Hara T, Inagaki K, Kosaka N, Morita T
Department of Radiology, International Medical Center of Japan, Tokyo.
J Nucl Med. 2000 Sep;41(9):1507-13.
11C-choline and FDG are PET tracers used to visualize various malignancies. In this study, we compared their capabilities in detecting mediastinal lymph node metastasis originating from non-small cell lung cancer (NSCLC).
Twenty-nine patients with biopsy-proven NSCLC were studied with PET. 11C-choline PET and FDG PET were performed from 5 and 40 min, respectively, after injection of 370 MBq tracer. PET data were analyzed in terms of the standardized uptake value (SUV). After the PET study, the patients underwent lung resection and mediastinal lymph node dissection. The resected specimens were examined pathologically, and the PET data were analyzed in reference to the pathologic data.
With 11C-choline, the SUV in metastasis was similar to the SUV in the primary tumor, where the similarity of the SUV was 100% allowing for a 40% difference. With FDG, small metastases were invisible on the PET image. The SUV of FDG in metastasis was much smaller than that in the primary tumor, and the similarity of the SUV was only 19% allowing for a 40% difference. When pathologic findings were used as standards, the sensitivities of 11C-choline PET and FDG PET in detecting mediastinal lymph node metastasis were 100% and 75%, respectively.
11C-choline PET was very effective in detecting lymph node metastases in the mediastinum originating from NSCLC, with a sensitivity of 100%. 11C-choline PET promises to be useful not only before surgery but also after surgery.
11C-胆碱和氟代脱氧葡萄糖（FDG）是用于可视化各种恶性肿瘤的正电子发射断层扫描（PET）示踪剂。在本研究中，我们比较了它们检测非小细胞肺癌（NSCLC）纵隔淋巴结转移的能力。
对29例经活检证实为NSCLC的患者进行PET研究。分别在注射370MBq示踪剂后5分钟和40分钟进行11C-胆碱PET和FDG PET检查。PET数据根据标准化摄取值（SUV）进行分析。PET研究后，患者接受肺切除和纵隔淋巴结清扫术。对切除的标本进行病理检查，并参照病理数据对PET数据进行分析。
使用11C-胆碱时，转移灶的SUV与原发肿瘤的SUV相似，SUV的相似性为100%，允许有40%的差异。使用FDG时，PET图像上小转移灶不可见。转移灶中FDG的SUV远小于原发肿瘤中的SUV，SUV的相似性仅为19%，允许有40%的差异。以病理结果为标准时，11C-胆碱PET和FDG PET检测纵隔淋巴结转移的敏感性分别为100%和75%。
11C-胆碱PET在检测源自NSCLC的纵隔淋巴结转移方面非常有效，敏感性为100%。11C-胆碱PET不仅在手术前有用，在手术后也有望发挥作用。
