ỨNG DỤNG CỦA FDG PET/CT TRONG KHẢO SÁT ĐẶC ĐIỂM HÌNH ẢNH UNG THƯ THỰC QUẢN=The utility of FDG PET/CT in investigating the imaging characteristics of esophageal cancer

0 Người đánh giá. Xếp hạng trung bình 0

Tác giả: Văn Tấn Ngô, Đình Hùng Nguyễn, Xuân Cảnh Nguyễn, Minh Hoàng Trần

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Điện quang và Y học hạt nhân Việt Nam, 2024

Mô tả vật lý: tr.21-30

Bộ sưu tập: Metadata

ID: 486844

Thêm vào giỏ

Đặt vấn đề: PET/CT là một phương tiện hữu hiệu trong chẩn đoán và theo dõi ung thư thực quản (UTTQ). Nghiên cứu này nhằm khảo sát đặc điểm của các tổn thương nguyên phát, di căn hạch vùng và di căn xa trên hình ảnh FDG PET/CT và phân tích mối tương quan giữa các chỉ số hoạt động chuyển hóa với khả năng xâm lấn cũng như di căn của UTTQ.Đối tượng và phương pháp: Nghiên cứu hồi cứu mô tả những bệnh nhân UTTQ nguyên phát chưa điều trị đặc hiệu được ghi hình FDG PET/CT nhằm khảo sát đặc điểm hình ảnh các tổn thương và đánh giá tương quan giữa hoạt động chuyển hóa tổn thương nguyên phát thực quản với khả năng xâm lấn và di căn.Kết quả: PET/CT phát hiện được tất cả 76 tổn thương nguyên phát thực quản trong 69 bệnh nhân, thường gặp nhất là thực quản ngực đoạn 1/3 giữa (38,2%) và ít nhất ở thực quản đoạn bụng (2,6%). 14/76 tổn thương nguyên phát đã xâm lấn cơ quan lân cận, thường gặp nhất là xâm lấn khí quản (6,6%), động mạch chủ ngực (5,3%) và xâm lấn phổi (3,9%). Giá trị của các chỉ số hoạt động chuyển hóa tổn thương thực quản maxSUV=16,1±7,5
peakSUV=12,6±6,1
meanSUV=6,5±2,6
TLG=288,2±326,1
MTV= 41,1±41,6. Có 54/69 bệnh nhân đã di căn hạch vùng (78,3%), trong đó thường gặp nhất là các nhóm hạch cạnh phải khí quản đoạn cao (10%), cạnh thực quản đoạn ngực trên (8,5%) và đoạn ngực giữa (8,5%). Giá trị đại diện cho chỉ số hoạt động chuyển hóa glucosecủa hạch vùng di căn là maxSUV=9,9±5,9. PET/CT phát hiện 23/69 bệnh nhân (33,3%) có tổn thương di căn xa, thường gặp nhất là di căn hạch xa (15,9%) và di căn xương (11,6%). Có 3 trường hợp (4,3%) bệnh nhân di căn đồng thời 2 cơ quan. Thể tích khối u chuyển hóa MTV có tương quan đến khả năng xâm lấn cơ quan lân cận (p<
0,05) với ngưỡng cắt tối ưu MTV≥36,68 cm3 (độ nhạy 71%, độ đặc hiệu 71%, AUC=0,73). Ngoài ra, ngưỡng cắt tổng lượng khối u chuyển hóa TLG≥132,26 (độ nhạy 71%, độ đặc hiệu 76%, AUC=0,71) và thể tích khối u chuyển hóa MTV≥17,47 cm3 (độ nhạy 78%, độ đặc hiệu 65%, AUC=0,71) của tổn thương thực quản nguyên phát tương quan có ý nghĩa với khả năng di căn hạch vùng (p<
0,05).Kết luận: Tổn thương ung thư thực quản thường biểu hiện tăng hoạt động chuyển hóa trên hình ảnh FDG PET/CT. PET/CT có vai trò trong chẩn đoán vị trí tổn thương nguyên phát và các tổn thương di căn. Thể tích khối u chuyển hóa (MTV) và tổng lượng khối u chuyển hóa (TLG) tương quan với khả năng xâm lấn của tổn thương nguyên phát và khả năng di căn hạch vùng nhiều hơn các giá trị hấp thu chuẩn (SUV).Introduction: PET/CT is an effective modality in the diagnosis and monitoring esophageal cancer (EC). This study aims to investigate the imaging characteristics of primary lesions, regional lymph node metastasis, and distant metastasis on FDG PET/CT images, as well as to analyze the correlation between metabolic activity indices and the invasiveness and metastasis of esophageal cancer.Methods: A retrospective study described untreated primary EC patients who underwent FDG PET/CT imaging to investigate the imaging characteristics of lesions and assess the correlation between the metabolic activity of primary esophageal lesions and their invasiveness and metastasis.Results: PET/CT identified all 76 primary esophageal lesions in 69 patients. The most common locations of primary lesions were the mid-thoracic esophagus (38.2%), while the least common was the abdominal esophagus (2.6%). Cancers invading adjacent organs were observed in 14/76 lesions, most frequently the trachea (6.6%), the thoracic aorta (5.3%) and the lungs (3.9%). The values for glucose metabolism in esophageal lesions were maxSUV=16.1±7.5
peakSUV=12.6±6.1
meanSUV=6.5±2.6
TLG=288.2±326.1
MTV= 41.1±41.6. 54/69 patients had regional lymph node metastases (78.3%) with the most common being the right upper paratracheal (10% of lymph nodes), upper thoracic paraesophageal (8.5% of lymph nodes) and middle thoracic paraesophageal (8.5% of lymph nodes). The glucose metabolism values for metastatic lymph nodes were maxSUV=9.9±5.9. PET/CT identified distant metastasis in 23 out of 69 patients (33.3%), with the most common being distant lymph node metastasis (15.9%) and bone metastasis (11.6%). Three cases (4.3%) had simultaneous metastasisto two organs. The metabolic tumor volume (MTV) is correlated with the ability to invade adjacent organs (p<
0.05) with an optimal cutoff value of MTV≥36.68 cm³ (sensitivity 71%, specificity 71%, AUC=0.73). Additionally, the total lesion glycolysis (TLG) cutoff threshold of ≥132.26 (sensitivity 71%, specificity 76%, AUC=0.71) and the metabolic tumor volume (MTV) of ≥17.47 cm³ (sensitivity 78%, specificity 65%, AUC=0.71) for primary esophageal lesions are significantly correlated Conclusion: Esophageal cancer lesions often exhibit increased glucose metabolism on FDG PET/CT. PET/CT plays a crucial role in diagnosing primary lesion locations and detecting metastatic lesions. The metabolic tumor volume (MTV) and total lesion glycolysis (TLG) are more strongly correlated with the invasiveness of primary lesions and the potential of regional lymph node metastasis compared to standard uptake values (SUV). with the potential of regional lymph node metastasis (p<
0.05).

1. Đọc trực tuyến

1. Đọc trực tuyến

Tạo bộ sưu tập với mã QR