[18F]3′-deoxy-3′-fluorothymidine PET for the diagnosis and grading of brain tumors
[18F]3′-deoxy-3′-fluorothymidine PET for the diagnosis and grading of brain tumors
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DOI：
10.1007/s00259-004-1742-3
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发表时间：
2005-06-01
影响因子：
9.1
通讯作者：
Moon, DH
中科院分区：
文献类型：
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作者：
Choi, SJ;Kim, JS;Moon, DH
本研究旨在探讨[F-18] 3′-脱氧-3′-氟胸苷（FLT）正电子发射断层扫描（PET）在脑肿瘤诊断和分级中的可行性。方法：26例脑肿瘤患者（18例）或非肿瘤病变患者（8例），其中男15例，女11例。2-[F-18]氟-2-脱氧-d -葡萄糖（FDG）和FLT在注射370 MBq FDG或FLT 1小时后使用专用PET扫描仪获得PET图像。与正常脑组织相比，病变对FDG和FLT的摄取进行了视觉和半定量评估。结果：在26个脑病变中，4个显示与正常灰质相比FDG摄取增加（5级）。这四个病变显示FLT摄取强烈增加，均为高级别肿瘤。与正常灰质相比，22个FDG摄取相似（4级）或减少（1-3级）的病变表现出不同的病理。在18个脑肿瘤中，FLT PET显示所有12个高级别肿瘤摄取增加，但FDG摄取变化。在22例FDG PET上与正常灰质摄取相似或减少的脑病变中，FLT PET诊断脑肿瘤的敏感性和特异性分别为79%（11/14）和63%（5/8）。FLT PET显示14例脑肿瘤FDG摄取比显著高于病变与灰质的比值（p=0.012）和病变与白质的比值（p=0.036），高（5.1 +/- 2.6）和低（2.1 +/- 1.1）级肿瘤间差异显著（p=0.029）。在9个胶质瘤中，FLT摄取与Ki-67增殖指数显著相关（rho=0.817, p=0.007）。结论：FLT PET对脑肿瘤的分级及细胞增殖有一定的评价价值。FDG PET在评估与正常灰质摄取相似或减少的脑病变时显示出高灵敏度和良好的对比。然而，FLT PET在区分肿瘤和非肿瘤病变方面似乎没有足够的用处。
The aim of this study was to evaluate the feasibility of using [F-18] 3'-deoxy-3'-fluorothymidine (FLT) positron emission tomography (PET) for the diagnosis and grading of brain tumors.Methods: The patient population comprised 26 patients (15 males, 11 females) with brain tumors (n=18) or nontumorous lesions (n=8). 2-[F-18]fluoro-2-deoxy-D-glucose (FDG) and FLT PET images were obtained using a dedicated PET scanner 1 h after the injection of 370 MBq of FDG or FLT. Uptake of FDG and FLT by the lesions was visually and semiquantitatively assessed in comparison with normal brain tissue.Results: Of 26 brain lesions, four showed increased FDG uptake compared with normal gray matter (grade 5). These four lesions showed intensely increased FLT uptake and were all high-grade tumors. Twenty-two lesions with similar (grade 4) or decreased (grades 1-3) FDG uptake compared with normal gray matter showed variable pathology. Among the 18 brain tumors, FLT PET showed increased uptake in all 12 high-grade tumors but FDG uptake was variable. In 22 brain lesions with similar or decreased uptake compared with normal gray matter on FDG PET, the sensitivity and specificity of FLT PET for the diagnosis of brain tumor were 79% (11/14) and 63% (5/8), respectively. The uptake ratios of 14 brain tumors on FLT PET were significantly higher than the lesion to gray matter ratios (p=0.012) and lesion to white matter ratios (p=0.036) of FDG uptake and differed significantly between high (5.1 +/- 2.6) and low (2.1 +/- 1.1) grade tumors (p=0.029). In nine gliomas, FLT uptake was significantly correlated with the Ki-67 proliferation index (rho=0.817, p=0.007).Conclusion: These findings indicate that FLT PET is useful for evaluating tumor grade and cellular proliferation in brain tumors. It displayed high sensitivity and good contrast in evaluating brain lesions that showed similar or decreased uptake compared with normal gray matter on FDG PET. FLT PET, however, did not appear to be sufficiently useful for differentiating tumors from nontumorous lesions.