粒细胞集落刺激因子治疗后脾脏氟脱氧葡萄糖摄取增加：PET成像结果

Splenic fluorodeoxyglucose uptake increased by granulocyte colony-stimulating factor therapy: PET imaging results.

作者信息

Sugawara Y, Zasadny K R, Kison P V, Baker L H, Wahl R L

机构信息

Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor 48109, USA.

出版信息

J Nucl Med. 1999 Sep;40(9):1456-62.

PMID:10492365

Abstract

UNLABELLED

Using PET, we investigated the change in 18F-fluorordeoxyglucose (FDG) uptake in the spleen after granulocyte colony-stimulating factor (G-CSF) treatment.

METHODS

Forty-two FDG PET scans in 12 patients with locally advanced breast cancer who received G-CSF treatment were studied (12 baseline, 10 during G-CSF, 20 after G-CSF treatment). The PET images obtained at 50-60 and 60-70 min after intravenous FDG (370 MBq) injection were assessed visually and were compared with those before G-CSF treatment. For a semiquantitative index of FDG uptake, we determined the standardized uptake value calculated on the basis of predicted lean body mass (SUL) on these images, and we calculated the SUL ratios normalized to their baseline SUL values.

RESULTS

During G-CSF treatment (n = 10), 9 scans (90%) showed increased splenic FDG uptake (3 slightly, 6 substantially). After G-CSF treatment (n = 20), 13 (65%) showed no change, 7 (35%) showed slightly increased uptake, but no case showed substantially increased FDG uptake in the spleen (P = 0.0003). Out of 30 PET scans obtained during and after G-CSF treatment, 16 (53%) showed increased FDG uptake in the spleen (10 slightly, 6 substantially), whereas 26 (87%) showed increased bone marrow FDG uptake (14 slightly, 12 substantially). The FDG uptake in other normal organs (liver, blood and lung) showed no change during or after G-CSF treatment. Similar to the change in the bone marrow, the SULs in the spleen significantly increased during G-CSF treatment (baseline, 1.50+/-0.31, versus during G-CSF, 2.69+/-0.84; P = 0.0004), then decreased after discontinuation of G-CSF (1.65+/-0.23). There was a significant correlation between the SUL ratios in the spleen and those in the bone marrow (r = 0.778, P < 0.0001), whereas there were no correlations between those in other organs and those in the bone marrow.

CONCLUSION

Substantially increased FDG uptake was observed in the spleen during and after G-CSF treatment, although this change was less frequent and not as marked as the change observed in the bone marrow. The recognition and understanding of this phenomenon will be increasingly important when interpreting FDG PET images in cancer patients to avoid confusing this normal phenomenon with pathological splenic (tumor) involvement.

摘要

未标注

我们使用正电子发射断层扫描（PET）研究了粒细胞集落刺激因子（G-CSF）治疗后脾脏中18F-氟脱氧葡萄糖（FDG）摄取的变化。

方法

对12例接受G-CSF治疗的局部晚期乳腺癌患者的42次FDG PET扫描进行了研究（12次基线扫描、10次G-CSF治疗期间扫描、20次G-CSF治疗后扫描）。在静脉注射FDG（370 MBq）后50 - 60分钟和60 - 70分钟获得的PET图像进行了视觉评估，并与G-CSF治疗前的图像进行了比较。对于FDG摄取的半定量指标，我们确定了基于这些图像上预测的瘦体重计算的标准化摄取值（SUL），并计算了相对于其基线SUL值标准化的SUL比值。

结果

在G-CSF治疗期间（n = 10），9次扫描（90%）显示脾脏FDG摄取增加（3次轻度增加，6次显著增加）。G-CSF治疗后（n = 20），13次（65%）无变化，7次（35%）显示摄取略有增加，但脾脏中无病例显示FDG摄取显著增加（P = 0.0003）。在G-CSF治疗期间和之后获得的30次PET扫描中，16次（53%）显示脾脏FDG摄取增加（10次轻度增加，6次显著增加），而26次（87%）显示骨髓FDG摄取增加（14次轻度增加，12次显著增加）。G-CSF治疗期间和之后，其他正常器官（肝脏、血液和肺）的FDG摄取无变化。与骨髓变化相似，脾脏中的SUL在G-CSF治疗期间显著增加（基线时为1.50±0.31，G-CSF治疗期间为2.69±0.84；P = 0.0004），G-CSF停用后下降（1.65±0.23）。脾脏中的SUL比值与骨髓中的SUL比值之间存在显著相关性（r = 0.778，P < 0.0001），而其他器官中的SUL比值与骨髓中的SUL比值之间无相关性。