The radiographic evaluation of choline uptake to the head and neck cancer by mean of PET

正电子发射断层扫描（PET）与FDG和13 <11>C-标记的胆碱（13 <11>C-胆碱）已被证明是有用的分期和检测癌症。人类癌症中FDG和胆碱摄取增加的背景尚未完全了解。本研究旨在探讨肿瘤细胞摄取~（13）<11>C-胆碱与细胞周期依赖性的关系，以及~（13）C-胆碱PET与~（13<11>）<18>F-脱氧葡萄糖（FDG）PET在头颈部恶性肿瘤中的临床应用价值。<11>HeLa S3细胞在G2/M期C-胆碱摄取较高。此外，FDG摄取在早期S期和G2/M期显著高于G1期。研究<11>了平均SUV与以下参数之间的关系：恶性肿瘤的组织学分级、细胞分化程度、原发病灶的大小和/或局部范围以及肿瘤的细胞密度。平均SUV，标准化摄取值的FDG摄取和放射性核素的管理剂量，体重的病人，不依赖于组织学分级或细胞分化程度，但往往是更大的原发性病变越大。SUV也依赖于细胞密度，肿瘤实质百分比越大，SUV越高，FDG鉴别良恶性病变的临界SUV为3.5。放射<11>化学治疗后残留肿瘤细胞，^C-胆碱显示略优于FDG，尽管两项研究存在一些重叠。C<11>-胆碱在恶性肿瘤中的蓄积速度明显快于FDG。胆碱PET的优点<11>是检查周期短。然而，<11>在唾液腺病变的评估中，13 C-胆碱和FDG都有一定的局限性。

Positron emission tomography (PET) with FDG and ^<11>C-labeled choline (^<11>C-choline) has been shown to be useful in the staging and detection of cancer. The background of the increased uptake of FDG and choline in human cancer is not completely understood. The aim of this research were designed to address investigate the relationship between the ^<11>C-choline uptake and the cell-cycle-dependent of tumor cell, and the clinical value of PET with ^<11>C-choline for malignant head and neck tumors as compared with ^<18>F-fluorodeoxyglucose (FDG) PET.^<11>C-choline uptake was higher in the G2/M phase in HeLa S3 cells. In addition, FDG uptake was significantly higher in the early S phase and G2/M phase compared to the G1 phase. It has been concluded cell cycle dependency is reflected in the uptake of ^<11>C-choline and EDG, seen during PET imaging of tumor tissue.The relationship between the mean SUV and the following parameters was examined : histological grade of malignancy, degree of cell differentiation, size and/or local extent of the primary lesion, and cell density of tumor. The mean SUV, standardized uptake value normalized to FDG-uptake and the administered dose of radionuclide, the body weight of the patient, did not depend on the histological grade or the degree of cell differentiation, but tended to be greater the larger the primary lesion. SUV also depended on cell density ; the greater the percentage of tumor parenchyma, the higher the SUV.The cutoff SUV for differentiating malignant and benign lesions was 3.5 for FDG. ^<11>C-choline showed slightly better than FDG for residual tumor cell after radio-chemo therapy, although some overlap existed on both studies. ^<11>C-choline showed significantly faster accumulation than FDG into Malignant tumors. The advantages of ^<11>C-choline PET were shorter examination period. However, both ^<11>C-choline and FDG have some limitations in the evaluation of salivary gland lesions.