Diagnostic usefulness of fluorine-18-α-methyltyrosine positron emission tomography in combination with 18F-fluorodeoxyglucose in sarcoidosis patients
Diagnostic usefulness of fluorine-18-α-methyltyrosine positron emission tomography in combination with 18F-fluorodeoxyglucose in sarcoidosis patients
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DOI：
10.1378/chest.06-2160
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发表时间：
2007-04-01
期刊：
影响因子：
9.6
通讯作者：
Mori, Masatomo
中科院分区：
文献类型：
--
作者：
Kaira, Kyoichi;Orinchi, Noboni;Mori, Masatomo
目的：L[3-F-18]-α-甲基酪氨酸（F-18-FMT）是一种用于正电子发射断层扫描（PET）的氨基酸示踪剂，用于肿瘤检测，因为恶性肿瘤细胞基于氨基酸转运蛋白表达增加而积累 F-18-FMT。本研究旨在探讨 F-18-FMT PET 联合氟 18-氟脱氧葡萄糖 (F-18-FDG) PET 诊断疑似恶性肿瘤患者的结节病的有效性。背景：24 名疑似恶性肿瘤的结节病患者接受了 F-18-FDG 和 F-18-FMT PET。该研究纳入了 17 名具有类似恶性疾病的肺外表现的患者（13 名患者患有全身性淋巴结肿大，其中 3 名患者伴有肝脾肿大；3 名患者有肝脾肿大但不伴有淋巴结肿大；1 名患者患有多发骨病变），3 名癌症患者出现双侧肺门淋巴结肿大，以及 4例患者出现多个类似肺转移的结节。结果：所有患者的淋巴结肿大中F-18-FDG的摄取增加，而F-18-FMT的积累没有增加。 F-18-FDG 和 F-18-FMT 的标准化摄取值 (SUV) 分别为 5.01 +/- 2.15 和 0.77 +/- 0.24（平均 SD）。所有结外病变（例如肝脏、脾脏和硼酸）在 F-18-FDG PET 上呈视觉阳性，在 F-18-FMT PET 上呈阴性。所有患者均未发现肿瘤。在对照组肺癌患者中，F-18-FDG和F-18-FMT的SUV分别为6.34+/-2.52和1.54+/-0.82。结论：结节病灶中F-18-FDG的摄取呈阳性，因此F-18-FDG PET不能区分结节病和恶性疾病。 F-18-FMT PET 与 F-18-FDG PET 联合使用可能是区分结节病和恶性肿瘤的有效方法。
Objectives: L[3-F-18]-alpha-methyltyrosine (F-18-FMT) is an amino-acid tracer for positron emission tomography (PET) and is used for tumor detection because malignant tumor cells accumulate F-18-FMT based on the increased expression of an amino-acid transporter. This study was conducted to investigate the usefulness of F-18-FMT PET in combination with fluorine-18-fluorodeoxyglucose (F-18-FDG) PET for the diagnosis of sarcoidosis in patients with suspected malignancy.Setting: Twenty-four sarcoidosis patients with suspected malignancy underwent F-18-FDG and F-18-FMT PET. The study included 17 patients with extrapulmonary manifestation mimicking malignant disease (13 patients with systemic lymphadenopathy, 3 of them with concomitant hepatosplenic processes; 3 patients with hepatosplenic processes without concomitant lymphadenopathy; and I patient with multiple bone lesions), 3 patients with occurrence of bilateral hilar lymphadenopathy in cancer patients, and 4 patients with multiple nodules mimicking pulmonary metastasis.Results: All patients showed increased uptake of F-18-FDG and no increase in the accumulation of F-18-FMT in their lymphadenopathy. Standardized uptake values (SUVs) of F-18-FDG and F-18-FMT were 5.01 +/- 2.15 and 0.77 +/- 0.24, respectively (mean SD). All extranodal lesions such as liver, spleen, and boric were visually positive on F-18-FDG PET and negative on F-18-FMT PET. No neoplasm was confirmed in all patients. In a control group of patients with lung cancer, SUVs for F-18-FDG and F-18-FMT were 6.34 +/- 2.52 and 1.54 +/- 0.82, respectively.Conclusion: The uptake of F-18-FDG was positive in the sarcoid lesions, and therefore F-18-FDG PET could not differentiate sarcoidosis from malignant disease. Use of F-18-FMT PET in combination with F-18-FDG PET may be the effective method to distinguish sarcoidosis from malignancy.