PET头颈癌 - Comparison of PET, CT, MRI.pptVIP

Positron Emission Tomography PET scanner FDG PET in Normal FDG accumulation in cancer cells Action of glucose transporter proteins. Highly active hexokinase bound to tumor mitochondria helps to trap FDG into cell. Relative hypoxia in tumor masses which activate the anaerobic glycolytic pathway. The increased glucose uptake is due to the need for nucleic acid synthesis and, therefore, is directly related to the tumor’s tendency to grow. FDG uptake is strongly related to the number of viable tumor cells, although not directly regulated by the need for DNA synthesis. PET in Oncology 顯影藥物：FDG, C-11 methionine, N-13 glutamate, F-18 FU, F-18 misonidazole, etc. 良性、惡性腫瘤鑑別 癌症病灶偵測定位 偵測癌症淋巴腺及轉移病灶 精確的癌症分期 癌症復發、壞死鑑別 藥物、受體分析 癌症篩檢 Health Care Finance Administration 臨床症狀 頭頸癌 黑色素瘤 結腸癌 淋巴瘤 食道癌 肺癌（非微小可疑點） 乳癌 Positron Emission Tomography in Head Neck cancer Positron Emission Tomography in Head Neck cancer Maxillary cancer, osteosarcoma Parotid gland ca, recurrence Nasopharyngeal carcinoma Nasopharyngeal carcinoma PET in Head Neck cancer, C/T H N cancer, recurrence 2Ms Tongue base CA, distant meta. PET in Head Neck cancer Pretreatment – staging, baseline Primary tuomr Regional nodes (neck adenopathy) Occult metastasis Posttreatment – therapeutic effect, prognosis Restaging for chemotherapy monitoring Irradiation effect and recurrence or residual Unknown primary detection PET in Head Neck cancer, primary Head Neck cancer (SCC), Liege Belgium 25 Pretherapy 13 Posttherapy either Sx C/T R/T: all Bx pf. PET in Head Neck cancer, neck nodes Head Neck cancer (SCC), Utrecht the Netherlands 81 neck sites in 54 p’ts Pretherapy: Bx Sx pf. PET in Head Neck cancer, recurrence Head Neck cancer (SCC), Utrecht the Netherlands 48 p’ts Post-R/T 3-100Ms: 24(+) Bx others F/U 6-21Ms PET in Head Neck cancer, R/T Head Neck cancer, Winston-Salem US 25 Pretherapy with 22,18 Post-R/T at 1,4M: Bx or F/U 4-11Ms. PET in Head Neck cancer, R/T Head Neck cancer, Pennsylvania US 28 p’ts Post-R/T 2-