Značaj 18FDG PET/CT u otkrivanju primarnog tumora nepoznate lokalizacije

  • Bogdan N Marković Univerzitet u Beogradu,medicinski fakultet
  • Dragana Šobić Šaranović

Abstract


Uvod: Tumori nepoznatog porekla čine grupu malignih tumora kod kojih postoji patohistološka verifikacija prisustva metastaze u bioptiranom materijalu, ali koji, i pored primene standardnih dijagnostičkih procedura, kliničkih i laboratorijskih ispitivanja, ostaju nepoznatog primarnog porekla. Ovi tumori čine 2-7% svih malignih tumora.

Cilj: Cilj našeg istraživanja bio je da se razmotri koju ulogu imaju pozitronska emisiona i kompjuterizovana tomografija (PET/CT sken) sa 18-fluorodeoksiglukozom (18FDG) u cilju otkrivanja lokalizacije primarnog tumora kod pacijenata kod kojih je prethodno biopsijom utvrđeno postojanje metastaze tumora nepoznatog primarnog porekla.

Materijal i metode: U retrospektivnu studiju je uključeno 56 pacijenata koji su pregledani u PET centru Centra za nuklearnu medicinu Kliničkog centra Srbije u periodu od maja 2011. do septembra 2017. godine. Pregledi sa 18FDG na PET/CT sistemu su učinjeni na 64-slajsnom Biograph True 64 PET/CT hibridnom imidžing sistemu (Siemens Medical Solutions USA Ing.) kod svih bolesnika. Akvizicija slike je urađena najmanje 60 min nakon aplikacije radiofarmaka (18FDG), koja je izvršena nakon adekvatne pripreme svakog od bolesnika.

Rezultati: Lokalizacija primarnog tumora utvrđena je kod 23 pacijenata (41%), što čini statistički značajnu vrednost 23/56, χ2 1,78; p < 0,05.

Zaključak: Imajući u vidu dobijene rezultate, 18FDG PET/CT predstavlja značajan pomak u neinvazivnoj dijagnostici primarnog tumora nepoznatog porekla.

Ključne reči : Tumori nepoznatog porekla, PET/CT, 18-FDG

 

References

Saidha NK, Ganguly M, Sidhu HS, Gupta S. The Role of 18FDG PET/CT in Evaluation of Unknown Primary Tumours. Indian J Surg Oncol 2013 Sep; 4(3): 236–241.

Pavlidis N. Cancer of unknown primary biological and clinical characteristics. Ann Oncol 14 2003: iii 111-iii 118.

Poeppel TD, Krauze BJ, Heusner TA et al. PET/CT for the staging and follow-up of patients with malignancies. Eur J Radiol 2009; 70:382-392.

Ficher B, Lassen U, Mortensen J et al. Preoperative staging of lung cancer with combined PET/CT. N Engl J Med 2009; 361:32-39.

Lardinois D, Weder V, Hany TF et al. Staging of non-small-cell lung cancer with intergratet pozitron emission tomography and conputed tomography. N Engl J Med 2003; 348:2500-2507.

Johansen J, Buus S, Loft A et al. Prospective study of 18FDG-PET in detection and management of patiens with lymph node metastazes to the neck from unknown primary tumor. Results from the DAH-ANCA-13 study. Head Neck 2008; 30:471-478.

Keller F, Psychogios G, Linke R et al. Carcinoma of unknown primary in the head and neck: Conparasion between positron emission tomography (PET) and PET/CT. Head neck 2011; 33:1569-1575.

Roh JL, Kim JS, Lee JH et al. Utility of combined (18) F-fluorodeoxyglucosae-positron emission tomography and computed tomography in patiens with cervical metastazes from unknown primary tumors. Oral oncol 2009; 45:218-224.

Rusthoven KE, Koshy M, Paulino AC. The role of fluorodeoxyglucosae-positron emission tomography in cervical lymph node metastazes from an unknown primary tumor. Cancer 2004; 101:2641-2649.

Fletcher JW, Đulbegović B, Soares HP, et al. Recommendations on the use of 18F – FDG PET/CT in oncology. J Nucl Med 2008; 49:480-508.

Kwee TC, Kwee RM. Combined FDG-PET/CT for the detection of unknown primary tumors: systematic review and meta-analysis. Eur Radiol 2009; 19:731-744.

Thomas C. Kwee, Sandip Basu, Gang Cheng and Abass Alavi ; FDG PET/CT in carcinoma unknown primary ; 2010; 37(3):635-644.

Karapolat I, Kumanloglu K. Impact of FDG PET/CT for the Detection of Unknown Primary Tumors in Pacients with Cervical Lymph Node Metastases. Mol Imaging Radionucl Ther 2012; 21(2):63-68.

Moller AKH, Loft A, Berthelsen AK et al. A Prospective Comparasion of 18F-FDG PET/CT and CT as Diagnostic Tools to Identify the Primary Tumor Site in Patients with Extracervical Carcinoma of Unknown primary Site. Oncologist 2012; 17:1146-1154.

Yaylali O, Kirac FS, Yuksel D. The role of 18F-FDG PET/CT in the detection of unknown primary malignancy: a retrospective study. Turk J Med Sci 2016; 46:474-482.

Published
2019/01/15
Section
Original Scientific Paper