Sugawara Y, Zasadny K R, Grossman H B, Francis I R, Clarke M F, Wahl R L
Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor 48109-0028, USA.
Radiology. 1999 Apr;211(1):249-56. doi: 10.1148/radiology.211.1.r99ap16249.
To evaluate the feasibility of positron emission tomography (PET) with 2-[fluorine-18]-fluoro-2-deoxy-D-glucose (FDG) in patients with germ cell tumor (GCT) to monitor treatment and differentiate residual masses after chemotherapy.
Twenty-six FDG PET studies were performed in 21 patients with GCT, FDG uptake of tumors was interpreted visually, and the lean standardized uptake value (SUVlean) was determined. Tumor kinetic rate constants (K1, k2, k3) and net rate of FDG phosphorylation (K = [K1.k3]/[k2 + k3]) in tumors were calculated from the dynamic data by means of a three-compartment model, assuming k4 = 0.
Viable tumors (n = 10) showed intense FDG uptake and could easily be differentiated visually from mature teratoma (n = 6) and necrosis or scar (n = 10). The SUVlean of residual viable tumors (4.51 +/- 1.34 [mean +/- SD]) was higher than that of mature teratoma (1.38 +/- 0.71) and necrosis or scar (1.05 +/- 0.29) (P < .05). Although neither the visual interpretation nor SUVlean differentiated mature teratoma from necrosis or scar, there were statistically significant differences in the kinetic rate constants K1 and K between mature teratoma and necrosis or scar as follows: K1, 0.113 mL/min/g +/- 0.026 versus 0.036 mL/min/g +/- 0.005 (P < .05); K, 0.005 mL/min/g +/- 0.003 versus 0.0008 mL/min/g +/- 0.0001 (P < .05).
FDG PET with kinetic analysis appears to be a promising method for management of disease in patients with GCT after treatment.
评估采用2-[氟-18]-氟-2-脱氧-D-葡萄糖（FDG）进行正电子发射断层扫描（PET）在生殖细胞肿瘤（GCT）患者中监测治疗及鉴别化疗后残留肿块的可行性。
对21例GCT患者进行了26次FDG PET研究，对肿瘤的FDG摄取情况进行视觉解读，并测定瘦体标准化摄取值（SUVlean）。通过三室模型，假设k4 = 0，根据动态数据计算肿瘤的动力学速率常数（K1、k2、k3）和FDG磷酸化净速率（K = [K1·k3]/[k2 + k3]）。
存活肿瘤（n = 10）表现出强烈的FDG摄取，在视觉上很容易与成熟畸胎瘤（n = 6）以及坏死或瘢痕（n = 10）区分开来。残留存活肿瘤的SUVlean（4.51±1.34 [平均值±标准差]）高于成熟畸胎瘤（1.38±0.71）和坏死或瘢痕（1.05±0.29）（P <.05）。虽然视觉解读和SUVlean均无法区分成熟畸胎瘤与坏死或瘢痕，但成熟畸胎瘤与坏死或瘢痕之间的动力学速率常数K1和K存在统计学显著差异，如下：K1，0.113 mL/min/g±0.026与0.036 mL/min/g±0.005（P <.05）；K，0.005 mL/min/g±0.003与0.0008 mL/min/g±0.0001（P <.05）。
进行动力学分析的FDG PET似乎是治疗后GCT患者疾病管理的一种有前景的方法。
