INVIVO IMAGING OF GLUCOSE CONSUMPTION AND LACTATE CONCENTRATION IN HUMAN GLIOMAS
INVIVO IMAGING OF GLUCOSE CONSUMPTION AND LACTATE CONCENTRATION IN HUMAN GLIOMAS
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DOI：
10.1002/ana.410310315
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发表时间：
1992-03-01
影响因子：
11.2
通讯作者：
HEISS, WD
中科院分区：
文献类型：
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作者：
HERHOLZ, K;HEINDEL, W;HEISS, WD
通过正电子发射断层扫描 (PET) 和质子磁共振波谱 (H-1-MRS) 对 20 名经组织学证实的神经胶质瘤患者进行了研究。带有 F-18-2-氟-2-脱氧-D-葡萄糖 (FDG) 的 PET 提供了葡萄糖代谢率的断层图。 MRS 图像是通过将体积选择性激励与相位编码采集相结合获得的。通过 32 x 32 梯度相位编码步骤，实现了 7 x 7 毫米的面内分辨率。根据这组光谱，创建乳酸图并与葡萄糖代谢的 PET 图进行比较。肿瘤内的最大葡萄糖代谢率（相对于大脑对侧区域的葡萄糖代谢率）与最大乳酸浓度（相对于大脑对侧部分的 N-乙酰天冬氨酸峰值）显着相关。在 8 个肿瘤中，没有检测到乳酸，其中 7 个肿瘤的最大葡萄糖代谢率低于中位值。乳酸浓度最高的肿瘤也具有最高的葡萄糖代谢率。通过 PET 和 MRS 图像的三维对齐，可以分析 9 名患者的葡萄糖代谢率和乳酸浓度之间的地形关系。在该分析中，最大乳酸浓度通常不是在与最大葡萄糖代谢相同的位置发现的，但乳酸往往积聚在肿瘤囊肿、坏死区域和侧脑室附近。 FDG PET 和 H-1-MRS 成像相结合，详细展示了非氧化糖酵解、葡萄糖摄取和乳酸沉积这两个极点之间的空间关系。这两种方法都可以用作诊断工具来研究能量代谢异常，这可能是去分化和恶性肿瘤的指标。
Twenty patients with histologically confirmed gliomas were studied with positron emission tomography (PET) and proton magnetic resonance spectroscopy (H-1-MRS). PET with F-18-2-fluoro-2-deoxy-D-glucose (FDG) provided tomograms of the metabolic rate of glucose. MRS images were obtained by combining volume-selective excitation with phase-encoded acquisition. With 32 x 32 gradient phase-encoding steps, an in-plane resolution of 7 x 7 mm was achieved. From this set of spectra, lactate maps were created and compared with PET maps of glucose metabolism. Maximum glucose metabolic rates within tumors (relative to metabolic rates of glucose in contralateral regions of the brain) were correlated significantly with maximum lactate concentrations (relative to N-acetyl aspartate peaks in the contralateral part of the brain). In 8 tumors, no lactate was detected, and in 7 of these the maximum glucose metabolic rate was below the median value. The tumor with the highest lactate concentration also had the highest glucose metabolic rate. The topographic relation between glucose metabolic rate and lactate concentration could be analyzed in 9 patients by three-dimensional alignment of the PET and MRS images. In that analysis, maximum lactate concentrations were often not found in the same location as maximum glucose metabolism, but lactate tended to accumulate in tumor cysts, necrotic areas, and the vicinity of the lateral ventricles. The combination of FDG PET and H-1-MRS imaging demonstrates details of the spatial relation between the two poles of nonoxidative glycolysis, glucose uptake and lactate deposition. Both methods can be used as diagnostic tools to study an abnormality of energy metabolism that may be an indicator of dedifferentiation and malignancy.