Watanabe H, Inoue T, Shinozaki T, Yanagawa T, Ahmed A R, Tomiyoshi K, Oriuchi N, Tokunaga M, Aoki J, Endo K, Takagishi K
Department of Orthopedic Surgery, Gunma University Faculty of Medicine, Maebashi, Japan.
Eur J Nucl Med. 2000 Oct;27(10):1509-17. doi: 10.1007/s002590000344.
Fluorine-18 labelled alpha-methyltyrosine (FMT) was developed for positron emission tomography (PET) imaging, and its potential for clinical application in patients with brain tumours has been demonstrated. This is the first trial to compare FMT with 18F-fluoro-2-deoxy-D-glucose (FDG) for the evaluation of musculoskeletal tumours. Seventy-five patients were examined with both FMT- and FDG-PET within a 2-week period. Imaging findings were visually inspected in conjunction with computed tomography and/or magnetic resonance imaging, and standardized uptake values (SUVs) for both FMT and FDG in lesions were also generated and compared with histological findings. A significant correlation between FMT and FDG SUVs was found for all lesions (r=0.769, P<0.0001), and mean values for malignant tumours were significantly higher than those for benign lesions in both FMT- and FDG-PET. The diagnostic sensitivities and specificities for malignancy were 72.7% and 84.9%, respectively, using FMT with a cut-off SUV of 1.2, and 72.7% and 66.0%, respectively, using FDG with a cut-off SUV of 1.9. The resultant accuracy with FMT was 81.3%, higher than that for FDG (68.0%), and the difference with respect to specificity was significant (chi2cal=5.0625, P<0.05). On the other hand, while a significant correlation was found between malignant tumour grade and SUV with both FMT- (rho=0.656) and FDG-PET (rho=0.815), only the latter demonstrated significant differences among grades I, II and III. FMT and FDG for PET appear equally effective at detecting musculoskeletal tumours. In evaluating musculoskeletal tumours, FMT may be superior to FDG in the differentiation between benign and malignant tumours, while FDG may be the better choice for non-invasive malignancy grading.
氟-18标记的α-甲基酪氨酸（FMT）被开发用于正电子发射断层扫描（PET）成像，并且其在脑肿瘤患者中的临床应用潜力已得到证实。这是首次比较FMT与18F-氟-2-脱氧-D-葡萄糖（FDG）用于评估肌肉骨骼肿瘤的试验。75例患者在2周内接受了FMT-PET和FDG-PET检查。结合计算机断层扫描和/或磁共振成像对影像结果进行了目视检查，还生成了病变中FMT和FDG的标准化摄取值（SUV），并与组织学结果进行了比较。在所有病变中均发现FMT和FDG的SUV之间存在显著相关性（r = 0.769，P <0.0001），并且在FMT-PET和FDG-PET中，恶性肿瘤的平均值均显著高于良性病变。使用SUV截止值为1.2的FMT时，对恶性肿瘤的诊断敏感性和特异性分别为72.7%和84.9%，使用SUV截止值为1.9的FDG时，分别为72.7%和66.0%。FMT的最终准确率为81.3%，高于FDG（68.0%），并且在特异性方面的差异具有显著性（卡方检验值=5.0625，P <0.05）。另一方面，虽然在FMT-PET（rho = 0.656）和FDG-PET（rho = 0.815）中均发现恶性肿瘤分级与SUV之间存在显著相关性，但只有后者在I、II和III级之间显示出显著差异。PET用FMT和FDG在检测肌肉骨骼肿瘤方面似乎同样有效。在评估肌肉骨骼肿瘤时，FMT在区分良性和恶性肿瘤方面可能优于FDG，而FDG可能是无创恶性肿瘤分级的更好选择。
