Jeong Hwan-Jeong, Chung June-Key, Kim Yu Kyeong, Kim Chae Yong, Kim Dong Gyu, Jeong Jae Min, Lee Dong Soo, Jung Hee Won, Lee Myung Chul
Department of Nuclear Medicine, Seoul National University College of Medicine, Korea.
J Nucl Med. 2002 Nov;43(11):1432-7.
The aim of this study was to evaluate the diagnostic value of whole-body (18)F-FDG PET imaging in the differentiation of metastatic brain tumor from primary brain tumor and in the localization of the primary lesion in patients with metastatic brain tumor.
The subjects consisted of 127 patients (77 men, 50 women; mean age +/- SD, 55 +/- 12 y) with brain masses that were suspected to be metastatic brain tumors on radiologic studies: 77 with confirmed metastatic brain tumor and 50 with primary brain tumor. Whole-body (18)F-FDG PET was performed on all patients. When the abnormal lesion was detected outside the brain, we interpreted the brain lesion as metastatic brain tumor.
In 61 of the 77 patients with metastatic brain tumor, primary lesions were detected using whole-body (18)F-FDG PET. Of the remaining 16 patients (all false-negative cases), 7 were classified as metastases of unknown origin. In 47 of the 50 patients with primary brain tumor, whole-body (18)F-FDG PET did not show any other abnormal lesions. The sensitivity, specificity, positive and negative predictive values, and accuracy of PET for the detection of primary origin were 79.2%, 94.0%, 95.3%, 74.6%, and 85.0%, respectively. The most common primary origin of metastatic brain tumors on PET examination was lung cancer (48/61, 78.7%). The concordance rate between (18)F-FDG PET and conventional radiologic work-up was 80% in identifying primary lesion. Unknown bone or bone marrow metastases and unsuspected distant metastases were found in 14 patients (18%) and 24 patients (31%), respectively, on PET examination.
Screening the patients with suspected metastatic brain tumors using whole-body (18)F-FDG PET could be helpful in differentiating metastatic brain tumor from primary brain tumor and in detecting the primary lesion.
本研究的目的是评估全身（18）F-FDG PET成像在鉴别转移性脑肿瘤与原发性脑肿瘤以及在转移性脑肿瘤患者中原发病灶定位方面的诊断价值。
研究对象包括127例脑部有肿块的患者（77例男性，50例女性；平均年龄±标准差，55±12岁），这些患者在放射学检查中被怀疑为转移性脑肿瘤：77例确诊为转移性脑肿瘤，50例为原发性脑肿瘤。所有患者均进行了全身（18）F-FDG PET检查。当在脑外检测到异常病变时，我们将脑内病变解释为转移性脑肿瘤。
在77例转移性脑肿瘤患者中，61例通过全身（18）F-FDG PET检测到了原发病灶。其余16例患者（均为假阴性病例）中，7例被归类为不明来源的转移瘤。在50例原发性脑肿瘤患者中，47例全身（18）F-FDG PET未显示任何其他异常病变。PET检测原发病灶的敏感性、特异性、阳性和阴性预测值以及准确性分别为79.2%、94.0%、95.3%、74.6%和85.0%。PET检查中转移性脑肿瘤最常见的原发部位是肺癌（48/61，78.7%）。在识别原发病灶方面，（18）F-FDG PET与传统放射学检查的符合率为80%。PET检查发现14例患者（18%）有不明骨或骨髓转移，24例患者（31%）有未被怀疑的远处转移。
对疑似转移性脑肿瘤患者进行全身（18）F-FDG PET筛查有助于鉴别转移性脑肿瘤与原发性脑肿瘤并检测原发病灶。
