正电子发射断层扫描 (PET) 是最重要的临床分子成像方式，尤其是在肿瘤学领域。与计算机断层扫描 (CT) 和磁共振成像 (MRI) 等传统解剖形态成像方法不同，PET 可在分子和细胞水平上提供内部活动的详细可视化。 18-氟-氟脱氧葡萄糖（[18F]FDG）-PET与对比增强CT（ceCT）相结合显着提高了各种癌症的检出率。适当的患者选择至关重要，医生应根据具体的临床标准和证据仔细评估 [18F]FDG-PET/CT 的适当性。由于其诊断准确性高，[18F]FDG-PET/CT 对于评估疾病范围、分期和已知恶性肿瘤的再分期以及评估治疗反应是必不可少的。 PET/CT 成像在患者管理方面具有显着优势，特别是通过识别可能未被发现的隐匿性转移。这有助于防止不必要的手术，使许多患者能够转而接受全身化疗。然而，值得注意的是，手术计划的黄金标准仍然是 CT 和/或 MRI，具体取决于身体部位。这些成像方式，无论有或没有相关血管造影，都能提供卓越的对比度和空间分辨率，这对于详细的手术准备和计划至关重要。 [18F]FDG-PET/CT 在癌症的精确和早期诊断中发挥着核心作用，为个性化治疗计划做出了重大贡献。然而，它也有局限性，包括非肿瘤特异性摄取，以及由于某些分化良好的肿瘤细胞系摄取较低而可能无法准确捕获某些肿瘤类型的代谢活动。因此，它应该用于临床场景，提供其他成像方式无法提供的重要诊断见解。要点：根据临床适当性标准和现有证据选择性使用 [18F]FDG-PET/CT，以优化资源利用并尽量减少患者暴露。在治疗计划和监测中采用 [18F]FDG-PET/CT，特别是用于评估 FDG 亲和性淋巴瘤和实体瘤的化疗或放疗反应。如果可用，[18F]FDG-PET/CT 可以与其他诊断工具（例如 MRI）集成，以提高整体诊断准确性。© 2024。作者。

Positron emission tomography (PET) stands as the paramount clinical molecular imaging modality, especially in oncology. Unlike conventional anatomical-morphological imaging methods such as computed tomography (CT) and magnetic resonance imaging (MRI), PET provides detailed visualizations of internal activity at the molecular and cellular levels. 18-fluorine-fluorodeoxyglucose ([18F]FDG)-PET combined with contrast-enhanced CT (ceCT) significantly improves the detection of various cancers. Appropriate patient selection is crucial, and physicians should carefully assess the appropriateness of [18F]FDG-PET/CT based on specific clinical criteria and evidence. Due to its high diagnostic accuracy, [18F]FDG-PET/CT is indispensable for evaluating the extent of disease, staging, and restaging known malignancies, and assessing the response to therapy. PET/CT imaging offers significant advantages in patient management, particularly by identifying occult metastases that might otherwise go undetected. This can help prevent unnecessary surgeries, allowing many patients to be redirected to systemic chemotherapy instead. However, it is important to note that the gold standard for surgical planning remains CT and/or MRI, depending on the body region. These imaging modalities, with or without associated angiography, provide superior contrast and spatial resolution, essential for detailed surgical preparation and planning. [18F]FDG-PET/CT has a central role in the precise and early diagnosis of cancer, contributing significantly to personalized treatment plans. However, it has limitations, including non-tumor-specific uptake and the potential to inaccurately capture the metabolic activity of certain tumor types due to low uptake in some well-differentiated tumor cell lines. Therefore, it should be utilized in clinical scenarios where it offers crucial diagnostic insights not readily available with other imaging modalities. KEY POINTS: Use [18F]FDG-PET/CT selectively based on clinical appropriateness criteria and existing evidence to optimize resource utilization and minimize patient exposure. Employ [18F]FDG-PET/CT in treatment planning and monitoring, particularly for assessing chemotherapy or radiotherapy response in FDG-avid lymphoma and solid tumors. When available, [18F]FDG-PET/CT can be integrated with other diagnostic tools, such as MRI, to enhance overall diagnostic accuracy.© 2024. The Author(s).