{"title":"[18F]FDG- PET/CT在食管癌患者初始分期和治疗中的应用：三级保健中心的经验。","authors":"Sankari Kommi, Ramya Priya Rallapeta, Bala Venkat Subramanian, Lakshmi Amancharla Yadagiri, Narendra Hulikal, C Chandramaliteeswaran, Rukmangada Nandyala, Tekchand Kalawat","doi":"10.4103/ijnm.ijnm_118_23","DOIUrl":null,"url":null,"abstract":"<p><strong>Aim of the study: </strong>This study aims to study the utility of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (<sup>18</sup>F-FDG PET/CT) findings in the initial staging and management of patients with esophageal carcinoma.</p><p><strong>Materials and methods: </strong>In this prospective study, we evaluated 74 patients with a mean age of 59.4 ± 11.6 with a range of 35-86 years. Comparison between the mean and standard deviation of SUV<sub>max</sub> of primary tumor between two histopathological groups, squamous cell carcinoma (SCC) and adenocarcinoma (AC) was done using unpaired Student's <i>t</i>-test. The mean of SUV<sub>max</sub> of primary tumor in relation to localized tumor to nodal to distant metastases was assessed by ANOVA test. <i>P</i> <0.05 was considered statistically significant. The extent of agreement between findings of contrast-enhanced computed tomography (CECT) chest and abdomen and <sup>18</sup>F-FDG PET/CT was done using Cohen's kappa coefficient (κ).</p><p><strong>Results: </strong>Among total <i>n</i> = 74 (42 males and 32 females with mean age 59.4 ± 11.4; range 35-86 years) patients, SCC was seen in 78.4% and AC in 21.6% of patients. There is a progressively increased SUV<sub>max</sub> value of primary tumor with nodal and distant metastases. <sup>18</sup>F-FDG PET/CT showed disease of Stage I-II in 12.1%, Stage III in 20.2%, Stage IVA in 25.6%, and Stage IVB in 41.8% patients. There is agreement between <sup>18</sup>F-FDG PET/CT and CECT chest and abdomen in the evaluation of regional lymph nodes (37.8% vs. 36.4%; κ - 0.96), nonregional lymph nodes (24.3% vs. 20.2%; κ -0.74), and distant organ involvement (21.6% vs. 17.5%; κ -0.82). In addition, <sup>18</sup>F-FDG PET/CT found synchronous malignancies in 4.0% of patients.</p><p><strong>Conclusion: </strong><sup>18</sup>F-FDG PET/CT metabolic parameters help in identifying metastatic involvement in morphologically equivocal and clinically suspicious lesions in carcinoma esophagus patients. Being a whole-body imaging modality, <sup>18</sup>F-FDG PET/CT has inbuilt advantage to detect occult, distant metastases, and synchronous malignancies for effective staging and improving plan of clinical management.</p>","PeriodicalId":45830,"journal":{"name":"Indian Journal of Nuclear Medicine","volume":"39 5","pages":"329-334"},"PeriodicalIF":0.4000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11884347/pdf/","citationCount":"0","resultStr":"{\"title\":\"Utility of [18F]FDG- PET/CT in Initial Staging and Management of Patients with Esophageal Carcinoma: A Tertiary Care Center Experience.\",\"authors\":\"Sankari Kommi, Ramya Priya Rallapeta, Bala Venkat Subramanian, Lakshmi Amancharla Yadagiri, Narendra Hulikal, C Chandramaliteeswaran, Rukmangada Nandyala, Tekchand Kalawat\",\"doi\":\"10.4103/ijnm.ijnm_118_23\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Aim of the study: </strong>This study aims to study the utility of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (<sup>18</sup>F-FDG PET/CT) findings in the initial staging and management of patients with esophageal carcinoma.</p><p><strong>Materials and methods: </strong>In this prospective study, we evaluated 74 patients with a mean age of 59.4 ± 11.6 with a range of 35-86 years. Comparison between the mean and standard deviation of SUV<sub>max</sub> of primary tumor between two histopathological groups, squamous cell carcinoma (SCC) and adenocarcinoma (AC) was done using unpaired Student's <i>t</i>-test. The mean of SUV<sub>max</sub> of primary tumor in relation to localized tumor to nodal to distant metastases was assessed by ANOVA test. <i>P</i> <0.05 was considered statistically significant. The extent of agreement between findings of contrast-enhanced computed tomography (CECT) chest and abdomen and <sup>18</sup>F-FDG PET/CT was done using Cohen's kappa coefficient (κ).</p><p><strong>Results: </strong>Among total <i>n</i> = 74 (42 males and 32 females with mean age 59.4 ± 11.4; range 35-86 years) patients, SCC was seen in 78.4% and AC in 21.6% of patients. There is a progressively increased SUV<sub>max</sub> value of primary tumor with nodal and distant metastases. <sup>18</sup>F-FDG PET/CT showed disease of Stage I-II in 12.1%, Stage III in 20.2%, Stage IVA in 25.6%, and Stage IVB in 41.8% patients. There is agreement between <sup>18</sup>F-FDG PET/CT and CECT chest and abdomen in the evaluation of regional lymph nodes (37.8% vs. 36.4%; κ - 0.96), nonregional lymph nodes (24.3% vs. 20.2%; κ -0.74), and distant organ involvement (21.6% vs. 17.5%; κ -0.82). In addition, <sup>18</sup>F-FDG PET/CT found synchronous malignancies in 4.0% of patients.</p><p><strong>Conclusion: </strong><sup>18</sup>F-FDG PET/CT metabolic parameters help in identifying metastatic involvement in morphologically equivocal and clinically suspicious lesions in carcinoma esophagus patients. Being a whole-body imaging modality, <sup>18</sup>F-FDG PET/CT has inbuilt advantage to detect occult, distant metastases, and synchronous malignancies for effective staging and improving plan of clinical management.</p>\",\"PeriodicalId\":45830,\"journal\":{\"name\":\"Indian Journal of Nuclear Medicine\",\"volume\":\"39 5\",\"pages\":\"329-334\"},\"PeriodicalIF\":0.4000,\"publicationDate\":\"2024-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11884347/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Indian Journal of Nuclear Medicine\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.4103/ijnm.ijnm_118_23\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/25 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q4\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Indian Journal of Nuclear Medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4103/ijnm.ijnm_118_23","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/25 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
引用次数: 0
摘要
研究目的：本研究旨在探讨18f -氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（18F-FDG PET/CT）在食管癌患者初始分期和治疗中的应用价值。材料和方法：在这项前瞻性研究中，我们评估了74例患者，平均年龄59.4±11.6岁，年龄范围为35-86岁。原发肿瘤的SUVmax在鳞癌（SCC）和腺癌（AC）两组间的均数和标准差采用unpaired Student’st检验进行比较。原发肿瘤与局部肿瘤、淋巴结转移和远处转移之间的SUVmax平均值采用方差分析（ANOVA）进行评估。采用Cohen’s kappa系数（κ）对p18f - fdg进行PET/CT检测。结果：共74例（男42例，女32例），平均年龄59.4±11.4岁；年龄在35-86岁之间)的患者中，78.4%的患者出现SCC， 21.6%的患者出现AC。原发性肿瘤伴淋巴结和远处转移时，SUVmax值逐渐升高。18F-FDG PET/CT显示I-II期12.1%，III期20.2%，IVA期25.6%，IVB期41.8%。18F-FDG PET/CT与CECT胸腹部对区域淋巴结的评估一致(37.8% vs. 36.4%；κ - 0.96)，非区域淋巴结(24.3% vs. 20.2%；κ -0.74)，远处脏器受累(21.6% vs. 17.5%；κ-0.82)。此外，18F-FDG PET/CT在4.0%的患者中发现同步恶性肿瘤。结论：18F-FDG PET/CT代谢参数有助于鉴别形态学模糊和临床可疑的食管癌病变的转移灶。18F-FDG PET/CT作为一种全身成像方式，在发现隐匿性、远处转移性和同步性恶性肿瘤方面具有固有的优势，可以有效地进行分期和改进临床管理方案。
Utility of [18F]FDG- PET/CT in Initial Staging and Management of Patients with Esophageal Carcinoma: A Tertiary Care Center Experience.
Aim of the study: This study aims to study the utility of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) findings in the initial staging and management of patients with esophageal carcinoma.
Materials and methods: In this prospective study, we evaluated 74 patients with a mean age of 59.4 ± 11.6 with a range of 35-86 years. Comparison between the mean and standard deviation of SUVmax of primary tumor between two histopathological groups, squamous cell carcinoma (SCC) and adenocarcinoma (AC) was done using unpaired Student's t-test. The mean of SUVmax of primary tumor in relation to localized tumor to nodal to distant metastases was assessed by ANOVA test. P <0.05 was considered statistically significant. The extent of agreement between findings of contrast-enhanced computed tomography (CECT) chest and abdomen and 18F-FDG PET/CT was done using Cohen's kappa coefficient (κ).
Results: Among total n = 74 (42 males and 32 females with mean age 59.4 ± 11.4; range 35-86 years) patients, SCC was seen in 78.4% and AC in 21.6% of patients. There is a progressively increased SUVmax value of primary tumor with nodal and distant metastases. 18F-FDG PET/CT showed disease of Stage I-II in 12.1%, Stage III in 20.2%, Stage IVA in 25.6%, and Stage IVB in 41.8% patients. There is agreement between 18F-FDG PET/CT and CECT chest and abdomen in the evaluation of regional lymph nodes (37.8% vs. 36.4%; κ - 0.96), nonregional lymph nodes (24.3% vs. 20.2%; κ -0.74), and distant organ involvement (21.6% vs. 17.5%; κ -0.82). In addition, 18F-FDG PET/CT found synchronous malignancies in 4.0% of patients.
Conclusion: 18F-FDG PET/CT metabolic parameters help in identifying metastatic involvement in morphologically equivocal and clinically suspicious lesions in carcinoma esophagus patients. Being a whole-body imaging modality, 18F-FDG PET/CT has inbuilt advantage to detect occult, distant metastases, and synchronous malignancies for effective staging and improving plan of clinical management.
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