outcomes. RESULTS: Before ASCT, 31 patients achieved complete remission (CR), and 23 patients achieved uncertain CR. Before ASCT, 44 patients (75%) were had negative PET images; and, after ASCT, 48 patients (80%) had negative PET images. One year after ASCT, the estimated event-free survival (EFS) rate was 80% in patients who had negative pre-ASCT PET images compared with 43% in patients who had positive pre-ASCT PET images (P = .0002). The EFS rate was 81% in patients who had negative post-ASCT PET images compared with 25% in patients who had negative post-ASCT PET images (P < .0001). In multivariate analysis, only the results for pre- and post-ASCT PET images retained prognostic value, with relative risks of failure estimated at 4.9 and 11.9, respectively. CONCLUSIONS: A positive pre-ASCT PET image indicated a high risk of ASCT failure, which was increased by a positive post-ASCT PET image. For patients with lymphoma who have positive pre-ASCT PET images, more investigations using new treatment approaches will be required. For patients who have negative pre-ASCT PET images, obtaining post-ASCT PET images does not seem to be mandatory.     

Pretransplant positive positron emission tomography/gallium scans predict poor outcome in patients with recurrent/refractory Hodgkin lymphoma

BACKGROUND: The objective was to determine the prognostic value of functional imaging (FI) in predicting outcome of patients with recurrent/refractory Hodgkin lymphoma (HL) before undergoing high-dose chemotherapy with autologous stem cell transplantation (ASCT). METHODS: Clinical and imaging data were retrospectively reviewed in 211 consecutive patients treated with ASCT from February 1993 to May 2004. The FI results were correlated with progression-free survival (PFS) and overall survival (OS) using Kaplan-Meier survival analysis. RESULTS: Responses were assessed by conventional criteria and evaluated by positron emission tomography (PET) (n = 68) and gallium scans (n = 144) before ASCT. A complete response (CR) or unconfirmed CR (CRu) was seen in 51% of patients, a partial response (PR) in 41% of patients, and stable or progressive disease in 7% of patients. FI was positive in only 6 of 110 (5%) of CR/CRu patients, in 48 of 86 (56%) of PR patients, and in all 3 patients with progressive disease. The 3-year PFS was 69% for patients with negative FI versus 23% for patients with positive FI (P < .0001). The 3-year OS rates were 87% and 58%, respectively (P < .0001). The 3-year PFS for patients in PR with negative FI was 51% comparable to patients in CR (76%) versus 27% for patients in PR with positive FI (P < .0001). In a multivariate model, positive FI was found to be independently prognostic of PFS. CONCLUSIONS: Pretransplant FI status predicts outcome in patients with recurrent/refractory HL. Positive FI confers a poor prognosis, independent of other traditional presalvage prognostic factors.     

Usefulness of 18-fluorodeoxyglucose positron emission tomography in the evaluation of tumor cardiac thrombus from renal cell carcinoma

Purpose Retrospectively analysed our experience in Renal Cell carcinoma (RCC) patients studied with 18-Fluorodeoxyglucose Positron Emission Tomography (FDG PET) to rule out the incidence and clinical impact of heart metastases. Material and methods In two years, 37 patients with RCC were studied with FDG PET. 10 were studied for initial staging and 27 patients were evaluated for suspected recurrence or re-staging. Results In two patients (5%), PET scan showed pathological focal uptake in myocardium. On the bases of this finding. MRI was performed visualizing a myocardial mass in both lesions and confirmed by histology in one of them. The hypothesis of prolepses of the tumour by thrombus in RCC patients justified the surgery. Conclusion Whole-body FDG PET in RCC patients could help to diagnose cardiac metastasis, and allows the possibility of therapeutic surgery, due to the thrombus significance of heart involvement.     

Computed tomography and 18F-FDG positron emission tomography for therapy control of Hodgkin's and non-Hodgkin's lymphoma patients: when do we really need FDG-PET?

BACKGROUND: The aim of this study was to evaluate the accuracy of computed tomography (CT) and [(18)F]fluoro-deoxy-d-glucose positron emission tomography (FDG-PET) for prediction of progression-free survival of Hodgkin's disease (HD) and non-Hodgkin's lymphoma (NHL) patients after completion of therapy. PATIENTS AND METHODS: CT and FDG-PET were performed in 40 HD, 17 indolent NHL and 44 aggressive NHL patients (29 women, 72 men; aged 41+/-14 years) in a median of 2 months after therapy. Progression-free survival was evaluated using the Kaplan-Meier method. Independent prognostic factors were identified by means of Cox proportional hazards model. RESULTS: CT imaging results were progressive disease (PD) in five, stable disease (SD) in 57, and partial response (PR) or complete remission (CR) in 39 patients. FDG-PET suggested residual lymphoma in 24 patients. Three-year progression-free survival rates after exclusion of five PD patients were: 100% (PET negative; CT: PR or CR), 81% (PET negative; CT: SD), 21% (PET positive; CT: SD) and 0% (PET positive; CT: PR). FDG-PET (P<0.0001) and bulky disease (P <0.05) were identified as independent prognostic variables. CONCLUSIONS: Among lymphoma patients with PR and SD on CT, FDG-PET discriminated those destined to progress into a low risk of < or =20% and a high risk for recurrence of > or =80%.