INTESTINE Vol.13 No.2(2-4-2)


特集名 大腸癌画像診断の最先端
題名 2. 大腸癌の存在診断 (4) PET b. 大腸癌におけるFDG-PET(PET/CT)の臨床的有用性
発刊年月 2009年 03月
著者 北島 一宏 獨協医科大学放射線医学教室/PETセンター
著者 村上 康二 獨協医科大学PETセンター
著者 山崎 英玲奈 獨協医科大学PETセンター
著者 楫 靖 獨協医科大学放射線医学教室
著者 百目木 泰 獨協医科大学第一外科学教室
著者 椿 昌裕 獨協医科大学第一外科学教室
著者 砂川 正勝 獨協医科大学第一外科学教室
【 要旨 】 今やFDG-PET(PET/CT)は癌の臨床に欠かすことのできない診断法になり,急速な勢いで普及している.大腸癌の診療においても進行癌における病期診断や再発,遠隔転移の診断などでとくに威力を発揮する.術前リンパ節転移の診断は従来のCTやMRIよりも診断能は上昇するが,サイズの小さな病巣では感度が低く十分とは言い難い.PET/CTに造影CTを加えると,さらに有用性が高まる.PET/CTにCT angiographyや仮想内視鏡などの三次元画像を組み合わせると新たな“術前マッピング”として有用な画像情報を得ることができる.
Theme Frontier of image diagnosis for colorectal carcinoma
Title Clinical utility of colorectal cancer diagnosis through FDG-PET (PET/CT) observation
Author Kazuhiro Kitajima Department of Radiology / PET Center, Dokkyo Medical University School of Medicine
Author Koji Murakami PET Center, Dokkyo Medical University School of Medicine
Author Erena Yamasaki PET Center, Dokkyo Medical University School of Medicine
Author Yasushi Kaji Department of Radiology, Dokkyo Medical University School of Medicine
Author Yasushi Domeki Department of First Surgery, Dokkyo Medical University School of Medicine
Author Masahiro Tsubaki Department of First Surgery, Dokkyo Medical University School of Medicine
Author Masakatsu Sunagawa Department of First Surgery, Dokkyo Medical University School of Medicine
[ Summary ] We outline the usefulness and limitations of evaluating colorectal cancer through use of FDG-PET (PET/CT) scanning, in relation to categories such as detection of primary lesions, lymph node metastasis or recurrence, as well as detection of distant metastasis. PET (PET/CT) scanning is effective for detecting metastases and recurrence rather than evaluation of primary tumors. It is especially useful for finding unexpected lesions as compared to other imaging modalities. 3D images reconstructed by fused contrast enhanced CTs and FDG-PET scans are used to produce navigation images. These images may be used to detect hypermetabolic tumors and vascular structures simultaneously. They are useful for preoperative mapping to clarify the correlationship of tumors and blood vessels.
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