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Positron emission tomography with 18F-fluorothymidine for monitoring therapeutic effect after chemoradiation therapy

18F-氟胸苷正电子发射断层扫描用于监测放化疗后的疗效

基本信息

批准号：
18591342
负责人：
NAKAMOTO Yuji
金额：
$ 2.04万
依托单位：
Kyoto University
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
2006
资助国家：
日本
起止时间：
2006 至 2007
项目状态：
已结题

来源：
https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-18591342/
关键词：
FLT FDG PET therapeutic effect neoadjuvant chemotherapy 腫瘍核医学画像診断学

项目摘要

The aim of this study was to assess the prevalence of discrepancy and which yielded more accurate diagnoses in patients who underwent both FDG-PET and FLT-PET. Thirteen patients underwent both FDG-PET and FLT-PET scans after they have completed neoadjuvant chemotherapy or chemo-radiation therapy. Of 38 lesions, 32 were true positive lesions. There were 10 lesions (26%) with discrepant findings. For these lesions, FDG-PET yielded 4 true-positives and 2 true-negatives, and FLT-PET showed 2 true-positives and 2 true-negatives. Overall, the lesion-based sensitivity, specificity, positive predictive value, negative predictive value and accuracy of FDG-PET were 50%, 33%, 80%, 11% and 47%, respectively, while those of FLT-PET were 38%, 67%, 86%, 17% and 42%, respectively. In addition, 13 patients had FDG-PET and FLT-PET scans for the purpose of differentiation, staging or restaging. Of 29 lesions, 26 were true positive lesions. There were 9 lesions (31%) with discrepant findings. For these lesions, FDG-PET yielded 5 true-positives and FLT-PET showed 2 true-positives and 2 true-negatives. Overall, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of FDG-PET were 62%, 33%, 89%, 9%, and 59%, respectively, while those of FLT-PET were 50%, 100%, 100%, 19%, and 50%, respectively. Based on these preliminary data, we concluded (i) FDG-PET tended to yield more false positive findings, while FLT-PET false negative findings, (ii) the diagnostic discrepancy occurred in one-fourth to one-third of the lesions, with the half accuracy of each study, and (iii) the positive predictive value of FLT-PET was reasonably high. FLT-PET could be helpful for detecting non-FDG-avid metastatic lesions.

本研究的目的是评估差异的发生率，并为同时接受 FDG-PET 和 FLT-PET 的患者提供更准确的诊断。 13 名患者在完成新辅助化疗或化放疗后接受了 FDG-PET 和 FLT-PET 扫描。在 38 个病变中，32 个为真阳性病变。有 10 个病变 (26%) 的结果不一致。对于这些病变，FDG-PET 产生 4 个真阳性和 2 个真阴性，FLT-PET 显示 2 个真阳性和 2 个真阴性。总体而言，FDG-PET 基于病变的敏感性、特异性、阳性预测值、阴性预测值和准确性分别为 50%、33%、80%、11% 和 47%，而 FLT-PET 分别为 38%、67%、86%、17% 和 42%。此外，13 名患者还进行了 FDG-PET 和 FLT-PET 扫描，以进行分化、分期或再分期。在 29 个病变中，26 个为真阳性病变。有 9 个病变 (31%) 的结果不一致。对于这些病变，FDG-PET 产生 5 个真阳性，FLT-PET 显示 2 个真阳性和 2 个真阴性。总体而言，FDG-PET 的敏感性、特异性、阳性预测值、阴性预测值和准确性分别为 62%、33%、89%、9% 和 59%，而 FLT-PET 分别为 50%、100%、100%、19% 和 50%。根据这些初步数据，我们得出结论：(i) FDG-PET 往往会产生更多的假阳性结果，而 FLT-PET 则出现假阴性结果；(ii) 四分之一到三分之一的病变出现诊断差异，每项研究的准确度只有一半；(iii) FLT-PET 的阳性预测值相当高。 FLT-PET 可能有助于检测不富含 FDG 的转移性病变。