The incremental value of 18F-FDG PET/CT in paediatric malignancies
The incremental value of 18F-FDG PET/CT in paediatric malignancies
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DOI：
10.1007/s00259-006-0253-9
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发表时间：
2007-05-01
影响因子：
9.1
通讯作者：
Israel, Ora
中科院分区：
文献类型：
--
作者：
Bar-Sever, Zvi;Keidar, Zohar;Israel, Ora
目的F-18-氟代脱氧葡萄糖(18stopF-FDG)正电子发射断层扫描(PET)在儿科恶性肿瘤诊断中的应用。PET/CT可提高成人癌症患者的诊断准确率。方法对46例儿童恶性肿瘤患者的118(18)次FDG PET/CT检查进行回顾性分析。将PET和PET/CT结果分为恶性、可疑和良性，进行现场和研究分析，并与临床结果进行比较。结果共检测到324个摄取FDG增加的部位。在27项研究(22%)中，97个部位(30%)的PET和PET/CT的解释不一致。与正电子发射计算机断层扫描相比，经统计学处理，正电子发射计算机断层扫描的可疑病变比例更高，良性病变的比例更低(p<；0.001)。PET检出良性病变153个(47%)，可疑病变84个(26%)，恶性病变87个(27%)，而PET/CT检出良性病变226个(70%)，可疑病变10个(3%)，恶性病变88个(27%)。PET/CT主要改善棕色脂肪(39%)、肠道(17%)、肌肉(8%)和胸腺(7%)的摄取特征。基于研究的分析表明，17个可疑的PET研究和7个阳性的PET研究(20%)在PET/CT上被解释为良性，而3个可疑的研究被解释为恶性。基于研究的灵敏度和特异度分别为92%和78%。结论PET/CT显著改善了儿童癌症患者18个FDG异常病灶的特征，主要是通过排除示踪剂活动增加的部位存在的活跃的恶性肿瘤。
Purpose F-18-fluorodeoxyglucose ((18) stopF-FDG) positron emission tomography (PET) imaging has been used in the assessment of paediatric malignancies. PET/CT increases the diagnostic accuracy in adult cancer patients. The present study assesses the incremental value of FDG PET/CT in paediatric malignancies.Methods A total of 118 (18)FDG PET/CT studies of 46 paediatric patients were reviewed retrospectively. PET and PET/CT results were classified as malignant, equivocal or benign, compared on a site- and study-based analysis, and also compared with the clinical outcome.Results Three hundred and twenty-four sites of increased FDG uptake were detected. Discordant PET and PET/CT interpretations were found in 97 sites (30%) in 27 studies (22%). PET yielded a statistically significant higher proportion of equivocal and a lower proportion of benign lesion and study results (p < 0.001) than PET/CT. With PET there were 153 benign (47%), 84 (26%) equivocal and 87 (27%) malignant sites, while PET/CT detected 226 benign (70%), 10 (3%) equivocal and 88 (27%) malignant lesions. PET/CT mainly improved the characterisation of uptake in brown fat (39%), bowel (17%), muscle (8%) and thymus (7%). The study-based analysis showed that 17 equivocal and seven positive PET studies (20%) were interpreted as benign on PET/CT, while three equivocal studies were interpreted as malignant. The study-based sensitivity and specificity of PET/CT were 92% and 78% respectively.Conclusion PET/CT significantly improved the characterisation of abnormal (18)FDG foci in children with cancer, mainly by excluding the presence of active malignancy in sites of increased tracer activity.