摘要目的 观察化疗前后多次8F标记脱氧葡萄糖(18F-FDG)正电子发射及计算机辅助断层一体机(PET/CT)全身显像的最大标准化摄取值(SUVmax)变化率在评价非小细胞肺癌化疗疗效中的临床价值.方法 回顾分析2008年7月至2014年7月在苏州大学附属第一医院就诊的18例Ⅳ期非小细胞肺癌患者,治疗前、治疗2～4疗程后、治疗结束后4周内分别行3次PET/CT显像;另3人次为治疗结束1年后进行,共计行57人次PET/CT全身显像.以SUVmax变化率25％为标准来评价疗效、决定治疗方案,随访至诊断明确后36个月.以同期未进行PET/CT显像的47例Ⅳ期肺癌患者为对照进行生存曲线分析.结果 (1) 7/18例的患者通过治疗前PET/CT显像新发现了转移病灶,PET/CT显像灵敏度为91.7％,阳性预测值为93.2％.(2)以SUVmax变化率评价疗效后,有5例患者在第2次显像后改变治疗方案;2例患者在第3次显像后增加靶向治疗药物.(3)行PET/CT显像的18例患者生存期明显长于对照组,差异有统计学意义(P＜0.05).结论 18F-FDG PET/CT显像的SUVmax变化率可以用来评价肺癌疗效并判断预后.

abstractsObjective To evaluate the clinical value of changes of maximum standardized uptake value (SUVmax) in series 18F-FDG PET/CT imaging before and after chemotherapy for non-small cell lung cancer.Methods From July 2008 to July 2014,a total of 18 patients with pathological confirmed advanced NSCLC who received systemic chemotherapy were enrolled.18 F-FDG PET/CT scans were performed before,3-4 weeks after 2-4 cycles chemotherapy,3-4 weeks after the end of chemotherapy for all patients,and added fourth scan for 3 patients 1 year later.The SUVmax of region of interesting was calculated.The histological diagnosis or clinical findings in a 36 months follow-up period served as the standard of control.Results New metastases foci were found by 18F-FDG PET/CT scans before chemotherapy in 7 of 18 patients.The plans of chemotherapy for 5 patients were changed as therapeutic responses were evaluated according to changes of SUVmax.Targeted therapy was added for 2 patients after the end of chemotherapy.There was a statistically significant difference in outcome of survival analysis between patients performed PET/CT scans and non-performed (P ＜ 0.05).Conclusion Changes of SUVmax in series 18F-FDG PET/CT imaging before and after chemotherapy could be used to evaluate therapeutic response and effectively predict survival in patients with advanced NSCLC.