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題名 | The Utility of PET and CT in the Differential Diagnosis of Pancreatic Masses: A Prospective Study in 34 Patients=正子攝影與電腦斷層掃描應用於胰臟腫瘤之鑑別診斷:34例病患之前瞻性分析 |
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作者姓名(中文) | 陳瑞灝; 楊國卿; 吳金珠; 陳遠光; | 書刊名 | 核子醫學雜誌 |
卷期 | 23:1 2010.03[民99.03] |
頁次 | 頁1-9 |
分類號 | 414.93 |
關鍵詞 | 正子/電腦斷層造影; 氟-18-氟化去氧葡萄糖; 標準攝取值; 胰臟癌; PET/CT; FDG; Standard uptake value; Pancreatic cancer; |
語文 | 英文(English) |
中文摘要 | 背景:以氟-18-氣化去氧葡萄糖(FDG)進行正子攝影(PET)已行之多年,它被認爲可以分辨良性及惡性腫瘤。但過去PET卻無法明確指出真正的解剖構造之所在。目前新一代的正子攝影結合電腦斷層(PET/CT)的複合影像,不但可以找到病變,且可明確指出病變之所在。本研究目的在於評估PET/CT是否可以分辨胰臟病灶爲良性或惡性腫瘤。方法:34例胰腫瘤之病人進行PET/CT複合掃描。造影1小時用以計算標凖攝取值(SUV)。34例病人中的21例並且進行2小時後的延遲造影。所有的病人都接受超音波及對比劑強化電腦斷層掃描。只有一部分病人接受逆行性內視鏡膽胰管攝影。結果:34例病人當中,14例證實爲良性腫瘤,20例惡性腫瘤。PET之SUV值在良性病人爲0.42至4.41(平均2.20±1.21),在惡性病人爲1.24至15.07(平均6.64±3.0。若以SUV=4.4爲分界點,PET/CT診斷之敏感性爲80%,特異性爲93%。在惡性腫瘤之病人有4例呈假陰性。結論:相較於傳統之診斷方法,PET/CT比超音波及逆行性內視鏡膽胰管攝影爲佳,但此未優於電腦斷層掃描。 |
英文摘要 | Background: Positron emission tomography (PET) using 18F-fluoro-2-deoxy-D-glucose (FDG) can differentiate benign from malignant lesions, yet lack of anatomic information in FDG-PET images limits utility. Dual-modality FDG-PET/computed tomography (PET/CT) provides intrinsically aligned functional and anatomical data. Our aim was to determine if PET/CT can differentiate benign from malignant pancreatic lesions. Methods: A total of 34 patients with pancreatic lesions were prospectively enrolled to receive PET/CT. The standard uptake value (SUV) was calculated 1 h after initiating the scan, and a delayed PET/CT scan at 2 h was performed in 21 of 34 patients. All patients also received sonography and contrast enhanced computed tomography scan (ceCT). Only part of patients received endoscopic retrograde cholangiopancreaticography (ERCP). Results: There were 14 benign tumors (proven by histology in 4 cases and by follow-up in 10 cases) and 20 malignant tumors (proven by histology in 14 cases and by follow-up in 6 cases). SUV in benign masses was 0.42 to 4.41 (mean, 2.20±1.21), and in malignant masses was 1.24 to 15.07 (mean, 6.64±3.6). Using SUV=4.4 as a cut-off, sensitivity was 80% and specificity was 93%. There were 4 false-negative patients in the malignant group. PET/CT is superior to sonography in differential diagnosis. Conclusion: PET/CT scan is a sensitive and specific method for differential diagnosis of pancreatic lesions, yet PET/CT seems not superior to ceCT alone. |
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