Assessing the use of FDG-PET in the detection of regional and metastatic nodes in alveolar rhabdomyosarcoma of extremities
Assessing the use of FDG-PET in the detection of regional and metastatic nodes in alveolar rhabdomyosarcoma of extremities
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DOI：
10.1097/01.mph.0000212949.12856.02
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发表时间：
2006-07-01
影响因子：
1.2
通讯作者：
Israel, Ora
中科院分区：
文献类型：
--
作者：
Weyl Ben Arush, Myriam;Bar Shalom, Rachel;Israel, Ora
腺泡状横纹肌肉瘤 (ARS) 占儿童横纹肌肉瘤的 20% 至 30%，已知其预后比胚胎性横纹肌肉瘤更差。肺泡肿瘤患者的转移性疾病更为常见，而这些患有转移性疾病的儿童的情况较差，5 年生存率在 20% 至 30% 之间。因此，ARS 代表了重大的诊断和治疗挑战，需要比传统方法更好的技术来评估疾病。 F18 氟脱氧葡萄糖-正电子发射断层扫描 (FDG-PET) 描绘了异常组织中新陈代谢的增加，从而能够准确评估可疑的区域和转移性疾病。新的 PET/CT 组合系统可以进一步改善 PET 判读并影响患者管理。 FDG 在软组织肉瘤患者中的价值已在多个系列中得到证实，但没有特别在 ARS 中得到证实。本报告评估了 FDG-PET/CT 在 3 名被诊断患有四肢 ARS 的儿童的区域和转移淋巴结检测中的应用。我们介绍的所有 3 名患者在诊断时进行的治疗前 PET 中，淋巴结站的示踪剂摄取均出现局灶性增加。 2 名患者的组织确认结果为，1 名患者的淋巴结转移呈阴性，而另一名患者的转移性淋巴结扩散呈阳性。根据第三位患者后来的病程，可能也存在转移性腋窝疾病。
Alveolar rhabdomyosarcoma (ARS) accounts for 20% to 30% of childhood rhabdomyosarcoma and is known to have a worse prognosis than embryonal rhabdomyosarcoma. Metastatic disease is more frequent in patients with alveolar tumors and these children with metastatic disease fare poorly, with a 5-year survival between 20% and 30%. Therefore, ARS represents a significant diagnostic and therapeutic challenge that requires techniques to provide better assessment of the disease than provided by traditional means. F18 fluorodeoxyglucose-positron emission tomography (FDG-PET) depicts the increased metabolism in abnormal tissues, enabling accurate evaluation of suspicious regional and metastatic disease. The new combined PET/CT systems can further improve PET interpretation and affect patient management. The value of FDG in patients with soft tissue sarcomas has been demonstrated in several series, but none specifically in ARS. This report assesses the use of FDG-PET/CT in the detection of regional and metastatic nodes in 3 children diagnosed with ARS of the extremities. All the 3 patients we present had focally increased tracer uptake in nodal stations on a pretherapy PET performed at diagnosis. Tissue confirmation available in 2 patients was negative in I patient and positive for metastatic nodal spread in the other. Metastatic axillary disease was possibly also present in the third patient according to his later course of disease.