| Purpose To investigate the clinical value of whole body positron emission tomography/computed tomography(PET/CT)as an imaging tool in the detection,diagnosis,treatment and follow-up of ophthalmic tumors.Subjects and methods 1.Subjects1.1 Hospitalized patients who were diagnosed or suspected of ophthalmic tumors in our department and were performed whole body PET/CT in our PET Center from August 1st 2010 to July 31 st 2015 were retrospectively collected.1.2 Inclusion criteria: patients who underwent surgery or biopsy with pathological findings and patients without pathological result but had long-term follow-up results.1.3 Exclusion criteria: patients without pathological or follow-up results.2.Methods2.1 The patients’ clinical data including past medical history,chief complain,visual acuity,biomicroscopy,funduscopy,ultrasound scan,CT and/or MRI were collected.2.2 The gold standard was pathologic examination and comprehensive clinical follow-up,the follow-up time was equal or more than six months.2.3 Standard uptake value(SUV)is defined as the ratio of the activity within the tissue(Bq/ml)to the injected dose(Bq)divided by the body weight(kg).The SUV is expressed as its maximum(SUVmax).2.4 PET images with SUVmax ≥2.5 were considered to be PET-positive and malignant as imaging diagnostic criteria.SUVmax <2.5 was considered to be PET-negative and benign as imaging diagnostic criteria.2.5 PET/CT findings were compared with pathologic findings or long-term follow-up.The sensitivity,specificity and accuracy of whole body PET/CT in ophthalmic tumors were investigated.Results Thirty patients,including 18 men(60.0%)and 12 women(40.0%)were collected.The mean age was 43.0 years(range 4-63y).One patient had a past history of malignancy 4 years ago,the other patients had no past history of malignancy.Among the 30 patients,24 patients performed whole body PET/CT before management and 6 after surgery.Seventeen patients had orbital tumors,11 intraocular tumors,one eyelid tumor and one conjunctival tumor.The mean size of orbital lesions was 26.8×17.8 mm,intraocular tumors was 11.2×6.1 mm.In these 24 patients,PET-positive were found in 15 patients and PET-negative in 9 patients.Seventeen patients were diagnosed as malignant tumor and 7 as benign tumor by gold standard.As a whole,the overall sensitivity,specificity,accuracy,positive predictive value and negative predictive value of whole body PET/CT in the ophthalmic tumors in this series were 76.5%,71.4%,75.0%,86.7% and 55.6% respectively.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of whole body PET/CT in orbital tumors were 100%,60.0%,84.6%,80.0% and 100%,in intraocular tumors were 62.5%,100%,70.0%,100% and 40.0%,respectively.PET/CT findings help us make appropriate treatment options in 27 out of 30(90.0%)patients.In which,PET/CT has a positive effect on treatment in 5 of 6 postoperative patients.In addition,PET/CT led to treatment strategy alteration in 12 patients(40.0%).Conclusions This study indicates that whole body PET/CT was an effective imaging modality for patients with ophthalmic tumors.It has important values in detecting,diagnosing and developing treatment plans of ophthalmic tumors.It was more sensitive and accurate for the detection of orbital tumors than intraocular tumors.It help us to estimate tumor character and find distant lesions,thus,lead to appropriate treatment options for patients before operations.For postoperative patients,it could discover the residual lesion or metastatic tumor and help to make further treatmemt plan. |
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