Posttreatment assessment of response using FDG-PET/CT for patients treated with definitive radiation therapy for head and neck cancers
Posttreatment assessment of response using FDG-PET/CT for patients treated with definitive radiation therapy for head and neck cancers
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DOI：
10.1016/j.ijrobp.2006.03.015
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发表时间：
2006-08-01
影响因子：
7
通讯作者：
Avril, Norbert
中科院分区：
文献类型：
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作者：
Andrade, Regiane S.;Heron, Dwight E.;Avril, Norbert
目的：本研究的目的是评估联合配准 [F-18] 氟脱氧葡萄糖 (FDG)-正电子发射断层扫描 (PET)/计算机断层扫描 (CT) 用于检测头颈癌明确放射治疗后持续性疾病。方法和材料：28 名患者在完成明确放射治疗后平均 8 周（范围为 4 至 15.7 周）进行治疗后 FDG-PET/CT。对整个患者组以及治疗后两个时间点（4-8 周和 > 8 周）的 FDG-PET/CT 进行视觉分析。 PET/CT 的对比增强 CT 部分在不了解 FDG-PET/CT 联合配准结果的情况下单独进行分析，并将残留局部疾病分类为阴性或阳性。病理结果和临床随访作为参考标准。结果：所有28例患者均获得随访数据（中位17.6个月）。对于残留病灶的检测，FDG-PET/CT 的总体敏感性和特异性分别为 76.9% 和 93.3%，而对比增强 CT 的总体敏感性和特异性分别为 92.3% 和 46.7%。 FDG-PET/CT 的准确率为 85.7%，而单独 CT 的准确率为 67.9%。所有假阴性 (n = 3) 和假阳性 (n = 1) FDG-PET/CT 结果均发生在治疗后 4 至 8 周内。治疗后 8 周或之后，CT 的特异性为 28%，而 FDG-PET/CT 的特异性为 100%。结论：在放射治疗结束后 8 周后进行时，来自共同配准的 FDG-PET/CT 的代谢解剖信息可以提供最准确的治疗反应评估。 FDG-PET/CT 比单独的 CT 成像具有更高的特异性和整体诊断性能。这些。结果支持 FDG-PET/CT 在确定性放射治疗后早期治疗反应评估中的潜在临床作用。 (c) 2006 爱思唯尔公司
Purpose: The goal of this study was to evaluate coregistered [F-18] fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography (CT) for the detection of persistent disease after definitive radiation therapy in head and neck cancer.Methods and Materials: Posttreatment FDG-PET/CT was performed in 28 patients on average 8 weeks (range, 4 to 15.7 weeks) after completing definitive radiation therapy. FDG-PET/CT was visually analyzed for the entire patient group and at two time points (4-8 and > 8 weeks) after treatment. The contrast-enhanced CT portion of PET/CT was separately analyzed blinded to the results of coregistered FDG-PET/CT and classified as negative or positive for residual locoregional disease. Pathologic findings and clinical follow-up served as the reference standard.Results: Follow-up data were available for all 28 patients (median, 17.6 months). Regarding the detection of residual disease, the overall sensitivity and specificity of FDG-PET/CT was 76.9% and 93.3%, respectively, compared with 92.3% and 46.7% for contrast-enhanced CT. The accuracy of FDG-PET/CT was 85.7%, compared with 67.9% for CT alone. All false-negative (n = 3) and false-positive (n = 1) FDG-PET/CT results occurred between 4 and 8 weeks after treatment. At 8 weeks or later after treatment, the specificity of CT was 28%, compared with 100% for FDG-PET/CT.Conclusion: The metabolic-anatomic information from coregistered FDG-PET/CT provided the most accurate assessment for treatment response when performed later than 8 weeks after the conclusion of radiation therapy. FDG-PET/CT excelled by a higher specificity and overall diagnostic performance than CT imaging alone. These. results support a potential clinical role of FDG-PET/CT in the early assessment of therapy response after definitive radiation therapy. (c) 2006 Elsevier Inc.