Objective To evaluate the diagnostic accuracy of 1BF - FDG PET - CT on gynecological cancer by comparing it with conventional imaging, serological and histological examinations. Methods Sixty three patients with gynecological cancer were divided into four groups;ovarian cancer group( 29 patients ),cervical cancer group( 17 patients ),endometrial cancer group( 12 patients ) and vaginal cancer group( 5 patients ). Forty five to fifty minutes after the injection of 1BF - FDG at 5. 5 MBq/kg,all patients underwent the whole - body 1BF - FDG PET - CT scanning, and then the images were collected and reorganized. Fifty one patients underwent radiological testing CT/MRI/ultrasound ). Fifteen patients received the serological analysis and 40 patients received the histological or cytological diagnosis. Results The diagnostic accuracy of 1BF - FDG PET - CT was 84. 2% ,in which 58. 8% were true positive and 25.4% were true negative. The diagnostic accuracy of 1BF - FDG PET - CT on primary focus of cancer was 82. 8% ,82. 3% ,91. 7% and 80% in ovary,cervix,endometrium and vagina,respectively. The incorret results only accounted for 15.8% in the 1BF - FDG PET -CT scanning,in which 6. 3% were false positive and 9. 5% were false negative. Moreover,the false positive results were relevant to the inflammatory cells around the 1BF - FDG uptake region; the false negative results were relevant to the low grading of tumors( 2 patients ), chemotherapy^ 2 cases )and technical problems( 1 case ); one case of false negative result only was relevant to the slight increase of serologic index, but there were no supports from cytology and histology. Among the 51 patients received the radiological testing,metastases were found in 21 ones by the 1BF - FDG PET - CT,but these metastases were not found in the radiological detection. The positive predictive value of 1BF - FDG PET- CT was 84. 6% ( 22/26 ), and the negative predictive value was 76. 9% ( 10/13). Conclusion 1BF - FDG PET - CT can accurately diagnose the recurrence of gynecological tumors or the residual of tumor tissues in the early time. But in the tumors treated with chemotherapy or with low malignant grading, false negative results may occur. It needs to obtain more data to support meaningful conclusions.%目的 通过与传统的影像学、血清学和组织学检查比较,评估18F - FDG PET - CT在妇科肿瘤诊断中的准确性.方法 63例妇科肿瘤中,卵巢肿瘤29例,宫颈肿瘤17例,子宫内膜肿瘤12例,阴道肿瘤5例.全部患者进行全身18F - FDG PET - CT扫描,51例进行了放射学检测(CT/MRI/超声),15例进行了血清学分析,40例进行了组织学或细胞学诊断.采用PET - CT扫描仪,经肘静脉注射5.5 MBq/kg 18F - FDG后45～50 min,采集、重组图像.结果 18F - FDG PET - CT诊断准确率为84.2%,其中58.8%为真阳性,25.4%为真阴性.18F - FDG PET - CT对肿瘤原发灶(卵巢、宫颈、子宫内膜、阴道)的诊断准确率分别为82.8%、82.3%、91.7%和80%;而18F - FDG PET - CT仅显示了15.8%的错误结果,包括6.3%的假阳性和9.5%的假阴性.而且假阳性结果与18F - FDG摄取区周围有炎性细胞的存在有关;假阴性结果与肿瘤的分级低(2例)、正在化疗(2例)和技术问题(1例)有关;还有1例假阴性结果仅与血清学指标的轻度升高有关,但没有细胞学和组织学支持.放射学检测的51例中,21例18F - FDG PET - CT发现转移灶,而放射学检测却没有提示.18F - FDG PET - CT的阳性预测值为84.6%(22/26),阴性预测值为76.9%(10/13).结论 18F - FDG PET - CT能早期准确诊断妇科肿瘤的复发或肿瘤活性组织的残留;但在化疗中的肿瘤和恶性程度低的肿瘤中,会出现假阴性结果;想得到有意义的结论还需要更多数据的支持.
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