FDG-PET in the detection of recurrence of uterine cervical carcinoma following radiation therapy-tumor volume and FDG uptake value
FDG-PET in the detection of recurrence of uterine cervical carcinoma following radiation therapy-tumor volume and FDG uptake value
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DOI：
10.1016/j.ygyno.2005.09.030
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发表时间：
2006-03-01
影响因子：
4.7
通讯作者：
Nakano, T
中科院分区：
文献类型：
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作者：
Sakurai, H;Suzuki, Y;Nakano, T
目的.我们评价了正电子发射断层扫描（PET）与氟-18-标记的氟-2-脱氧-D-葡萄糖（FDG）在宫颈癌患者放射治疗后的随访研究中的应用。对25例患者的32项研究进行了审查。20例患者接受了外照射和腔内近距离放射治疗，5例患者在初次手术后接受了照射。从初始治疗到FDG-PET的时间为23.3（5.2-88.0）个月。FDG-PET的理由是6例患者存在症状，13例患者血清肿瘤标志物值异常，19例患者其他诊断成像模式的异常病变，2例患者要求。病灶的油可视化，计算病灶的最大标准化摄取值（maxSUV），超过2.0的值被归类为FDG阳性。通过计算机断层扫描（CT）或磁共振成像估计相应疾病的最大肿瘤直径和肿瘤体积。结果：FDG-PET诊断复发的敏感性和特异性分别为91.5%（43/47）和57.1%（4/7）。对于体积小于1 cm的小肺转移瘤，观察到4个假阴性结果（3）。三个假阳性病例为局部肺炎、良性耻骨骨折和间质性近距离放射治疗后纤维化。盆腔外淋巴结转移的敏感性极高（100%），而肺和骨病变的敏感性和特异性分别为75.0%（12/16）和33.3%（1/3）。关于肿瘤体积测量，FDG-PET上的maxSUV与肿瘤体积之间具有良好的相关性（肺转移，P = 0.03;盆腔外淋巴结，P < 0.0001）。在本研究中，所有大于1 cm（3）的相应病变均显示最大SUV值大于2.0。FDG-PET是宫颈癌放射治疗后随访期间检测盆腔外病变的有用工具。这项研究表明，FDG摄取与肿瘤体积有关，FDG-PET在检测小于1 cm（3）的病变或显微镜下病变方面存在局限性。PET和CT/MRI对阳性但良性病变（如炎症和骨折）的仔细诊断一致性仍然很重要。(C)2005年爱思唯尔公司All rights reserved.
Purpose. We evaluated the use of positron emission tomography (PET) with fluorine-18-labeled fluoro-2-deoxy-D-glucose (FDG) in follow-up study after radiation therapy in patients With uterine cervical carcinoma.Materials and methods. Thirty-two studies in 25 patients were reviewed. Twenty patients were treated with external beam irradiation and intracavitary brachytherapy, and five with irradiation following initial surgery. Time from initial treatment to FDG-PET was 23.3 (5.2-88.0) months. Rationale for FDG-PET was the presence of symptoms in 6 patients, abnormal serum tumor marker values in 13, abnormal lesions oil other diagnostic imaging modalities in 19, and patient request in 2. Oil visualization of a lesion, the maximum standardized uptake value (maxSUV) of the lesion was calculated, and values over 2.0 were classified as FDG-positive. Maximum tumor diameter and tumor volume in the corresponding disease were estimated by computed tomography (CT) or magnetic resonance imaging. (MRI).Results. Sensitivity and specificity of FDG-PET in the detection of recurrent disease were 91.5% (43/47) and 57.1% (4/7), respectively. Four false-negative findings were seen for small lung metastases having a Volume less than 1 cm(3). Three false-positive cases were a localized pneumonitis, a benign pubic bone fracture, and a fibrosis after interstitial brachytherapy. Sensitivity for extrapelvic lymph node metastases was extremely high (100%); in contrast, sensitivity and specificity for lung and bone lesions were 75.0% (12/16) and 33.3% (1/3), respectively. Regarding tumor volume measurement, good correlation between maxSUV on FDG-PET and tumor volume was obtained (lung metastases, P = 0.03; extrapelvic nodes, P < 0.0001). Within this study, all corresponding lesions over 1 cm(3) showed a maxSUV value greater than 2.0.Conclusion. FDG-PET is a useful tool for the detection of extrapelvic lesions during the follow-up period after radiation therapy for cervical cancer. This Study Suggests that FDG uptake is associated With tumor volume, and FDG-PET has limitations in the detection of lesions less than 1 cm(3) or microscopic disease. Careful diagnostic agreement between PET and CT/MRl for positive but benign lesions, Such as inflammation and bone fracture, remains important. (C) 2005 Elsevier Inc. All rights reserved.