Role of 18F-fluorodeoxyglucose positron emission tomography imaging in surgery for pancreatic cancer
Role of 18F-fluorodeoxyglucose positron emission tomography imaging in surgery for pancreatic cancer
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DOI：
10.3748/wjg.14.64
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发表时间：
2008-01-07
影响因子：
4.3
通讯作者：
Suzuki, Yasuyuki
中科院分区：
文献类型：
--
作者：
Wakabayashi, Hisao;Nishiyama, Yoshihiro;Suzuki, Yasuyuki
目的：为了评估正电子发射断层扫描使用18 F-氟脱氧葡萄糖（FDG-PET）在胰腺癌患者的手术治疗中的作用，包括诊断，分期和选择患者进行后续的手术treatment.METHODS：本研究涉及53例确诊为原发性胰腺癌。采用FDG-PET、CT、胆汁或胰液细胞学检查、血清癌胚抗原（CEA）和糖类抗原19-9（CA 19 -9）检测对原发癌的诊断敏感性。然后比较FDG-PET和CT对肿瘤分期的准确性。最后用标准摄取值（SUV）半定量分析FDG-PET。结果：FDG-PET、CT、胆汁或胰液细胞学检查、血清CEA和CA 19 -9检测的敏感性分别为92.5%、88.7%、46.4%、37.7%和69.8%。在分期方面，FDG-PET仅在诊断远处病变（骨转移）方面优于CT（上级）。在局部分期方面，CT的敏感性优于FDG-PET。SUV与pTNM分期、分级、血管、神经侵犯及肿瘤大小无关。然而，有一个统计学上的显着差异（4.6 +/- 2.9比7.8 +/- 4.5，P = 0.024），在SUV之间的患者与可敬的和不可切除的disease.CONCLUSION：FDG-PET因此被认为是有用的胰腺癌的诊断。然而，关于疾病的分期，FDG-PET并不被认为是一种足够准确的诊断方法。虽然SUV与病理组织学预后因素无关，但它可能有助于选择应接受后续手术治疗的患者。(C)2008年WJG。All rights reserved.
AIM: To evaluate the role of positron emission tomography using 18F-fluorodeoxyglucose (FDG-PET) in the surgical management of patients with pancreatic cancer, including the diagnosis, staging, and selection of patients for the subsequent surgical treatment.METHODS: This study involved 53 patients with proven primary pancreatic cancer. The sensitivity of diagnosing the primary cancer was examined for FDG-PET, CT, cytological examination of the bile or pancreatic juice, and the serum levels of carcinoembrionic antigens (CEA) and carbohydrate antigen 19-9 (CA19-9). Next, the accuracy of staging was compared between FDG-PET and CT Finally, FDG-PET was analyzed semiquantitatively using the standard uptake value (SUV). The impact of the SUV on patient management was evaluated by examining the correlations between the SUV and the histological findings of cancer.RESULTS: The sensitivity of FDG-PET, CT, cytological examination of the bile or pancreatic juice, and the serum levels of CEA and CA19-9 were 92.5%, 88.7%, 46.4%, 37.7% and 69.8%, respectively. In staging, FDG-PET was superior to CT only in diagnosing distant disease (bone metastasis). For local staging, the sensitivity of CT was better than that of FDG-PET The SUV did not correlate with the pTNM stage, grades, invasions to the vessels and nerve, or with the size of the tumor. However, there was a statistically significant difference (4.6 +/- 2.9 vs 7.8 +/- 4.5, P = 0.024) in the SUV between patients with respectable and unresectable disease.CONCLUSION: FDG-PET is thus considered to be useful in the diagnosis of pancreatic cancer. However, regarding the staging of the disease, FDG-PET is not considered to be a sufficiently accurate diagnostic modality. Although the SUV does not correlate with the patho-histological prognostic factors, it may be useful in selecting patients who should undergo subsequent surgical treatment. (C) 2008 WJG. All rights reserved.