Go K G, Pruim J, Que T H, Vaalburg W, Haaxma-Reiche H
Department of Neurosurgery, University Hospital of Groningen, The Netherlands.
Acta Neurochir (Wien). 2000;142(6):627-31. doi: 10.1007/s007010070105.
In the preoperative diagnosis of malignant brain tumours there is often uncertainty regarding their metastatic or primary nature, requiring dissemination studies. Currently FDG-wbPET is being used for the efficient detection of systemic tumours. It therefore may become a substitute for the conventional dissemination studies if it allows an earlier diagnosis.
In this descriptive and preliminary study a population of 14 patients with suspected or proven metastatic lesions, [18F]-fluoro-2-deoxy-D-glucose whole body positron emission tomography (FDG-wbPET) was conducted and verified by additional conventional dissemination studies. FINDINGS AND THEIR INTERPRETATION: The entire series of dissemination studies required an average of 30 days with a range of 4-73 days. The FDG-wbPET was corroborated by the other dissemination studies in 10 of the 14 patients. In 7 of these 10 patients both PET and dissemination studies showed systemic abnormal findings, but in one case the presence of high pulmonary activity on the FDG-wbPET and the abnormal findings on the chest X-rays proved to be Aspergillus infection at autopsy. In the other 2 cases the negative PET findings corresponded to the absence of systemic dissemination. In 5 cases there was disagreement of the results of the FDG-wbPET with other evidence, among which there were 2 cases of glioblastoma in which systemic metastases were most unlikely, and the foci of activity on the FDG-wbPET had to be considered as false positives. In the remaining 3 cases the systemic presence of high activity on the FDG-wbPET indicated the systemic presence of tumour, whereas the other dissemination studies disclosed no tumour.
The results warrant the use of FDG-wbPET as a screening method for the search of metastases, allowing other studies to be focussed on the lesion. But from the cost/benefit point of view this would make the method less suitable as a substitute for dissemination studies in general, although it may speed up the diagnostic process.
在恶性脑肿瘤的术前诊断中，其转移性质或原发性质往往存在不确定性，这就需要进行播散研究。目前，氟代脱氧葡萄糖全身正电子发射断层扫描（FDG-wbPET）正被用于高效检测全身肿瘤。因此，如果它能实现更早诊断，那么它可能会替代传统的播散研究。
在这项描述性初步研究中，对14例疑似或确诊有转移病灶的患者进行了[18F] - 氟 - 2 - 脱氧 - D - 葡萄糖全身正电子发射断层扫描（FDG-wbPET），并通过额外的传统播散研究进行验证。
整个系列的播散研究平均需要30天，范围为4 - 73天。14例患者中有10例的FDG-wbPET结果得到了其他播散研究的证实。在这10例患者中的7例中，PET和播散研究均显示全身有异常发现，但在1例中，FDG-wbPET上肺部高活性的存在以及胸部X线检查的异常发现在尸检时被证明是曲霉菌感染。在另外2例中，PET阴性结果与无全身播散相符。在5例中，FDG-wbPET结果与其他证据不一致，其中有2例胶质母细胞瘤，全身转移极不可能，FDG-wbPET上的活性灶不得不被视为假阳性。在其余3例中，FDG-wbPET上全身高活性的存在表明全身有肿瘤存在，而其他播散研究未发现肿瘤。
这些结果证明FDG-wbPET可作为筛查转移灶的方法，使其他研究能够集中于病变部位。但从成本效益的角度来看，尽管它可能会加快诊断过程，但总体上该方法不太适合替代播散研究。
