综述18FDGPETCT在临床肿瘤诊断中的应用.docVIP

综述18FDG PET/CT一体机在临床 肿瘤治疗中的应用 摘要 正确的诊断和分期对一个癌症病人来说有非比寻常的意义。目前最常用的PET显像剂为18F标记的FDG（18F-FDG 氟化脱氧葡萄糖），是一种葡萄糖的。18氟18氟Integrated 18FDG PET/CT: Utility and Applications in Clinical Oncology Abstract Accurate diagnosis and staging are essential for an optimal management of cancer patients. Positron emision tomography with 2-deoxy-2-fluorine-18-fluoro-D-glucose (18FDG-PET) and, more recently, 18FDG-PET/computed tomography (18FDG-PET/CT) have emerged as powerful imaging tools in oncology, because of the valuable functional information they provide. The combined acquisition of PET and CT has synergistic advantages over its isolated constituents and minimizes their limitations. It decreases examination times by 25%–40%, leads to a higher patient throughput and unificates two imaging procedures in a single session. There is evidence that 18FDG-PET/CT is a more accurate test than either of its components for the evaluation of various tumors. It is a particularly valuable tool for detection of recurrence, especially in asymptomatic patients with rising tumor markers and those with negative or equivocal findings on conventional imaging tests. Yet, there are some limitations and areas of uncertainty, mainly regarding the lack of specificity of the 18FDG uptake and the variable 18FDG avidity of some cancers. This article reviews the advantages, limitations and main applications of 18FDG-PET/CT in oncology, with especial emphasis on lung cancer, colorectal cancer, lymphomas, melanoma and head and neck cancers. Keywords: PET, PET/CT, FDG, oncology, cancer 介 绍 癌症是当今全球最主要的死亡原因。准确的诊断、分期对于取得好的治疗效果是必不可少的。传统的影像学技术，如计算机断层摄影和核磁共振依靠对解剖变化和异常部位的对比度增强，从而锁定病变的位置大小结构。 正电子发射计算机断层显像(positron emission tomography PET)，是反映病变的基因、分子、代谢及功能状态的显像设备。它是利用正电子核素标记葡萄糖等人体代谢物作为显像剂，通过病灶对显像剂的摄取来反映其代谢变化，从而为临床提供疾病的生物代谢信息。是当今生命科学、医学影像技术发展的里程碑.而PET的主要缺点在于空间分辨率有限以及能精确定位的焦点18氟化葡萄糖的摄取妨碍了能通过生理代谢变化识别病变器官和相邻器官对18FDG的摄取（例如肠道、泌尿道）。PET/CT的数据获得和成像过程中可以得到准确的解剖定位，这就说明正电子摄影的优势之处。通过综合数据的证明PET/CT迅速取得临床认可，在过去的十年里，它已成为肿瘤成像中的重要工具。 CT（C