Novel Strategy for a Cocktail 18F-Fluoride and 18F-FDG PET/CT Scan for Evaluation of Malignancy: Results of the Pilot-Phase Study
Novel Strategy for a Cocktail 18F-Fluoride and 18F-FDG PET/CT Scan for Evaluation of Malignancy: Results of the Pilot-Phase Study
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DOI：
10.2967/jnumed.108.058339
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发表时间：
2009-04-01
影响因子：
9.3
通讯作者：
Gambhir, Sanjiv Sam
中科院分区：
文献类型：
--
作者：
Iagaru, Andrei;Mittra, Erik;Gambhir, Sanjiv Sam
F-18-FDG PET/CT用于检测癌症和监测癌症对治疗的反应。然而，由于葡萄糖代谢率的变化，并不是所有的癌症都能被可靠地识别出来。钠F-18以前用于骨成像，可以用作PET/CT骨骼示踪剂。在单独的PET/CT研究中，联合使用F-18和F-18- fdg用于癌症检测迄今尚未有报道。方法：这是一项前瞻性的初步研究（2007年11月- 2008年11月），14例确诊为恶性肿瘤的患者（6例肉瘤、3例前列腺癌、2例乳腺癌、1例结肠癌、1例肺癌和1例恶性副神经节瘤）分别接受了F-18 PET/CT和F-18- fdg PET/CT以及F-18/F-18- fdg PET/CT联合扫描以评估恶性肿瘤（每组共3次扫描）。男性11例，女性3例（年龄19-75岁，平均50.4岁）。结果：F-18/F-18- fdg PET/CT联合扫描的解释优于F-18- fdg PET/CT（无病变遗漏）和F-18 PET/CT扫描（F-18 PET/CT扫描在相应的联合扫描中仅遗漏1个颅骨病变）。通过图像处理，F-18/F-18- fdg联合扫描产生的骨放射性示踪剂摄取结果与单独进行的F-18 PET/CT扫描相当。结论：我们的中试阶段前瞻性试验表明，联合使用F-18/F-18- fdg，然后进行一次PET/CT扫描，对于癌症检测是可行的。这种综合方法为改善病人护理和降低保健费用提供了可能。
F-18-FDG PET/CT is used for detecting cancer and monitoring cancer response to therapy. However, because of the variable rates of glucose metabolism, not all cancers are identified reliably. Sodium F-18 was previously used for bone imaging and can be used as a PET/CT skeletal tracer. The combined administration of F-18 and F-18-FDG in a single PET/CT study for cancer detection has not been reported to date. Methods: This is a prospective pilot study (November 2007-November 2008) of 14 patients with proven malignancy (6 sarcoma, 3 prostate cancer, 2 breast cancer, 1 colon cancer, 1 lung cancer, and 1 malignant paraganglioma) who underwent separate F-18 PET/CT and F-18-FDG PET/CT and combined F-18/F-18-FDG PET/CT scans for the evaluation of malignancy (a total of 3 scans each). There were 11 men and 3 women (age range, 19-75 y; average, 50.4 y). Results: Interpretation of the combined F-18/F-18-FDG PET/CT scans compared favorably with that of the F-18-FDG PET/CT (no lesions missed) and the F-18 PET/CT scans (only 1 skull lesion seen on an F-18 PET/CT scan was missed on the corresponding combined scan). Through image processing, the combined F-18/F-18-FDG scan yielded results for bone radiotracer uptake comparable to those of the F-18 PET/CT scan performed separately. Conclusion: Our pilot-phase prospective trial demonstrates that the combined F-18/F-18-FDG administration followed by a single PET/CT scan is feasible for cancer detection. This combined method opens the possibility for improved patient care and reduction in health care costs.