Utility of 18F-FDG PET-CT in staging and restaging of patients with malignant salivary gland tumours: a single-institutional experience
Utility of 18F-FDG PET-CT in staging and restaging of patients with malignant salivary gland tumours: a single-institutional experience
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18F-FDG PET-CT 在恶性唾液腺肿瘤患者分期和再分期中的应用：单机构经验
DOI：
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发表时间：
2013
影响因子：
1.5
通讯作者：
A. Malhotra
中科院分区：
文献类型：
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作者：
P. Sharma;T. Jain;Harmandeep Singh;Sudhir K C Suman;N. Faizi;Rakesh Kumar;C. Bal;A. Malhotra
本研究的目的是评估18 F-氟脱氧葡萄糖（18 F-FDG）正电子发射断层扫描-计算机断层扫描（PET-CT）在恶性原发性涎腺肿瘤患者分期和再分期中的临床应用。方法回顾性分析30例经手术病理证实的原发性涎腺恶性肿瘤患者的资料，年龄43.8±16.8岁，男/女20例，均行36次18F-FDGPET-CT检查。10例PET-CT用于分期，26例用于再分期。原发部位腮腺22例，颌下腺7例，小唾液腺1例。18F-FDG PET-CT图像由两名核医学医生一致重新评估。结果分为局部疾病，淋巴结疾病和远处转移。将结果与常规成像模式[CIM（CT/超声/骨显像）]（n=28）进行比较。临床或影像学随访（至少6个月）数据沿着组织病理学信息（如可用）作为参考标准。结果PET-CT阳性25例，阴性11例。18F-FDG PET-CT显示局部病变21例，淋巴结病变17例，远处转移9例（肺4例，肝3例，骨4例，甲状腺1例）。23例PET-CT为真阳性，9例为真阴性，2例为假阳性，2例为假阴性。18F-FDG PET-CT诊断乳腺癌的敏感性为92%，特异性为82%，阳性预测值为92%，阴性预测值为82%，准确性为89%。分期组和再分期组之间PET-CT的准确性无显著差异（100 vs. 85%; P=0.468）。在具有可比CIM数据的患者中（n=28），PET-CT未显示出任何显著优于CIM的优势（P=0.012），但更具特异性（71 vs. 43%）。结论18F-FDG PET-CT对原发性涎腺恶性肿瘤的分期和再分期具有较高的准确性。在这方面，它比CIM更具体。
ObjectiveThe aim of this study was to evaluate the clinical utility of 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography–computed tomography (PET-CT) in staging and restaging of patients with malignant primary salivary gland tumours. MethodsData pertaining to 30 patients (age: 43.8±16.8 years; male/female: 20/10) with histopathologically proven malignant primary salivary gland tumours who underwent 36 18F-FDG PET-CTs were retrospectively analysed. Ten PET-CTs were performed for staging and 26 for restaging. The primary site was the parotid gland in 22 patients, the submandibular gland in seven and the minor salivary gland in one patient. 18F-FDG PET-CT images were revaluated by two nuclear medicine physicians in consensus. Findings were grouped into local disease, nodal disease and distant metastasis. Results were compared with those of conventional imaging modalities [CIM (CT/ultrasound/bone scintigraphy)] when available (n=28). Clinical or imaging follow-up (minimum 6 months) data along with histopathological information (when available) were taken as the reference standard. ResultsOverall, 25 PET-CTs were positive and 11 were negative for disease. 18F-FDG PET-CT showed local disease in 21 patients, nodal disease in 17 and distant metastasis in nine (lungs, four; liver, three; bones, four; and thyroid, one). Twenty-three PET-CTs were true positive, nine were true negative, two were false positive and two were false negative. The overall sensitivity of 18F-FDG PET-CT was 92%, specificity was 82%, positive predictive value was 92%, negative predictive value was 82% and accuracy was 89%. No significant difference was seen in the accuracy of PET-CT between the staging and restaging groups (100 vs. 85%; P=0.468). In patients for whom comparable CIM data were available (n=28), PET-CT did not show any significant advantage over CIM (P=0.012) but was more specific (71 vs. 43%). Conclusion 18F-FDG PET-CT shows high accuracy in staging and restaging of patients with malignant primary salivary gland tumours. It is more specific than CIM for this purpose.