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目的 :评价18FDG PET对胃癌的诊断价值和胃肠生理性摄取等因素对诊断的影响。材料和方法 :无消化道疾病史的FDG PET查体者 3 0 3例为组 1;PET发现胃部最大SUV值≥ 3 .5 ,并在 1～ 2周内接受胃镜检查者 2 7例为组 2 ;胃镜初步诊断为胃癌且经PET检查、手术和病理检查 3 3例为组 3。用ROI方法测定胃等病灶SUV最大值 (SUVmax)和平均值(SUVave)。结果 :组 1胃部FDG摄取SUVmax为 0 .71～ 5 .7,SUVave为 0 .61～ 4.6。 16%胃SUVmax<1.5 ;5 5 %SUVmax>2 .0 ;17%SUVmax>3 .0 ;6%SUVmax>3 .5。组 2胃部SUVmax3 .5～ 5 .7,胃镜证实 19例正常 ,5例胃炎 ,3例溃疡 ;炎性及溃疡病变FDG摄取高于正常胃 (p <0 .0 5 )。PET检出组 3原发病灶 97% ( 3 1/ 3 2 ) ;远处转移 6/ 6;胃局部淋巴结转移 6/ 11。假阴性 1例 ,纠正胃镜误诊 1例 ,上调UVmax从≥ 3 .0至≥ 3 .5 ,则组 1中假阳性从 17%降至 6% ,组 3假阴性仍保持不变。结论 :提高SUV阈值可减少胃肠道生理或 /和炎性摄取对结果的影响。
Objective: To evaluate the diagnostic value of 18FDG PET in gastric cancer and physiological factors such as gastrointestinal intake on the diagnosis. MATERIALS AND METHODS: A total of 303 patients with FDG PET without a history of gastrointestinal diseases were Group 1. The maximum SUV value of the stomach was ≥ 3.5 in PET, and 27 patients underwent gastroscopy within 1-2 weeks Group 2; gastroscopy was initially diagnosed as gastric cancer and PET examination, surgery and pathological examination of 33 cases for the group. The ROI method was used to determine the SUV max and SUVave of gastric lesions. Results: The gastric FDG uptake in group 1 was 0.71-5.7 for SUVmax and 0.61-4.6 for SUVave. 16% stomach SUVmax <1.5; 5 5% SUVmax> 2.0; 17% SUVmax> 3.0; 6% SUVmax> 3.5. Group 2 stomach SUVmax3.5 ~ 5 .7, 19 cases confirmed by gastroscopy, 5 cases of gastritis, 3 cases of ulcer; FDG uptake of inflammatory and ulcer lesions was higher than normal stomach (p <0.05). PET primary detection group 3 primary lesions 97% (3 1/3 2); distant metastasis 6/6; gastric local lymph node metastasis 6/11. One case of false negative, correct one case of endoscopy misdiagnosis, upregulated UVmax from ≥ 3.0 to ≥ 3.5, then the false positive in group 1 dropped from 17% to 6%, group 3 false negative remains unchanged. Conclusion: Increasing SUV threshold may reduce the effect of gastrointestinal physiological or / and inflammatory uptake on outcome.