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- Pitfalls of Fluorine-18 Fluorodeoxy-D-Glucose Positron Emission Tomography in A Patient with Advanced Oral Cavity Cancer Treated by Radical Surgery with Adjuvant Radiotherapy: A Case Report
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頁籤選單縮合
題名 | Pitfalls of Fluorine-18 Fluorodeoxy-D-Glucose Positron Emission Tomography in A Patient with Advanced Oral Cavity Cancer Treated by Radical Surgery with Adjuvant Radiotherapy: A Case Report=氟-18-氟化去氧葡萄糖正子斷層攝影應用於經根除性切除加輔助性放射線治療之後期口腔癌病患的缺點:個案報告 |
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作者 | 鄭乃銘; 詹勝傑; 張東杰; 廖俊達; 吳樹鏗; 閻紫宸; | 書刊名 | 核子醫學雜誌 |
卷期 | 21:2 2008.06[民97.06] |
頁次 | 頁115-120 |
分類號 | 416.932 |
關鍵詞 | 正子斷層攝影; 氟-18-氟化去氧葡萄糖; 口腔癌; 復發; PET; FDG; Oral cavity cancer; Recurrence; |
語文 | 英文(English) |
中文摘要 | 後期口腔癌病患主要接受手術加上其他輔助性的治療。上述治療通常會造成正常組織的嚴重扭曲和局部發炎,使得傳統影像無法正確分辨腫瘤復發和經治療後的正常組織。最近,氟-18-氟化去氧葡萄糖正子斷層攝影應用於復發和殘留口腔癌有高度的正確性。我們報告一位接受過根除性切除與輔助性放射治療的晚期口腔癌病例,放射治療後18個月,電腦斷層與核磁共振檢查懷疑有局部復發。之後進行的氟-18-氟化去氧葡萄糖正子斷層攝影亦懷疑有復發。然而組織學檢驗卻只有膿瘍產生。在之後追蹤的氟-18-氟化去氧葡萄糖正子斷層攝影發現這一病變已經消失。這一個膿瘍可能與放射線治療造成傷口癒合不良和導致腔室生成的有關。我們建議接受過輔助性放射線治療之晚期口腔癌病患,必須非常小心局部軟組織產生僞陽性正子斷層掃描結果,即使在治療過幾年之後。 |
英文摘要 | Patients with advanced oral cavity cancer are primarily treated by surgery with adjuvant therapy. Such treatment often causes significant distortions of normal tissue and local inflammation, impairing accurate differentiation of recurrent tumor from normal post-treatment changes in conventional imaging modalities. Recently, 18F-2-fluoro-2-deoxyglucose (FDG) positron emission tomography (PET) has been advocated in assessing recurrent and residual oral cancers due to its high accuracy. Herein, we report a case with advanced buccal cancer who had received radical surgery and adjuvant radiotherapy but was suspected to have local recurrence in both CT and MRI studies performed 18 months after treatment. The corresponding FDG PET scan was also suggestive of tumor recurrence. Histopathological biopsy showed abscess formation only. And the lesion regressed completely in the follow-up PET/CT scan. The abscess was probably associated with poor wound healing and sinus track formation induced by adjuvant radiotherapy. We concluded that for advanced oral cancer patients who had received adjuvant radiotherapy, the chance of false positive PET result in local soft tissue should be watched out even years after treatment. |
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