Comparison of 18F-FET and 18F-FDG PET in brain tumors
Comparison of 18F-FET and 18F-FDG PET in brain tumors
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DOI：
10.1016/j.nucmedbio.2009.05.005
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发表时间：
2009-10-01
影响因子：
3.1
通讯作者：
Langen, Karl-Josef
中科院分区：
文献类型：
--
作者：
Pauleit, Dirk;Stoffels, Gabriele;Langen, Karl-Josef
本研究的目的是比较使用[F-18]-氟脱氧葡萄糖（F-18-FDG）和O-（2-[F-18]氟乙基）-L-酪氨酸（F-18-FET）的正电子发射断层扫描（PET）对脑部病变可疑脑胶质瘤患者的诊断价值。方法：52例疑似脑胶质瘤患者 脑胶质瘤纳入本研究。注射 180 MBq F-18-FET 30 至 50 分钟后，进行第一次 PET 扫描（F-18-FET 扫描）。此后，注射 240 MBq F-18-FDG，并在第二次注射后 30 至 60 分钟进行第二次 PET 扫描（F-18-FET/F-18-FDG 扫描）。 F-18-FDG 的脑积聚通过从 F-18-FET/F-18-FDG 扫描中减去 F-18-FET 扫描的衰减校正来计算。通过视觉评分和病变与背景 (L/B) 比率来评估示踪剂的摄取。将影像学结果与组织学结果和预后进行比较。结果：组织学显示世界卫生组织（WHO）II级低级别胶质瘤（LGG）24例，WHO III或IV级高级别胶质瘤（HGG）19例，以及其他9例，主要为良性组织学。 86% 的神经胶质瘤显示 F-18-FET 摄取增加（>正常大脑），35% 的神经胶质瘤显示 F-18-FDG 摄取增加（>白质）。 T-18-FET PET 提供了诊断上有用的肿瘤范围描绘，而 F-18-FDG 由于灰质中示踪剂的高摄取而无法实现这一点。使用 F-18-FET 可以识别用于活检引导的肿瘤区域的局部最大值，使用 F-18-FDG 可以识别出 76%，使用 F-18-FDG 可以识别出 28%。 L/B 比率显示 LGG 和 HGG 两种示踪剂之间存在显着差异，但有相当大的重叠，因此不可能进行可靠的术前分级。仅使用 F-18-FDG 就发现示踪剂摄取与总生存率存在显着相关性。在脓肿等一些良性病变中，观察到两种示踪剂的摄取增加，表明两种技术的特异性有限。结论：F-18-FET PET 在脑胶质瘤的活检指导和治疗计划方面优于 F-18-FDG。 F-18-FDG 的摄取与预后相关，但预测价值有限，仍然需要对肿瘤组织进行组织学评估。因此，F-18-FET 等氨基酸是脑胶质瘤临床治疗的首选 PET 示踪剂。 (C) 2009 Elsevier Inc. 保留所有权利。
The purpose of this study was to compare the diagnostic value of positron emission tomography (PET) using [F-18]-fluorodeoxyglucose (F-18-FDG) and O-(2-[F-18]fluoroethyl)-L-tyrosine (F-18-FET) in patients with brain lesions Suspicious of cerebral gliomas.Methods: Fifty-two patients with suspicion of cerebral glioma were included in this study. From 30 to 50 min after injection of 180 MBq F-18-FET, a first PET scan (F-18-FET scan) was performed. Thereafter, 240 MBq F-18-FDG was injected and a second PET scan was acquired from 30 to 60 min after the second injection (F-18-FET/F-18-FDG scan). The cerebral accumulation of F-18-FDG was calculated by decay corrected subtraction of the F-18-FET scan from the F-18-FET/F-18-FDG scan. Tracer uptake was evaluated by Visual scoring and by lesion-to-background (L/B) ratios. The imaging results were compared with the histological results and prognosis.Results: Histology revealed 24 low-grade gliomas (LGG) of World Health Organization (WHO) Grade II and 19 high-grade gliomas (HGG) of WHO Grade III or IV, as well as nine others, mainly benign histologies. The gliomas showed increased F-18-FET uptake (>normal brain) in 86% and increased F-18-FDG uptake (>white matter) in 35%. T-18-FET PET provided diagnostically useful delineation of tumor extent while this was impractical with F-18-FDG due to high tracer uptake in the gray matter. A local maximum in the tumor area for biopsy guidance could be identified with F-18-FET in 76% and with F-18-FDG in 28%. The L/B ratios showed significant differences between LGG and HGG for both tracers but considerable overlap so that reliable preoperative grading was not possible. A significant correlation of tracer uptake with overall survival was found with F-18-FDG only. In some benign lesions like abscesses, increased uptake was observed for both tracers indicating a limited specificity of both techniques.Conclusions: F-18-FET PET is Superior to F-18-FDG for biopsy guidance and treatment planning of cerebral gliomas. The uptake of F-18-FDG is associated with prognosis, but the predictive value is limited and a histological evaluation of tumor tissue remains necessary. Therefore, amino acids like F-18-FET are the preferred PET tracers for the clinical management of cerebral gliomas. (C) 2009 Elsevier Inc. All rights reserved.