论文部分内容阅读
Objective: To evaluate the value of 18F-fluorodeoxyglucose (18F-FDG) PET/CT in the follow-up of post-treatment patients with gastric cancer, to investigate the impact of 18F-FDG PET/CT on the clinical restaging and therapeutic regimens, and to assess the value of 18F-FDG PET/CT of delayed phase after gastric filling with moderate water.Methods: A retrospective study was conducted in 40 post-treatment patients with gastric cancer,including 38 males and 2 females with the average age 62.98 years.18F-FDG PET/CT scan was performed at 60 min (early phase) and 120 min (delayed phase) after 18F-FDG administration.18F-FDG PET/CT of delayed phase was undertaken after gastric filling with moderate water.If necessary, enhanced CT was also performed.The value of 18F-FDG PET/CT in the follow-up of post-treatment patients with gastric cancer was evaluated based on recurrence, lymph node metastases and metastases in the sites other than lymph node respectively, and compared with CT.Meanwhile, the impact of 18F-FDG PET/CT on the restaging and treatment decision was also analyzed in this study.Additionally, the high metabolic maximum of standardized uptake value (SUVmax) of early and delayed phases in the anastomotic stoma was measured, and the percentage change in SUVmax (△SUVmax%=[SUVmax,delayed-SUVmax, early]/ SUVmax, early×100%) was also calculated in this study.Data were analyzed with SAS 9.13.Results: The sensitivity, specificity and accuracy of 18F-FDG PET/CT in the diagnosis of gastric recurrence were 100% (9/9), 96.77% (30/31) and 97.50% (39/40), respectively.In the detection of lymph node metastases, the values of 18F-FDG PET/CT were 93.75% (15/16), 100% (24/24) and 97.50% (39/40), respectively.In addition, the values of sensitivity, specificity and accuracy of 18F-FDG PET/CT in detecting metastases in the sites other than lymph node were 77.78% (14/18),95.45% (21/22) and 87.50% (35/40), respectively.The difference was statistically significant between 18F-FDG PET/CT and CT in the sensitivity and accuracy in the diagnosis of lymph node metastases, with P values 0.033, 0.048, respectively.18F-FDG PET/CT changed the TNM stage in 35% (14/40) cases, and the therapeutic strategies of 20% (8/40) cases were changed due to PET/CT findings./△SUVmax % was 22.81±9.79% and 8.63±13.33% in gastric recurrence and the anastomotic inflammation, respectively, with statistical significance between the two groups (p<0.05).Conclusions: 18F-FDG PET/CT is a superior post-operative surveillance modality in the diagnosis of recurrence and metastases in post-treatment patients with gastric cancer, 18F-FDG PET/CT has great impact on the clinical restaging and proper re-treatment regimens.Delayed phase of 18F-FDG PET/CT after gastric filling with water may be one of the best ways of discriminating the recurrence from the inflammation or physiological uptake in anastomotic stoma.