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비뇨기과 영역에서 18F-FDG PET/CT의 임상적 역할

The Clinical Roles of 18F-Fluorodeoxyglucose Positron Emission Tomography/Computerized Tomography for Urological Disease

대한비뇨기과학회지 2008년 49권 9호 p.775 ~ 780
유광호 ( Ryu Kwang-Ho ) - 전남대학교 의과대학 비뇨기과학교실

정승일 ( Jung Seung-Il ) - 전남대학교 의과대학 비뇨기과학교실
박광성 ( Park Kwang-Sung ) - 전남대학교 의과대학 비뇨기과학교실
강택원 ( Kang Taek-Won ) - 전남대학교 의과대학 비뇨기과학교실
권동득 ( Kwon Dong-Deuk ) - 전남대학교 의과대학 비뇨기과학교실
류수방 ( Ryu Soo-Bang ) - 전남대학교 의과대학 비뇨기과학교실
정호석 ( Chung Ho-Suck ) - 전남대학교 의과대학 비뇨기과학교실

Abstract


Purpose: We evaluate the clinical roles of 18F-fluorodeoxyglucose positron emission tomography/computerized tomography(18F-FDG PET/CT) for diagnosing disease in the urogenital tract, and we compared this with the other established radiologic and pathologic diagnoses.

Materials and Methods: From June 2006 to June 2007, the total number of subjects who underwent 18F-FDG PET/CT was 4,438. The mean patient age was 57.4±7.6 years and the ratio of males to females was 1.28:1. During the study period, except for 152 patients who had been given a diagnosis of urologic tumor, 614(14.3%) healthy subjects and 3,672(85.7%) patients with non-urologic tumors were enrolled. The results of detecting urologic disease by 18F-FDG PET/CT were compared with the results of detecting urologic disease by conventional imaging techniques and the postoperative histopathological diagnoses.

Results: With including 147 healthy subjects and 251 non-urologic tumor patients, 398 (9.3%) urologic diseases were detected on 18F-FDG PET/CT. Diseases of the kidney, adrenal and prostate were frequently found(215, 95 and 52 patients, respectively). A thorough examination was indicated for 153(3.6%) of the patients as a result of positive findings that suggested possible tumor. A total 93 urologic cancers were confirmed, and the overall positive predictive value of 18F-FDG PET/CT was 60.7%. The positive predictive value for adrenal, kidney, bladder and prostate cancer were 87.7%, 73.3%, 57.1% and 14.0%, respectively.

Conclusions: 18F-FDG PET/CT was not superior to conventional imaging for making the diagnosis of urologic disease. But 18F-FDG PET/CT was more predictive for adrenal and renal tumor than for bladder and prostate tumor. So, urologic tumor that is incidentally detected on 18F-FDG PET/ CT, and especially adrenal and renal tumor, should be closely evaluated.

키워드

Fluorodeoxyglucose 18F;Positron-emission tomography;Tomography;emission-computed
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