Detection of recurrence in patients with rectal cancer: PET/CT after abdominoperineal or anterior resection
Detection of recurrence in patients with rectal cancer: PET/CT after abdominoperineal or anterior resection
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DOI：
10.1148/radiol.2323031065
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发表时间：
2004-09-01
期刊：
影响因子：
19.7
通讯作者：
Metser, U
中科院分区：
文献类型：
--
作者：
Even-Sapir, E;Parag, Y;Metser, U
目得：评估联合正电子发射断层扫描（PET）和计算机断层扫描（CT）在检测盆腔复发的直肠癌患者进行abdominoperineal或前切除术。材料和方法：62例患者参加了37名男性和25名女性。17名患者接受腹会阴切除术，45名患者在转诊进行PET/CT之前接受骨盆区吻合术的前切除术。在PET和PET/CT图像上，根据F-18 FDG摄取的形状、位置和强度，将氟18（F-18）FDG摄取的盆腔部位分别评定为良性或恶性（1-2 =良性和/或生理性，3 =可疑，4-5 =恶性）。两位读者对图像的解读意见一致。改变骨盆解剖和骶前异常的存在进行了评估与CT。盆腔复发经组织学分析或临床和影像学随访证实。采用卡方检验比较PET和PET/CT检测盆腔复发的敏感性、特异性、阳性和阴性预测值以及准确性，并与基于病灶和患者的分析进行比较。PET/CT评估的临床相关性determined.RESULTS：81盆腔部位增加F-18 FDG摄取，44恶性。PET/CT鉴别盆腔F-18 FDG摄取良恶性的敏感性、特异性、阳性预测值、阴性预测值和准确性分别为98%、96%、90%、97%和93%，PET分别为82%、65%、73%、75%和74%。PET结果假阳性解释的最常见原因是移位的盆腔器官生理性F-18 FDG摄取。62例患者中有30例（48%）出现骶前CT异常，7例（23%）异常为恶性。PET/CT用于区分良性和恶性骶前异常的敏感性、特异性、阳性预测值和阴性预测值分别为100%、96%、88%和100%。PET/CT结果与临床相关的29例（47%）62 patients.CONCLUSION：PET/CT是一种准确的技术，在检测盆腔复发后手术切除直肠癌。(C)RSNA，2004年。
PURPOSE: To assess diagnostic accuracy of combined positron emission tomography (PET) and computed tomography (CT) in detection of pelvic recurrence in patients with rectal cancer who underwent abdominoperineal or anterior resection.MATERIALS AND METHODS: Sixty-two patients were enrolled; 37 were men, and 25 were women. Seventeen patients underwent abdominoperineal resection and 45 underwent anterior resection with an anastomosis in the pelvic region before referral for PET/CT. Pelvic sites of fluorine 18 (F-18) fluorodeoxyglucose (FDG) uptake were rated separately on PET and PET/CT images as benign or malignant on the basis of shape, location, and intensity of F-18 FDG uptake (1-2 = benign and/or physiologic, 3 = equivocal, 4-5 = malignant). Two readers interpreted images in consensus. Altered pelvic anatomy and presence of presacral abnormalities were assessed with CT. Pelvic recurrence was confirmed with histologic analysis or clinical and imaging follow-up. Sensitivity, specificity, positive and negative predictive values, and accuracy of PET and PET/CT in the detection of pelvic recurrence were compared with lesion- and patient-based analyses by using the chi(2) test. Clinical relevance of PET/CT assessment was determined.RESULTS: Of 81 pelvic sites with increased F-18 FDG uptake, 44 were malignant. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for differentiating malignant from benign F-18 FDG uptake in the pelvis were 98%, 96%, 90%, 97%, and 93% for PET/CT and 82%, 65%, 73%, 75%, and 74% for PET, respectively. The most common cause for false-positive interpretation of PET findings was physiologic F-18 FDG uptake in displaced pelvic organs. Presacral CT abnormalities were present in 30 (48%) of 62 patients, and seven (23%) abnormalities were malignant. PET/CT was used to distinguish benign and malignant presacral abnormalities with a sensitivity, specificity, positive predictive value, and negative predictive value of 100%, 96%, 88%, and 100%, respectively. PET/CT findings were clinically relevant in 29 (47%) of 62 patients.CONCLUSION: PET/CT is an accurate technique in the detection of pelvic recurrence after surgical removal of rectal cancer. (C) RSNA, 2004.