| Objective The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of 18F-FDG PET/CT on the recurrence or metastasis of anastomotic esophageal cancer were analyzed and compared with the postoperative pathology or follow-up Kappa test.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value were compared between early SUV values,delayed SUV values and postoperative anastomotic recurrence and inflammatory lesions of esophageal cancer.The 18 F-FDG PET/CT The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of CT,PET and CT in patients with esophageal cancer after lung cancer metastasis were compared.Materials and Methods Material The clinical data of 112 patients with esophageal cancer who had previous clinical suspicion of anastomotic recurrence or metastasis from 18F-FDG PET/CT at the First Affiliated Hospital of the University of Science and Technology of China from April 2010 to September 2016 were retrospectively analyzed.Complete,accurate preoperative pathological types.Method 1.PET/CT examination was performed within the prescribed time after all the patients had been injected with 18F-FDG.The PET and CT images were fused by Siemens post-processing fusion technique,and routine diagnostic imaging was performed to measure the SUVmax in the region of interest.After the test,the patient was resting quietly,and the second scan was performed on patients whose lesion uptake was greater than that of the liver tissue which was lower than that of the brain parenchyma,ie delayed scanning.The SUVmax values measured on the first PET/CT scan are shown as early SUV and the SUVmax values measured on the second scan as SUV delay values.2.According to the statistical formula to calculate PET/CT,separate CT,PET results sensitivity,specificity,accuracy,positive predictive value and negative predictive value comparison.3.Comparative analysis of esophageal anastomotic recurrence and inflammatory lesions SUV early value,SUV delay value difference.4.To compare the sensitivity,specificity,accuracy,positive predictive value and negative predictive value of SUV early value and SUV delay value for esophageal cancer recurrence and inflammatory lesions after operation.5.To compare and analyze the sensitivity,specificity,accuracy,positive rate predictive value and negative rate of 18F-FDG PET/CT,PET and CT on the lung metastasis of esophageal cancer after treatment.Results 1.112 cases of esophageal cancer patients after surgery,PET/CT diagnosis of recurrent or metastasis in 97 cases,no recurrence in 15 cases,and postoperative pathology and follow-up results were compared with Kappa test,the test results were good.2.112 cases of esophageal cancer patients after treatment,check the pathology prompted or check after follow-up,91 cases of anastomotic recurrence,21 cases of anastomotic recurrence.97 cases were diagnosed as recurrent by PET/CT,15 cases without recurrent.The accuracy was 92.9%,the sensitivity was 98.9%,the specificity was 66.7%,the positive predictive value was 92.8% and the negative predictive value was 93.3%.And CT,PET alone on the anastomotic recurrence or metastasis to judge,suggesting that the PET/CT,PET,CT diagnostic efficiency between the three no significant difference.3.Among the 112 patients,53 patients with early SUV ranging from liver tissue to brain parenchyma had delayed scanning.The postoperative pathology confirmed or follow-up confirmed 32 patients with anastomotic recurrence of esophageal cancer,inflammatory lesions Or granulation tissue lesions in 21 cases.The SUV delay of anastomotic recurrence was higher than that of early SUV.The early SUV value was 5.4±1.0 and the SUV delay value was 7.1±1.5.After esophageal examination or follow-up for esophageal inflammatory lesions or granulation tissue proliferation,the SUV delay lesion values compared with the SUV early value decreased.The early value of SUV was 5.51±1.25,with statistical significance.4.SUV alone was used to diagnose the recurrence in 30 cases and no recurrence in 23 cases.The accuracy was 77.4%,the sensitivity was 78.1%,the specificity was 76.2%,the positive predictive value was 83.3% and the negative predictive value was 93.55%.31 cases diagnosed as relapse and 23 cases without recurrence were diagnosed as SUV with delayed diagnosis.The accuracy rate was 90.6%,the specificity was 90.5%,the specificity was 90.5%,the positive predictive value was 93.6% and the negative predictive value was 82.6 %.The sensitivity of combined SUV early diagnosis with SUV delay is higher than that of SUV alone.5.112 patients with lung metastases in 21 cases,bone metastases in 32 cases.PET/CT,PET and CT were used to diagnose them.Among them,23 cases were diagnosed as lung metastasis by PET/CT,89 cases without metastasis,the accuracy was 98.2%,the sensitivity was 100%,the specificity was 97.8% and the positive predictive value was 91.3%,The negative predictive value was 100%;the accuracy of PET was 97.3%,the sensitivity was 90.5%,the specificity was 98.9%,the positive predictive value was 95.0%,the negative predictive value was 97.8%;the accuracy of CT was 98.2% and the sensitivity was 100 %,Specificity was 97.8%,positive predictive value was 91.3%,negative predictive value was 100%..The diagnostic efficiency of the three was not statistically significant.Conclusion 1.18F-FDG PET/CT for the detection of esophageal cancer anastomotic recurrence and distant metastasis postoperative esophageal cancer patients can provide a reliable basis for the monitoring,has important clinical significance.2.18F-FDG PET/CT diagnosis of esophageal cancer anastomotic recurrence and distant metastasis after the diagnosis and postoperative pathology or follow-up results compared with high accuracy,sensitivity,specificity,Kappa test consistency.3.The SUV retardation values of esophageal cancer recurrence and inflammatory lesions after operation were statistically different.The SUV delay value of anastomotic recurrence was higher than the SUV delay value of inflammatory lesions,which had diagnostic value.4.SUV early ?SUV delay combined diagnosis of esophageal anastomotic recurrence sensitivity than SUV early use alone,can be used to identify anastomotic recurrence and benign lesions.5.For lung metastatic lesions,the diagnostic efficacy of PET/CT,PET,CT difference is not significant,if the separate detection of esophageal cancer lung metastases after the progress of changes,the recommended use of ordinary CT. |
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