使用正电子发射断层扫描（PET）和2-18F-氟-L-酪氨酸进行全身肿瘤成像：初步评估及与18F-氟代脱氧葡萄糖（18F-FDG）的比较

Whole-body tumor imaging using PET and 2-18F-fluoro-L-tyrosine: preliminary evaluation and comparison with 18F-FDG.

作者信息

Hustinx Roland, Lemaire Christian, Jerusalem Guy, Moreau Pierre, Cataldo Didier, Duysinx Bernard, Aerts Joel, Fassotte Marie-France, Foidart Jacqueline, Luxen André

机构信息

Division of Nuclear Medicine, University Hospital/CHU de Sart Tilman, 4000 Liège 1, Belgium.

出版信息

J Nucl Med. 2003 Apr;44(4):533-9.

PMID:12679396

Abstract

UNLABELLED

18F-FDG PET imaging is now established as a valuable tool for evaluating cancer patients. However, a limitation of (18)F-FDG is its absence of specificity for tumor. Both protein synthesis and amino acid transport are enhanced in most tumor cells, but their metabolism is less affected in inflammation. We therefore decided to evaluate the ability of PET with 2-(18)F-fluoro-L-tyrosine ((18)F-TYR) to visualize cancer lesions in patients compared with (18)F-FDG PET.

METHODS

(18)F-FDG PET and (18)F-TYR PET were performed on 23 patients with histologically proven malignancies (11 non-small cell lung cancers (NSCLCs), 10 lymphomas, and 2 head and neck carcinomas). Fully corrected, whole-body PET studies were obtained on separate days. (18)F-FDG studies were performed after routine clinical fashion. (18)F-TYR studies were started 36 +/- 6 min after tracer injection and a second scan centered over a reference lesion was acquired after completion of the whole-body survey-on average, 87 min after injection. Standardized uptake values (SUVs) were calculated for all abnormal foci and for various normal structures. Results were compared with pathologic or correlative studies.

RESULTS

(18)F-FDG PET correctly identified 54 malignant lesions, among which 36 were also visualized with (18)F-TYR (67%). (18)F-TYR did not detect any additional lesion. Tumor SUVs (SUV(bw), 5.2 vs. 2.5), tumor-to-muscle (7.4 vs. 2.7), and tumor-to-mediastinum activity ratios (3 vs. 1.4) were higher with (18)F-FDG than with (18)F-TYR. Two of 11 NSCLCs and 4 of 10 lymphomas were understaged with (18)F-TYR compared with (18)F-FDG. Although the NSCLC lesions missed by (18)F-TYR PET were small, several large lymphoma lesions did not accumulate the tracer. In 4 patients, (18)F-TYR-positive lesions coexisted with (18)F-TYR-negative lesions. There was a high physiologic (18)F-TYR uptake by the pancreas (average SUV(bw), 10.3) and the liver (average SUV(bw), 6.3). Muscle and bone marrow uptakes were also higher with (18)F-TYR than with (18)F-FDG: average SUV(bw), 1 versus 0.7 and 2.6 versus 1.8, respectively. There was no change over time in the (18)F-TYR uptake by the tumors or the normal structures.

CONCLUSION

(18)F-TYR PET is not superior to (18)F-FDG PET for staging patients with NSCLC and lymphomas.

摘要

未标注

18F-FDG PET成像现已成为评估癌症患者的一种有价值的工具。然而，18F-FDG的一个局限性是其对肿瘤缺乏特异性。大多数肿瘤细胞中蛋白质合成和氨基酸转运均增强，但炎症对它们代谢的影响较小。因此，我们决定评估2-(18)F-氟-L-酪氨酸((18)F-TYR)PET与18F-FDG PET相比在患者中使癌症病灶显影的能力。

方法

对23例经组织学证实为恶性肿瘤的患者（11例非小细胞肺癌（NSCLC）、10例淋巴瘤和2例头颈部癌）进行了18F-FDG PET和18F-TYR PET检查。在不同日期进行了完全校正的全身PET研究。18F-FDG研究按照常规临床方式进行。18F-TYR研究在注射示踪剂后36±6分钟开始，在全身检查完成后，平均注射后87分钟，对一个参考病灶进行第二次扫描。计算所有异常病灶和各种正常结构的标准化摄取值（SUV）。将结果与病理或相关研究进行比较。

结果

18F-FDG PET正确识别出54个恶性病灶，其中36个也能用18F-TYR显影（67%）。18F-TYR未检测到任何其他病灶。18F-FDG的肿瘤SUV（SUV(bw)，5.2对2.5）、肿瘤与肌肉的比值（7.4对2.7）以及肿瘤与纵隔的活性比（3对1.4）高于18F-TYR。与18F-FDG相比，11例NSCLC中有2例、10例淋巴瘤中有4例用18F-TYR分期偏低。虽然18F-TYR PET遗漏的NSCLC病灶较小，但几个大的淋巴瘤病灶未摄取示踪剂。在4例患者中，18F-TYR阳性病灶与18F-TYR阴性病灶共存。胰腺（平均SUV(bw)，10.3）和肝脏（平均SUV(bw)，6.3）对18F-TYR有较高的生理性摄取。18F-TYR对肌肉和骨髓的摄取也高于18F-FDG：平均SUV(bw)分别为1对0.7和2.6对1.8。肿瘤或正常结构对18F-TYR的摄取随时间无变化。