18F-FDG PET/CT 在宫颈癌诊断及分期中的临床价值

目的:探讨氟代脱氧葡萄糖(~(18)F-FDG)正电子发射断层显像/X线计算机体层成像仪(PET/CT)检查在局灶早期宫颈癌中的临床应用价值。方法:53例病理确诊为早期宫颈癌的患者行全身~(18)F-FDG PET/CT检查,并在检查结束10日内行广泛性全子宫切除术+双附件切除术+盆腔淋巴结清扫术,计算~(18)F-FDG PET/CT诊断宫颈原发部位肿瘤及盆腔淋巴结转移的敏感度,特异度与准确度。结果:~(18)F-FDG PET/CT检查诊断的宫颈原发部位肿瘤的敏感度为79.25%,特异度为86.79%,准确度为84.9%;以病人为单位诊断盆腔淋巴结转移的准确度为85.71%,特异度为97.87%;以淋巴结为单位诊断盆腔淋巴结转移的准确度为84.61%,特异度为99.00%。结论:PET/CT显像对宫颈癌诊断,分期诊断及盆腔淋巴结转移的检出具有重要临床意义。     

~(18)F-FDGPET/CT显像对淋巴瘤诊断、分期及疗效评价价值探讨

目的:探讨18氟-氟代脱氧葡萄糖(18F-FDG)PET/CT对淋巴瘤诊断、分期和疗效的评价价值。方法:入选我院2008年1月至2013年1月收治的52例经手术病理证实为淋巴瘤的患者,均进行18F-FDG PET/CT检查,并与病理结果进行比较,评价诊断价值,治疗前后对比分期改变,评价疗效和改变治疗方案。结果:PET/CT诊断发现异常高代谢情况51例(98.1%),其对淋巴瘤检查的灵敏度为98.1%(51/52),诊断率与病理结果比较相当,差异无统计学意义(P0.05),治疗后,11例(21.2%)完全恢复,PET/CT未见高代谢或肿大情况,3例(5.8%)临床分期上调,15例(28.8%)分期下调,其中15例(28.8%)改变治疗方案。结论:18F-FDG PET/CT对淋巴瘤诊断准确性高,在分期和疗效评价中具有重要意义,有助于准确分期并鉴别残余病变性质。     

Preoperative Prediction of Cervical Lymph Node Metastasis Using Primary Tumor SUVmax on 18F-FDG PET/CT in Patients with Papillary Thyroid Carcinoma

Objectives

The aim of the current study was to evaluate the value of preoperative ¹⁸F-FDG (FDG) PET/CT in predicting cervical lymph node (LN) metastasis in patients with papillary thyroid carcinoma (PTC).

Methods

One hundred and ninety-three newly diagnosed PTC patients (M: F = 25:168, age = 46.8 ± 12.2) who had undergone pretreatment FDG PET/CT and had neck node dissection were included in this study. The FDG avidity of the primary tumor and the SUVmax of the primary tumor (pSUVmax) were analyzed for prediction of LN metastasis. Detectability by ultrasonography (US) and FDG PET/CT for cervical LN metastasis were also assessed and compared with the pSUVmax.

Results

The FDG avidity of the primary tumor was identified in 118 patients (FDG avid group: 61.0%, M: F = 16:102, age 47.0 ± 12.7 years) and pSUVmax ranged from 1.3 to 35.6 (median 4.6) in the FDG avid group. The tumor size in the FDG avid group was bigger and there was a higher incidence of LN metastasis compared to the FDG non-avid group (0.93 vs. 0.59 cm, p <0.001 and 49.2 vs. 33.3%, p <0.05). In the FDG avid group, patients with LN metastasis had higher pSUVmax than patients without LN metastasis (8.7 ± 8.3 vs. 5.7 ± 5.1, p <0.001). The incidence of central LN metastasis in patients with a pSUVmax >4.6 was 54%; however, the detectability of central LN metastasis by US and FDG PET/CT were 10.3% and 3.6%, respectively.

Conclusion

A high FDG avidity of the primary tumor was related to LN metastasis in PTC patients. Therefore, patients with a high pSUVmax should be cautiously assessed for LN metastasis and might need a more comprehensive surgical approach.     

增强CT和18F-FDG PET/CT在胃癌术前分期评估中的临床价值比较

目的:对比评估增强计算机断层扫描(contrast enhancement computed tomography,CECT)和~(18)F-FDG正电子发射计算机断层扫描(positron emission tomography/computed tomography,PET/CT)在胃癌术前分期中的临床应用价值。方法:回顾性分析经病理证实的胃癌患者的术前CECT(27例)及~(18)F-FDG PET/CT(39例)图像,于两种影像学手段下,双盲法判定每位患者胃癌的TNM分期,然后分别计算每种影像学方法在胃癌术前分期中的敏感性、特异性、阳性预测值、阴性预测值和准确性。两种影像学方法的差异比较采用Pearson卡方检验。结果:CECT和~(18)F-FDG PET/CT诊断胃癌T分期的敏感性、阳性预测值和准确性分别是100.00%、72.73%、59.26%和100.00%、90.91%、76.92%;CECT和~(18)F-FDG PET/CT诊断胃癌N分期的敏感性、特异性、阳性预测值、阴性预测值和准确性分别是75.00%、71.43%、88.24%、50.00%、74.07%和42.86%、92.00%、75.00%、74.19%、35.90%。结论:CECT和~(18)F-FDG PET/CT均可用于胃癌术前分期的预估,尤其在N分期方面,CECT的敏感性和准确性高于~(18)F-FDG PET/CT。     

The utility of 18F-FDG PET/CT in brain tumours diagnosis

BackgroundThe purpose of the study was to discuss whether 2-deoxy-2-[18F]fluoro-D-glucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT) study protocol should include brain imaging.Materials and methodsAnalysis of international societies recommendations compared with the original data obtained in over 1000 consecutive torso and brain ¹⁸F-FDG PET/CT studies collected in 2010.ResultsAccording to the international societies recommendations, the ¹⁸F-FDG should not be the radiotracer of choice considering the brain region PET/CT study. However, it can be performed as an additional brain imaging tool. Based on at least a 3-year follow-up, we detected 8 cases of suspicious brain findings and no primary lesion among over 1000 consecutive torso and brain 18F-FDG PET/CT scans performed in 2010. However, in 5 out of 8 patients, the brain lesion was the only metastasis detected, affecting further therapy.ConclusionsThe ¹⁸F-FDG PET/CT study may help detect malignant brain lesions and, therefore, including brain region imaging into the study protocol should be considered.     

Comparison of 68GA-FAPI-04 PET/CT and 18F-FDG PET/CT in detection of metastatic bone disease in various cancers

ObjectiveOur aim in this retrospective study was to compare the diagnostic accuracy of ⁶⁸Ga-FAPI-04 PET/CT and ¹⁸F-FDG PET/CT in detecting bone metastases of various cancers and to evaluate the potential usefulness of ⁶⁸Ga-FAPI-04 PET/CT in detecting metastatic bone disease.Material and methodOur retrospective study included 44 patients diagnosed with bone metastases due to various cancers between January 2021 and February 2022. All patients underwent ⁶⁸Ga-FAPI-04 PET/CT and ¹⁸F-FDG PET/CT imaging within 14 days. In the semi-quantitative analysis of the skeletal system, all regions with higher uptake than background activity were considered pathological. SUVmax and Metastasis-to-background ratio (TBR) values were calculated from metastatic sites.ResultsA total of 827 bone metastases were detected in our study. The diagnostic accuracies of FAPI PET/CT and ¹⁸F-FDG PET/CT were 91.8% and 81.5%, respectively (P < 0.001). When all bone metastases were compared, the SUVmax of ⁶⁸Ga-FAPI-04 PET/CT was statistically significantly higher than that of ¹⁸F-FDG PET/CT (median 6.15 vs. 5.2; P < 0.001). When FDG and FAPI SUVmax values were compared according to metastasis types, FAPI SUVmax and TBR values in osteolytic, medullary and mixed type bone metastases were found to be statistically significantly higher than FDG (P-values: < 0.001, < 0.001, < 0.001, respectively). There was no statistically significant difference between FDG and FAPI SUVmax values in osteoblastic bone metastases (P = 0.26).ConclusionIt has been shown that ⁶⁸Ga-FAPI-04 PET/CT is superior to ¹⁸F-FDG PET/CT in detecting metastatic bone disease and may have more clinical impact on disease management.     

Giant peritoneal loose body diagnosis by 18F-FDG PET/CT: A case report

An ¹⁸F-FDG PET/CT scan performed in a 70-year-old patient for characterization of a pulmonary nodule revealed a very rare image of a giant loose peritoneal body in this asymptomatic patient. A review of literature is presented. The knowledge of the characteristics of this typical lesion is important to avoid further invasive explorations.     

Prognostic Value of Lymph Node Uptake on Pretreatment F-18 FDG PET/CT in Patients with N1B Papillary Thyroid Carcinoma

Objective: The aim of this study was to investigate the prognostic value of metabolic characteristics of metastatic lymph node (LN) using pretreatment F-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) for patients with papillary thyroid carcinoma (PTC) and metastatic lateral LN (N1b).Methods: Ninety-six PTC patients (female:male = 72:24; median age, 44.5 years) with pathologic N1b who underwent pretreatment FDG PET/CT, total thyroidectomy, and radioactive iodine ablation were retrospectively reviewed. To predict responses to initial therapy and recurrence, clinicopathologic factors and metabolic parameters were reviewed, such as sex, age, tumor size, extranodal extension, number and ratio of metastatic LNs, serum thyroglobulin, and maximum standardized uptake value (SUVmax).Results: Among the 96 PTC patients, 81 (84.4%) were classified into the acceptable response (58 excellent; 23 indeterminate) and 15 (15.6%) into the incomplete response (8 biochemical incomplete; 7 structural incomplete) by the 2015 American Thyroid Association management guideline for differentiated thyroid carcinoma. The multivariate analysis showed that SUVmax of N1b (P = .018), pre-ablation stimulated thyroglobulin level (P = .006), and the ratio of metastatic LNs (P = .018) were related to incomplete response. The cutoff value of each variable was determined by receiver operating characteristic analysis. Nine (9.4%) patients experienced recurrences (median follow-up: 50 months). The Kaplan-Meier analysis revealed that SUVmax of N1b (cutoff value: 2.3; P = .025) and ratio of metastatic LNs (cutoff value: 0.218; P = .037) were significant prognostic factors for recurrence.Conclusion: High SUVmax of N1b cervical LN on pretreatment FDG PET/CT could predict incomplete responses to initial therapy and recurrence in patients with N1b PTC.Abbreviations: ATA = American Thyroid Association; DTC = well-differentiated thyroid carcinoma; FDG = F-18 fluorodeoxyglucose; IQR = interquartile range; LN = lymph node; N1b = metastatic lateral cervical lymph node; PET/CT = positron emission tomography/computed tomography; PTC = papillary thyroid carcinoma; RAI = radioactive iodine; ROC = receiver operating characteristic; SUVmax = maximum standardized uptake value; Tg = thyroglobulin; USG = ultrasonography     

Correlation of the Apparent Diffusion Coefficient (ADC) with the Standardized Uptake Value (SUV) in Lymph Node Metastases of Non-Small Cell Lung Cancer (NSCLC) Patients Using Hybrid 18F-FDG PET/MRI

ObjectiveTo compare the apparent diffusion coefficient (ADC) in lymph node metastases of non-small cell lung cancer (NSCLC) patients with standardized uptake values (SUV) derived from combined 18F-fluoro-deoxy-glucose-positron emission tomography/magnetic resonance imaging (18F-FDG PET/MRI).ResultsA total of 146 suspicious lymph nodes were found in 25 patients. One hundred lymph nodes were eligible for final analysis. Ninety-one lymph nodes were classified as malignant and 9 as benign according to the reference standard. In malignant lesions, mean SUV_max was 9.1 ± 3.8 and mean SUV_mean was 6.0 ± 2.5 while mean ADC_mean was 877.0 ± 128.6 x10^-5 mm²/s in PET/MRI. For all malignant lymph nodes, a weak, inverse correlation between SUV_max and ADC_mean as well as SUV_mean and ADC_mean (r = -0.30, p<0.05 and r = -0.36, p<0.05) existed.ConclusionThe present data show a weak inverse correlation between increased glucose-metabolism and cellularity in lymph node metastases of NSCLC patients. 18F-FDG-PET and DWI thus may offer complementary information for the evaluation of treatment response in lymph node metastases of NSCLC.     

Metabolic Tumour Burden Measured by 18F-FDG PET/CT Predicts Malignant Transformation in Patients with Neurofibromatosis Type-1

Background

To investigate the diagnostic and prognostic performances of ¹⁸F-FDG PET/CT measures of metabolic tumour burden in patients with neurofibromatosis type-1 (NF1), suspect of malignant transformation.

Methods

This retrospective study included 49 patients (15–60 years old, 30 women) with a diagnosis of NF1, followed in our Reference Centre for Rare Neuromuscular Diseases, who presented clinical signs of tumour progression (pain, neurological deficit, tumour growth). Quantitative metabolic parameters were measured on 149 tumoral targets, using semi-automatic software and the best cut off values to predict transformation was assessed by Receiver Operating Characteristics (ROC) analysis. Prognostic value of PET/CT metabolic parameters was assessed by Kaplan-Meier estimates of overall survival.

Results

Lesions were histologically documented in 40 patients: a sarcomatous transformation was found in 16, a dysplastic neurofibroma (NF) in 7, and a benign NF in 17; in the remaining 9 patients, a minimal follow-up of 12 mo (median 59 mo) confirmed the absence of transformation. The optimal cut off values for detection of malignant transformation were, in decreasing order of area under the ROC curves, a tumour-to-liver (T/L) ratio >2.5, SUV_max > 4.5, total lesion glycolysis (TLG) > 377, total metabolic tumour volume (TMTV) > 88 cm³, and heterogeneity index (HI_suv) > 1.69. The best prognostic marker was the TLG: the 4-y estimates of survival were 97% [95% CI, 90% - 100%] in patients with TLG ≤ 377 vs. 27% [95% CI, 5% - 49%] in patients with TLG > 377 (P < 0.0001; χ² 27.85; hazard ratio 13.27 [95% CI, 3.72–47.35]). T/L ratio, SUV_max and TMTV demonstrated slightly lower performance to predict survival, with χ² ranging 14.41–19.12. The HI_suv index was not predictive of survival.

Conclusion

Our study demonstrates that TLG and TMTV, as PET/CT measures of metabolic tumour burden, may be used clinically to identify sarcomatous transformation in patients with NF1 and predict overall survival, with a higher specificity for the TLG. Conventional measures such as the SUV_max, and T/L ratio also demonstrate high prognostic value.     

Prognostic Value of 18F-FDG PET/CT in Surgical Non-Small Cell Lung Cancer: A Meta-Analysis

Background

The identification of surgical non-small cell lung cancer (NSCLC) patients with poor prognosis is a priority in clinical oncology because of their high 5-year mortality. This meta-analysis explored the prognostic value of maximal standardized uptake value (SUV_max), metabolic tumor volume (MTV) and total lesion glycolysis (TLG) on disease-free survival (DFS) and overall survival (OS) in surgical NSCLC patients.

Materials and Methods

MEDLINE, EMBASE and Cochrane Libraries were systematically searched until August 1, 2015. Prospective or retrospective studies that evaluated the prognostic roles of preoperative 18F-FDG PET/CT with complete DFS and OS data in surgical NSCLC patients were included. The impact of SUV_max, MTV or TLG on survival was measured using hazard ratios (HR). Sub-group analyses were performed based on disease stage, pathological classification, surgery only and cut-off values.

Results

Thirty-six studies comprised of 5807 patients were included. The combined HRs for DFS were 2.74 (95%CI 2.33–3.24, unadjusted) and 2.43 (95%CI: 1.76–3.36, adjusted) for SUV_max, 2.27 (95%CI 1.77–2.90, unadjusted) and 2.49 (95%CI 1.23–5.04, adjusted) for MTV, and 2.46 (95%CI 1.91–3.17, unadjusted) and 2.97 (95%CI 1.68–5.28, adjusted) for TLG. The pooled HRs for OS were 2.54 (95%CI 1.86–3.49, unadjusted) and 1.52 (95%CI 1.16–2.00, adjusted) for SUV_max, 2.07 (95%CI 1.16–3.69, unadjusted) and 1.91 (95%CI 1.13–3.22, adjusted) for MTV, and 2.47 (95%CI 1.38–4.43, unadjusted) and 1.94 (95%CI 1.12–3.33, adjusted) for TLG. Begg’s test detected publication bias, the trim and fill procedure was performed, and similar HRs were obtained. The prognostic role of SUV_max, MTV and TLG remained similar in the sub-group analyses.

Conclusions

High values of SUV_max, MTV and TLG predicted a higher risk of recurrence or death in patients with surgical NSCLC. We suggest the use of FDG PET/CT to select patients who are at high risk of disease recurrence or death and may benefit from aggressive treatments.     

Radiobiological risks in terms of effective dose and organ dose from 18F-FDG whole-body PET/CT procedures

IntroductionIntegrated Positron Emission Tomography (PET) with Computerized tomography (CT) (PET/CT) are widely used to diagnose, stage and track human diseases during whole body scanning. Multi-modality imaging is an interesting area of research that aims at acquiring united morphological-functional image information for accurate diagnosing and staging of the disease. However, PET/CT procedure accompanied with high radiation dose from CT and administered radioactivity. The aim of the present study was to estimate the patients’ dose from ¹⁸F-fluorodeoxyglucose imaging (18F-FDG) hybrid PET/CT whole body scan.Materials and methodsRADAR (Radiation Dose Assessment Resource) software was used to estimate the effective dose for 156 patients (110 (70.5%)) males and 46 (39.5%) female) examined using Discovery PET/CT 710, GE Medical Systems installed at Kuwait Cancer Control Center (KCCC).ResultsThe effective dose results presented in this PET/CT study ranged from (1.56–9.94 mSv). The effective dose was calculated to be 3.88 mSv in females and 3.71 mSv in males. The overall breast (female), lung, liver, kidney and thyroid were 7.4, 7.2, 5.2, 4, 3 and 2.9, respectively.For females, the body mass index (BMI) was 28.49 kg/m² and for males it was 26.50 kg/m² which showed overweight values for both genders. Conclusions: The findings indicate that the effective dose of 18F-FDG in both male and female patients was not substantially different. The study suggested that the risk–benefit proportions of any ¹⁸F-FDG whole body PET/CT scan should be clarified and carefully weighed. Patient’s doses are lower compared with previous studies.     

Clinical Outcomes of Patients with Oral Cavity Squamous Cell Carcinoma and Retropharyngeal Lymph Node Metastasis Identified by FDG PET/CT

Purpose

Retropharyngeal lymph node (RPLN) metastasis is an uncommon finding in patients with oral cavity squamous carcinoma (OSCC). We sought to investigate the clinical outcomes, clinicopathological characteristics, and the priority of treatment with curative intent in OSCC patients with RPLN involvement.

Methods and Materials

Between January 2007 and January 2011, we identified 36 patients with primary RPLN metastases (n = 10) or RPLN relapse (n = 26). The follow-up continued until June 2013. Disease-specific survival (DSS), disease-free survival (DFS), and the potential benefits of salvage therapy served as the main outcome measures.

Results

The 2-year DSS and DFS rates of untreated patients with RPLN involvement were 20% and 24%, respectively. Level IV/V neck lymph node involvement was an adverse prognostic factor for DSS (P = 0.048) and DFS (P = 0.018). All of the patients presenting with neck lymph node involvement at level IV/V died within 6 months. Among patients who were treated for RPLN relapse, the 2-year DSS and DFS rates from the relapse day were 12.8% and 9.6%, respectively. Concomitant contralateral neck lymph node metastases (N2c) were associated with lower 2-year DSS (P = 0.005) and DFS (P = 0.011) rates. Moreover, five (55%) of the nine patients with recurrent disease in the contralateral RPLN had distant metastases within 6 months. Salvage therapy yielded the maximum survival benefit in patients without N2c disease and ipsilateral RPLN involvement alone (P = 0.005).

Conclusion

OSCC patients with RPLN involvement have poor outcomes. The risk factor for definitive treatment in OSCC patients with FDG PET/CT defined RPLN disease in primary disease was neck lymph node involvement at level IV/V and N2c and/or contralateral RPLN disease in recurrent disease. Treatment efforts with curative intent should be tailored according to individual risk factors.     

Predictive Role of Functional Visceral Fat Activity Assessed by Preoperative F-18 FDG PET/CT for Regional Lymph Node or Distant Metastasis in Patients with Colorectal Cancer

Objectives

To investigate the role of functional visceral fat activity assessed by preoperative F-18 fluorodeoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT) in colorectal cancer (CRC) for predicting regional lymph node (LN) or distant metastasis.

Method

We evaluated 131 patients with newly diagnosed CRC. They all underwent pre-operative ¹⁸F-FDG PET/CT and surgery. Functional fat activity was measured by maximum standardized uptake value (SUVmax) using ¹⁸F-FDG PET/CT. Functional visceral fat activity was measured by SUVmax of visceral fat/SUVmax of subcutaneous fat (V/S) ratio. Mann-Whitney U test, χ² test, Fisher’s exact test, receiver-operating characteristic (ROC) analysis, Spearrman’s correlation coefficient, and uni- and multivariate logistic regression statistical analyses were done.

Results

Patients with higher V/S ratio displayed a significantly higher rate of regional LN (p = 0.004) and distant metastasis (p<0.001). In addition, V/S ratio was the only factor that was significantly associated with distant metastasis. An optimal cut-off V/S ratio of 1.88 was proposed for predicting distant metastasis with a sensitivity of 84.6% and specificity of 78.8% (area under the curve: 0.86; p<0.0001)

Conclusion

Functional visceral fat activity is significantly associated with distant metastasis in CRC patients. Furthermore, V/S ratio can be useful as a complementary factor in predicting distant metastasis.     

初诊腋窝淋巴结阳性乳腺癌新辅助化疗后对腋窝淋巴结转阴性前哨活检的影响分析

摘要 目的：探究对初诊腋窝淋巴结阳性乳腺癌行新辅助化疗患者开展腋窝前哨淋巴结活检的临床意义。方法：选择2017年1月至2020年10月于我院接受改良根治术或保乳术治疗的100例初诊腋窝淋巴结阳性乳腺癌患者,将其中50例病理检测II B、III期行4~8个疗程新辅助化疗后实施前哨淋巴结活检患者设为研究组,将50例I、II A期直接行前哨淋巴结活检患者设为对照组,对比两组患者前哨淋巴结检出率、准确率、假阴性率和灵敏度,同时就患者病理特征与前哨淋巴结检出率的相关性开展分析。结果：（1）比较显示研究组患者与对照组患者在前哨淋巴结检出数、前哨淋巴结检出率以及前哨淋巴结假阴性率方面组间差异不大（P>0.05）;（2）病理学特征分析显示肿瘤直径以及临床N分期同新辅助化疗后患者前哨淋巴结检出阳性率密切相关（P<0.05）。结论：对初诊腋窝淋巴结阳性行新辅助化疗乳腺癌患者实施前哨淋巴结活检具有较显示的临床意义,能够较好的预测患者腋窝淋巴结状况,同时化疗前肿瘤直径、临床N分期是影响前哨淋巴结检出率的重要影响因素。     

Clinical value of (18)F-FDG PET/CT in postoperative monitoring for patients with colorectal carcinoma

Objective: To evaluate the clinical value of ¹⁸F-FDG PET/CT in postoperative monitoring for patients with colorectal carcinoma. Methods: 66 postoperative patients with colorectal carcinoma underwent whole-body FDG PET/CT. The final histopathological and formal clinical follow-up findings were used as gold standard to determine the sensitivity and specificity of FDG PET/CT and enhanced CT of the same periods. Results: The sensitivity and specificity of FDG PET/CT in detecting recurrence are 96.30%, 94.87% (while enhanced CT are 70.37% and 87.18% respectively). The sensitivity and specificity in detecting metastasis are 95.35%, 82.61% (enhanced CT are 61.90%, 75.00%). SUVmax was significantly higher in malignant lesions [range 4.16–22.00, mean ± standard deviation (x ± s) 8.06 ± 4.30] than in benign ones (range1.18–6.25, x ± s 2.82 ± 1.02). Conclusion: At present, whole-body ¹⁸F-FDG PET/CT is an advanced diagnostic imaging technique in detecting loco-regional recurrence and metastasis in postoperative patients with colorectal carcinoma for its higher sensitivity and specificity.     

胸部疾病FDGPET、PET／CT显像的假阳性和假阴性陷阱

^18F-FDGPET显像正在被越来越多用于临床鉴别良、恶性疾病,特别在胸部疾病的诊断中较传统影像发挥着更大的作用。然而,氟脱氧葡萄糖（FDG）不是肿瘤特异性显像示踪剂,由于存在设备显像精确度的局限,造成了它在一些脏器、组织和细胞中的生理性和病理性,特异性和非特异性的代谢摄取,也造成了假阳性和假阴性的产生。因此,熟悉这些假阳性和假阴性的结果,能帮助临床医生更加正确地解读PET影像的真实含义,避免误诊和漏诊。本文阐述了^18F-FDGPETPET／CT显像在多种胸部疾病中出现的假阳性和假阴性结果。     

Ratio between Negative and Positive Lymph Nodes Is Suitable for Evaluation the Prognosis of Gastric Cancer Patients with Positive Node Metastasis

Objective

To date, there is no consensus to evaluate the most appropriate category of the nodal metastasis for precise predication the prognosis of gastric cancer patients with positive node metastasis after curative surgery.

Methods

We retrospectively analyzed the clinicopathologic characteristics and overall survival (OS) of 299 gastric cancer patients with positive node metastasis after curative surgery for evaluation the optimal category of the nodal metastasis.

Results

With the univariate and multivariate survival analyses, the depth of primary tumor invasion was identified as the independent predicators with the OS of 299 gastric cancer patients with nodal metastasis postoperatively, as were the number of positive lymph nodes (PLNs), the number of negative lymph nodes (NLNs), and the ratio between negative and positive lymph nodes (RNPL). The RNPL was identified to be more suitable for predication the OS of gastric cancer patients with positive node metastasis than the ratio between positive and dissected lymph nodes (RPDL) by using the stratum procedure of survival analysis. Besides, we found both PLNs and NLNs were independently correlated with OS of gastric cancer patients with nodal metastasis when RNPL, instead of RPDL, was controlled in the partial correlation model.

Conclusions

RNPL, a new category of the nodal metastasis, was suitable for predication the OS of gastric cancer patients with nodal metastasis after curative resection, as were the PLNs, and NLNs.     

胸部疾病FDG PET、PET/CT显像的假阳性和假阴性陷阱

18F-FDG PET显像正在被越来越多用于临床鉴别良、恶性疾病,特别在胸部疾病的诊断中较传统影像发挥着更大的作用.然而,氟脱氧葡萄糖(FDG)不是肿瘤特异性显像示踪剂,由于存在设备显像精确度的局限,造成了它在一些脏器、组织和细胞中的生理性和病理性,特异性和非特异性的代谢摄取,也造成了假阳性和假阴性的产生.因此,熟悉这些假阳性和假阴性的结果,能帮助临床医生更加正确地解渎PET影像的真实含义,避免误诊和漏诊.本文阐述了18F-FDG PET PET/CT显像在多种胸部疾病中出现的假阳性和假阴性结果.