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目的评价~(18)F-脱氧葡萄糖(FDG)PET/CT 全身显像探测肿瘤患者意外病灶的临床价值。方法回顾性分析澳大利亚 Peter MacCallum 肿瘤医院 PET/CT 中心2002年8月～2003年7月1727例肿瘤患者~(18)F-FDG PET/CT 全身显像报告,男980例,女747例,中位年龄63岁,随访37个月(中位时间为27.5个月)。意外病灶指新发现的与原发肿瘤无关的良性病灶或第2原发肿瘤。通过分析病历记录、病理结果、其他影像学检查结果及临床随访,确定病灶最终结果。结果 1727例患者共发现238例(13.8%)有意外病灶,其中213例220个意外病灶具有完整的随访资料。60个病灶怀疑为意外第2原发肿瘤,其中21.7%(13/60)证实为真阳性,70.0%(42/60)为假阳性,8.3%(5/60)至研究结束时未得到证实。38个甲状腺意外良性病灶,其中9个被证实为临床前恶性或恶性病灶,26个良性,3个未能证实。38个纵隔意外良性病灶,其中86.8%(33/38)证实为良性,7.9%(3/38)为原发肿瘤淋巴结侵犯,5.3%(2/38)未能证实其性质。其他部位84个意外良性病灶,94.0%(79/84)证实为真阴性,6.0%(5/84)未能证实。共22例患者被证实存在第2原发肿瘤病灶,占本研究总人群的1.3%。结论 ~(18)F-FDG PET/CT 全身显像是目前探测肿瘤患者意外病灶较好的无创方法,为制定临床治疗方案提供及时准确的依据。
Objective To evaluate the clinical value of ~ (18) F-FDG PET / CT whole body imaging in the detection of unexpected lesions in cancer patients. Methods A retrospective analysis of 1827 F-FDG PET / CT whole body imaging in 1727 cancer patients from PET / CT center of Peter MacCallum Cancer Hospital in Australia from August 2002 to July 2003 was performed. There were 980 males and 747 females, Age 63 years, followed up for 37 months (median time was 27.5 months). Accidental lesions refer to newly discovered benign or unresectable primary tumors or secondary primary tumors. Through the analysis of records, pathological results, other imaging findings and clinical follow-up, to determine the final result of the lesion. Results A total of 238 patients (13.8%) had unplanned lesions in 1727 patients, of which 213 had unexpected accidents with complete follow - up data. Sixty lesions were suspected to have an unexpected second primary tumor, of which 21.7% (13/60) were true positive, 70.0% (42/60) were false positive, and 8.3% (5/60) were unconfirmed at the end of the study . Thirty-eight unexpected benign thyroid lesions, 9 of which were confirmed as preclinical malignant or malignant lesions, 26 benign and 3 failed to confirm. Thirty-eight mediastinal benign and malignant mediastinal lesions were diagnosed as benign, 86.8% (33/38) were benign, 7.9% (3/38) were primary tumor lymph nodes, and 5.3% (2/38) failed to confirm their nature. In 84 other unhealthy benign lesions, 94.0% (79/84) confirmed true negative and 6.0% (5/84) failed to confirm. A total of 22 patients were confirmed to have a second primary tumor lesion, accounting for 1.3% of the total population in this study. Conclusion ~ (18) F-FDG PET / CT whole body imaging is a better noninvasive method for detecting unexpected lesions in patients with cancer, providing a timely and accurate basis for the development of clinical treatment options.