头颈癌 Comparison of PET CT 课件(最新整理版).pptxVIP

Positron Emission Tomography PET scanner FDG PET in Normal FDG accumulation in cancer cellsAction of glucose transporter proteins.Highly active hexokinase bound to tumor mitochondria helps to trap FDG into cell.Relative hypoxia in tumor masses which activate the anaerobic glycolytic pathway.The increased glucose uptake is due to the need for nuclei acid synthesis and, therefore, is directly related to the tumor’s tendency to grow.FDG uptake is strongly related to the number of viable tumor cells, although not directly regulated by the need fo DNA synthesis.Cancer 1988:1776, JNM 1991:1548, JNM 1993:414 PET in Oncology顯影藥物：FDG, C-11methionine, N-13 glutamate, F-18 FU, F-18misonidazole, etc.良性、惡性腫瘤鑑別癌症病灶偵測定位偵測癌症淋巴腺及轉移病灶精確的癌症分期癌症復發、壞死鑑別藥物、受體分析癌症篩檢 Health Care Finance A 12/2000臨床症狀頭頸癌 黑色素瘤結腸癌 淋巴瘤 食道癌肺癌（非微小可疑點）乳癌給付類別診斷、分期、再分期診斷、分期、再分期（局部結點除外）診斷、分期、再分期診斷、分期、再分期診斷、分期、再分期診斷、分期、再分期MCAC 研究中 Positron Emission Tomography inHead Neck cancerLaryng 1992 (3):281FDG PETT1w MRI Positron Emission Tomography inHead Neck cancerLaryng 1992 (3):281FDG PETT1w MRI Maxillary cancer, osteosarcoma Parotid gland ca, recurrencerecurrence Nasopharyngeal carcinoma Nasopharyngeal carcinoma PET in Head Neck cancer, C/THN 1997 (12):666 H N cancer, recurrence 2Ms CT:necrosis Tongue base CA, distant meta. PET in Head Neck cancerPretreatment – staging, baselinePrimary tuomrRegional nodes (neck adenopathy)Occult metastasisPosttreatment – therapeutic effect, prognosisRestaging for chemotherapy monitoringIrradiation effect and recurrence or residualUnknown primary detection PET in Head Neck cancer, primaryHead Neck cancer (SCC), Liege Belgium25 Pretherapy 13 Posttherapy either Sx C/T R/T: all Bx pf.CECTPETTumorLNsTumorLNsTumorLNsInitial staging 25 patients (sites)TN014015015TP254244 (8)245 (9)FN061615FP010000Relapse in 13 patientsTN655464TP537856FN250022FP001101Laryng 1998 (10):1578 PET in Head Neck cancer, neck nodesHead Neck cancer (SCC), Utrecht the Netherlands81 neck sites in 54 p’ts Pretherapy