FDG PET for the study of primary hepatic malignancies in children.
FDG PET for the study of primary hepatic malignancies in children.
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FDG PET 用于研究儿童原发性肝脏恶性肿瘤。
DOI：
10.1002/pbc.20524
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发表时间：
2006
期刊：
影响因子：
--
通讯作者：
Shulkin,BarryL
中科院分区：
文献类型：
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作者：
Mody,RajenJ;Pohlen,JudithA;Malde,Sachit;Strouse,PeterJ;Shulkin,BarryL
目的本文描述了7例原发性肝脏恶性肿瘤（5例肝母细胞瘤，2例肝胚胎性横纹肌肉瘤）儿童（11次扫描）的FDG PET的应用，以及其他成像（CT和MRI）、血清肿瘤标志物和肿瘤病理学。 材料与方法7例经手术病理证实的肝脏恶性肿瘤患儿行11次FDG PET扫描，其中1例进行分期，6例进行再分期。定性评估肿瘤摄取FDG，并与生化和放射学结果进行比较。 结果7例患者中6例（10/11）出现异常摄取。三名患者随后接受了部分肝切除术，一名患者接受了脑活检，证实了FDG的异常摄取表明肿瘤存活。在一个病人中，强烈的吸收是由于坏死性肉芽肿。在1例患者中，由于不依从禁食，图像不理想。 结论儿童原发性肝肿瘤糖酵解活性增高，可采用PET和18F-FDG显像。该技术可能是最有用的评估反应的治疗，在以下AFP（甲胎蛋白）阴性的情况下，并检测转移性疾病，虽然大量的患者将需要进行研究，以确认我们的初步研究结果。非肿瘤性炎症也可能积聚FDG，并可能与恶性肿瘤混淆。由于这些肿瘤是罕见的，前瞻性多中心研究是必要的，以确定真正的临床效用的FDG PET成像在儿童原发性肝脏恶性肿瘤的管理。© 2005 Wiley-Liss公司。
Purpose This manuscript describes the use of FDG PET in a series of 7 children (11 scans) with primary hepatic malignancies (5 patients with hepatoblastoma, 2 patients with hepatic embryonal rhabdomyosarcoma), together with other imaging (CT and MRI), serum tumor markers, and tumor pathology. Materials and Methods Seven children with pathologically proven hepatic malignancies underwent 11 FDG PET scans for staging (1 patient) or restaging (6 patients). Tumor uptake of FDG was assessed qualitatively and compared with biochemical and radiological findings. Results Abnormal uptake was demonstrated in 6 of 7 patients (10 of 11 scans). Three patients subsequently underwent partial hepatic resection, and one underwent brain biopsy, confirming in each that the abnormal uptake of FDG indicated viable tumor. In one patient, intense uptake was due to necrotizing granulomas. In one patient, images were suboptimal due to noncompliance with fasting. Conclusion Primary hepatic tumors of childhood usually demonstrate increased glycolytic activity, which allows them to be imaged using PET and the tracer 18F-FDG. The technique is probably most useful for assessing response to therapy, in following AFP (alfa fetoprotein) negative cases and for detecting metastatic disease although a large series of patients will need to be studied to confirm our initial findings. Non neoplastic inflammation may also accumulate FDG and could be confused with malignancy. As these tumors are rare, prospective multicenter studies are necessary to determine the true clinical utility of FDG PET imaging in the management of children with primary hepatic malignancies. © 2005 Wiley-Liss, Inc.