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卵巢癌是女性生殖系统常见的恶性肿瘤之一,在全球范围内,其在女性恶性肿瘤发病率及病死率中均居第8位,预后较差[1-2]。目前,我国卵巢癌的流行现状不容乐观,据2019年中国肿瘤登记年报[3]数据显示,2016年我国卵巢癌新发病例15115例,在中国女性恶性肿瘤发病病例中位居第11位;死亡病例7241例,在中国女性恶性肿瘤死因病例中位居第9位。卵巢癌症状出现较晚,早期可表现为无症状,诊断较为困难,且初次治疗后复发率高,严重威胁着女性的生命和健康[4]。世界卫生组织将卵巢癌按细胞来源分为3大类:上皮性肿瘤、生殖细胞肿瘤和性索间质肿瘤。其中,上皮性肿瘤最常见,约占卵巢癌的85%~90%,而高级别浆液性癌是上皮性肿瘤最常见的亚型[5]。
目前,影像学检查在卵巢癌的临床诊疗中扮演着重要角色,不同的成像模式可为临床医师提供不同类型的信息。超声、CT、MRI等解剖成像可以提供器官、病变精细的解剖形态信息;核医学分子影像技术不但可以提供形态信息,而且可以提供组织生物化学的功能信息。笔者就PET/CT、PET/MRI及SPECT/CT在卵巢癌诊疗中的应用进展进行综述。
核医学分子影像在卵巢癌诊疗中的应用
Application of nuclear medicine molecular imaging in the diagnosis and treatment of ovarian cancer
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摘要: 卵巢癌是女性生殖系统常见的恶性肿瘤之一,早期诊断困难,初次治疗后容易复发,预后较差,其诊疗仍面临着巨大挑战。影像学在卵巢癌的诊疗中是不可或缺的重要组成部分。其中,核医学分子影像技术已经成为卵巢癌诊疗中极具潜力的非侵入性显像手段。PET/CT在卵巢癌的诊断、分期、治疗疗效、预后及复发的评估中应用广泛;PET/MRI因其较高的软组织分辨率和较低的辐射剂量,在卵巢癌诊疗中表现出较大的优势;SPECT/CT也因多种新型放射性示踪剂的研发而在卵巢癌的诊疗中发挥着重要作用。笔者就PET/CT、PET/MRI及SPECT/CT在卵巢癌中的应用及研究进展进行综述,以期进一步提高分子影像技术在卵巢癌诊疗中的价值。
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关键词:
- 卵巢肿瘤 /
- 正电子发射断层显像术 /
- 体层摄影术,X线计算机 /
- 磁共振成像 /
- 体层摄影术,发射型计算机,单光子
Abstract: Ovarian cancer is one of the common malignant tumors of female reproductive system. It is difficult to diagnose early, prone to relapse after initial treatment, and has a poor prognosis, so diagnosis and treatment still face great challenges. Imaging examination is an indispensable part in the diagnosis and treatment of ovarian cancer. Among them, nuclear medicine molecular imaging technology has become a highly potential non-invasive imaging method in the diagnosis and treatment of ovarian cancer. PET/CT has been widely used in the diagnosis, staging, treatment efficacy, prognosis, and recurrence evaluation of ovarian cancer. PET/MRI has shown significant advantages in the diagnosis and treatment of ovarian cancer due to its high soft tissue resolution and low radiation dose. SPECT/CT also plays an important role in the diagnosis and treatment of ovarian cancer due to the development of various new radioactive tracers. The authors review the application and research progress of PET/CT, PET/MRI and SPECT/CT about ovarian cancer, in order to further improve the value of molecular imaging technology in the diagnosis and treatment of ovarian cancer. -
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