臨牀消化器内科 Vol.16 No.1(5)


特集名 膵疾患の画像診断
題名 FDG-PETを用いる膵癌の診断
発刊年月 2001年 01月
著者 阪原 晴海 浜松医科大学放射線科
著者 佐賀 恒夫 京都大学大学院医学研究科核医学・画像診断学
著者 中本 裕士 京都大学大学院医学研究科核医学・画像診断学
【 要旨 】 腫瘍FDG-PET検査は悪性腫瘍組織の亢進した糖代謝を画像化する核医学診断法で,従来の形態画像診断法では得られない情報を提供する.膵癌においても,形態画像では明らかでない病巣の検出,腫瘍の良・悪性の鑑別,正確な病期診断に応用され,さらに一度に全身の検索が可能な全身FDG-PETの登場により,予期せぬ病巣の検出も可能となった.通常の画像診断法に比べその解像度は低く,1cm以下の小病変の検出には限界があり,炎症巣への集積,生理的集積の問題など今後,解決されなければならない点もあるが,従来の形態画像診断法とうまく組み合わせることにより,膵癌患者の診療において貴重な情報を与えてくれると考えられる.
Theme Imaging in Pancreatic Disease
Title Diagnosis of Pancreatic Cancer by FDG-PET
Author Harumi Sakahara Department of Radiology, Hamamatsu University School of Medicine
Author Tsuneo Saga Department of Nuclear Medicine and Diagnostic Imaging, Kyoto Unversity School of Medicine
Author Yuji Nakamoto Department of Nuclear Medicine and Diagnostic Imaging, Kyoto Unversity School of Medicine
[ Summary ] FDG-PET imaging is a newly developed nuclear medicine diagnostic procedure, which images the active glucose metabolism of malignant tumor tissues. In the diagnosis of pancreatic cancers, FDG-PET is used to depict those lesions, which are indeterminate or nondetectable using conventional imaging modalities, to differentiate malignant from benign pancreatic abnormalities, and to stage pancreatic cancers accurately. Furthermore, recently introduced whole-body PET machines, which can examine the whole body at one time, can depict unexpected metastatic foci for changes in therapeutic strategy. However, compared to the conventional imaging modalities, the resolution of FDG-PET is low, and the detectability of lesions smaller than 1cm is unsatisfactory. In addition, the accumulation of FDG in the inflammatory foci and physiological uptake by various normal organs are additional limitations of FDG-PET which remain to be solved. By properly combining FDG-PET with conventional imaging modalities, we can receive precious information for the treatment of patients with pancreatic cancer.
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