Positron emission tomographic imaging with 11C-choline in differential diagnosis of head and neck tumors:: comparison with 18F-FDG PET
Positron emission tomographic imaging with 11C-choline in differential diagnosis of head and neck tumors:: comparison with 18F-FDG PET
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DOI：
10.1007/bf02984484
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发表时间：
2004-07-01
影响因子：
2.6
通讯作者：
Endo, K
中科院分区：
文献类型：
--
作者：
Khan, N;Oriuchi, N;Endo, K
本研究的目的是评估与 F-18-氟脱氧葡萄糖 PET 相比，C-11 标记胆碱 (CHOL) 正电子发射断层扫描 (PET) 在鉴别头颈部恶性肿瘤与良性病变方面的临床价值。方法：我们在两周内使用 CHOL 和 FDG PET 对 45 名头颈部疑似病变的患者（28 名男性，17 名女性，年龄范围为 29-84 岁）进行了研究。所有患者在 CHOL 和 FDG 研究中均禁食至少 6 小时。分别在静脉注射CHOL和FDG后5分钟和50-60分钟进行PET成像。数据采集后，对 PET 图像进行衰减校正，并通过视觉解释对重建图像进行分析。然后，计算标准化摄取值（SUV），用于肿瘤示踪剂摄取的半定量评估。最后，将 PET 扫描结果与手术标本或活组织检查的组织学诊断进行比较。结果：采用CHOL PET，25名患者中24名（96％）正确检出恶性肿瘤，20名患者中14名（70％）检出良性病变，准确率为84.4％。通过 FDG PET，25 名患者中的 23 名 (92%) 被正确诊断为恶性肿瘤，20 名患者中的 13 名 (65%) 被正确诊断为良性病变，准确率达到 80%。所有病变的 CHOL 和 FDG SUV 之间均存在显着正相关（r = 0.677，p = 0.004，n = 45）。在 CHOL 和 FDG 研究中，恶性肿瘤显示示踪剂积累显着高于良性病变（5.69 +/- 1.61，n = 25 vs. 2.98 +/- 2.13，n = 20，p < 0.0001；9.21 +/- 4.23，n = 25 vs. 3.60 +/- 2.57，n = 20，p < 0.0001）。区分恶性和良性病变的截止 SUV 对于 CHOL 为 3.5，对于 FDG 为 3.9。尽管两项研究存在一些重叠，但 CHOL 在区分恶性和良性病变方面略优于 FDG。但差异无统计学意义。结论：本研究的新结果表明CHOL PET对于头颈部肿瘤成像在临床上是可行的。 CHOL PET 成像似乎能够与 FDG PET 一样有效地检测恶性头颈部肿瘤。 CHOL PET 的优点是检查时间短、肌肉吸收少。然而，CHOL和FDG在评估唾液腺病变方面均存在一定的局限性。
The aim of this study was to evaluate the clinical value of positron emission tomography (PET) with C-11-labeled choline (CHOL) for the differential diagnosis of malignant head and neck tumors from benign lesions as compared with F-18-fluorodeoxyglucose PET. Methods: We studied 45 patients (28 males, 17 females, age range, 29-84 years) with suspected lesions in the head and neck region using both CHOL and FDG PET within a 2-week period on each patient. All patients fasted for at least 6 hours for both the CHOL and FDG studies. PET imaging was performed 5 min and 50-60 min after intravenous injection of CHOL and FDG, respectively. After data acquisition, PET images were corrected for attenuation, and the reconstructed images were analyzed by visual interpretation. Then, the standardized uptake value (SUV) was calculated for semiquantitative evaluation of tumor tracer uptake. Finally the results of PET scans were compared with the histological diagnoses from surgical specimens or biopsies. Results: With CHOL PET, malignant tumors were correctly detected in 24 (96%) of 25 patients, and benign lesions in 14 (70%) of 20 patients with an accuracy of 84.4%. With FDG PET, malignancy was correctly diagnosed in 23 (92%) of 25 patients, and benign lesions in 13 (65%) of 20 patients resulting an accuracy of 80%. A significant positive correlation between CHOL and FDG SUVs was found for all lesions (r = 0.677, p = 0.004, n = 45). Malignant tumors showed significantly higher tracer accumulation than the benign lesions in both CHOL and FDG studies (5.69 +/- 1.61, n = 25 vs. 2.98 +/- 2.13, n = 20, p < 0.0001; 9.21 +/- 4.23, n = 25 vs. 3.60 +/- 2.57, n = 20, p < 0.0001). The cutoff SUV for differentiating malignant and benign lesions was 3.5 for CHOL and 3.9 for FDG. CHOL showed slightly better differentiation between malignant and benign lesions than FDG although some overlap existed on both studies. But the difference was not statistically significant. Conclusion: ne results of this study indicate that CHOL PET may be feasible clinically for head and neck tumor imaging. PET imaging with CHOL seems to be able to detect malignant head and neck tumors as effectively as FDG PET. ne advantages of CHOL PET were shorter examination period and low uptake in the muscle. However, both CHOL and FDG have some limitations in the evaluation of salivary gland lesions.