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目的探讨18F-FDG PET/CT双时相显像在膀胱癌术前分期中的应用价值。方法 2003年5月~2012年5月进行18F-FDG PET/CT检查的膀胱癌初诊患者73例,男54例,女19例,年龄58.7(41~80)岁。所有患者18F-FDG PET/CT常规全身显像后,口服40 mg呋塞米并多饮水,多次排尿,服呋塞米后约2 h憋尿充盈膀胱,再进行18F-FDG PET/CT盆腔延迟显像。所有患者于18FFDG PET/CT检查后1周内进行手术治疗,将PET/CT与手术病理学检查结果进行对比分析,评价18F-FDG PET/CT双时相显像在膀胱癌术前分期中的应用价值。结果18F-FDG PET/CT双时相显像对膀胱癌原发灶的T分期与病理分期符合率为63.0%(46/73),其中pT4期膀胱癌的分期符合率为100%(7/7);另外检出75.0%(6/8)的淋巴结转移灶,100%(4/4)的远隔器官转移灶和100%(4/4)原发性第二种恶性肿瘤病灶。结论本研究结果表明18F-FDG PET/CT双时相显像在T分期方面,尽管对pTa、pT1、pT2、pT3期膀胱癌的T分期价值不大,但对pT4期膀胱癌的T分期可能有重要的应用价值;在膀胱癌的N分期、M分期及发现第二种原发癌方面也可能有重要的应用价值。
Objective To investigate the value of 18F-FDG PET / CT double-phase imaging in the preoperative staging of bladder cancer. Methods 73 patients with bladder cancer who underwent 18F-FDG PET / CT from May 2003 to May 2012 were 54 males and 19 females, aged 58.7 (41-80) years. All patients underwent 18F-FDG PET / CT routine whole-body imaging, oral administration of 40 mg of furosemide and more water, multiple urination, furosemide filled with urine about 2 h after filling the bladder, and then 18F-FDG PET / CT pelvic Delayed imaging. All patients underwent surgical treatment within 1 week after 18FFDG PET / CT examination, and PET / CT and pathological examination results were compared to evaluate the 18F-FDG PET / CT dual-phase imaging in the preoperative bladder cancer staging Value. Results The coincidence rate of T stage and pathological stage of 18F-FDG PET / CT biopsy was 63.0% (46/73), and the staging coincidence rate of pT4 stage bladder cancer was 100% (7 / 7). In addition, 75.0% (6/8) lymph node metastases, 100% (4/4) distant organ metastases and 100% (4/4) primary second malignant tumor lesions were detected. Conclusions The results of this study suggest that T stage of 18F-FDG PET / CT dual bi-phase imaging may not be significant for T stage of pTa, pT1, pT2 and pT3 bladder cancer, but T stage of pT4 bladder cancer may be Has important application value; it may also have important application value in the N staging, M staging of bladder cancer and the discovery of the second primary cancer.