18F-氟脱氧葡萄糖正电子发射断层扫描/磁共振成像（18F-FDG PET/MRI）在诊断胰腺癌术后复发中的价值

doi:10.16150/j.1671-2870.2024.05.008

摘要/Abstract

摘要：

目的：评估¹⁸F-氟脱氧葡萄糖正电子发射断层扫描/磁共振成像（¹⁸F-fluorodeoxyglucose positron emission tomography/magnetic resonanceimaging，¹⁸F-FDG PET/MRI）在胰腺癌术后复发诊断中的价值。方法：连续纳入2018年4月至2023年12月期间86例胰腺癌切除术后的患者，在2024年8月至9月行¹⁸F-FDG PET/MRI检查。回顾性分析¹⁸F-FDG PET/MRI检测胰腺癌术后复发的效能，比较PET/MRI和血清糖类抗原19-9（CA19-9）水平在诊断复发的效能。结果：经随访证实，86例患者中有67.4%（58/86）发生了肿瘤复发。复发组的原发肿瘤直径大于未复发组[（3.4±1.3）cm比（2.7±1.2）cm]。复发的患者中，87.9%（51/58）为系统性复发，最常见的是肝脏转移和腹膜转移。PET/MRI检查结果改变了30.2%（26/86）患者的治疗方案。86例中，有79例患者同时检查了PET/MRI和血清CA19-9，在诊断胰腺癌术后复发中，PET/MRI显示出比血清CA19-9更高的诊断效能（AUC：0.847对0.719）。PET/MRI检出9/12例血清CA19-9正常的胰腺癌复发，排除了5/8例血清CA19-9升高的未复发患者。结论：PET/MRI在胰腺癌术后复发诊断中具有较大的临床价值，其不仅能诊断是否复发，还能提供肿瘤复发的具体部位，对于血清CA19-9正常的患者，PET/MRI检查更有意义，为下一步治疗方案的制定提供全面的信息。

关键词: 胰腺导管腺癌, 复发, ¹⁸F-FDG PET/MRI

Abstract:

Objective To evaluate the value of ¹⁸F-fluorodeoxyglucose positron emission tomography/magnetic resonance imaging (¹⁸F-FDG PET/MRI) in the diagnosis of postoperative recurrence of pancreatic cancer. Methods The study included 86 consecutive patients after resection of pancreatic cancer from April 2018 to December 2023, who underwent ¹⁸F-FDG PET/MRI from August to September 2024. The efficacy of 1¹⁸F-FDG PET/MRI in detecting postoperative recurrence of pancreatic cancer was retrospectively analyzed, and compared with that of serum carbohydrate antigen 19-9 (CA19-9) concentration in the diagnosis of recurrence. Results Follow-up confirmed that 67.4% (58/86) of patients experienced recurrence. The primary tumor diameter in the recurrence group (3.4±1.3cm) was larger than in the non-recurrence group (2.7±1.2cm). Among the patients with recurrence, 87.9% (51/58) had systemic recurrence, with the most common sites being liver metastasis and peritoneal metastasis. PET/MRI results changed the treatment plans for 30.2% (26/86) of patients. Among the 86 cases, 79 patients underwent both PET/MRI and serum CA19-9 tests. PET/MRI showed higher diagnostic efficacy for detecting postoperative recurrence of pancreatic cancer compared to serum CA19-9 (AUC: 0.847 vs. 0.719 ). PET/MRI detected 9/12 cases of pancreatic cancer recurrence with normal serum CA19-9 levels, and excluded 5/8 patients with elevated serum CA19-9 levels who did not experience recurrence. Conclusions PET/MRI has great clinical value in the diagnosis of postoperative recurrence of pancreatic cancer. It is particularly meaningful for patients with normal serum CA19-9 level. It can not only diagnose recurrence but also provide the specific site of tumor recurrence and comprehensive information for the formulation of the next treatment plan.

Key words: Pancreatic ductal adenocarcinoma, Recurrence, ¹⁸F-FDG PET/MRI

中图分类号:

R735.9
R817

冯国伟, 黄新韵, 孟宏平, 江旭峰, 陈克敏, 林晓珠. ¹⁸F-氟脱氧葡萄糖正电子发射断层扫描/磁共振成像（¹⁸F-FDG PET/MRI）在诊断胰腺癌术后复发中的价值[J]. 诊断学理论与实践, 2024, 23(05): 517-523.

FENG Guowei, HUANG Xinyun, MENG Hongping, JIANG Xufeng, CHEN Kemin, LIN Xiaozhu. Value of ¹⁸F-fluorodeoxyglucose positron emission tomography/magnetic resonance imaging (¹⁸F-FDG PET/MRI) in diagnosis of postoperative recurrence of pancreatic cancer[J]. Journal of Diagnostics Concepts & Practice, 2024, 23(05): 517-523.

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参考文献 18

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Indice	Recurrence group	Non-recurrence group	Statistics value	P value
Gender（male/female）	40/18	22/6	χ²=0.866	0.446
Age（mean±standard deviation，year）	62.2±10.1	61.4±8.2	t=0.332	0.740
Height（mean±standard deviation，cm）	168.2±7.7	167.9±7.3	t=0.160	0.873
Body weight（mean±deviation，Kg）	57.4±9.5	58.5±11.2	t=-0.464	0.644
Blood glucose（mean±deviation，mmol/L）	6.9±2.2	7.2±3.1	t=-0.518	0.606
Time between operation and PET/MRI（median，day）	306	365	U=666.000	0.180
Location of tumor（pancreatic head and uncinate process/body and tail）	27/31	12/16	χ²=0.104	0.819
Tumor size（mean±standard deviation，cm）	3.4±1.3	2.7±1.2	2.419	0.018

¹⁸F-氟脱氧葡萄糖正电子发射断层扫描/磁共振成像（¹⁸F-FDG PET/MRI）在诊断胰腺癌术后复发中的价值

Value of ¹⁸F-fluorodeoxyglucose positron emission tomography/magnetic resonance imaging (¹⁸F-FDG PET/MRI) in diagnosis of postoperative recurrence of pancreatic cancer

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