妇科肿瘤的影像学检查：(11)C-胆碱正电子发射断层显像（PET）与(18)F-氟代脱氧葡萄糖正电子发射断层显像（PET）的比较

Imaging of gynecologic tumors: comparison of (11)C-choline PET with (18)F-FDG PET.

作者信息

Torizuka Tatsuo, Kanno Toshihiko, Futatsubashi Masami, Okada Hiroyuki, Yoshikawa Etsuji, Nakamura Fumitoshi, Takekuma Munetaka, Maeda Makoto, Ouchi Yasuomi

机构信息

Positron Medical Center, Hamamatsu Medical Center, Hamakita, Japan.

出版信息

J Nucl Med. 2003 Jul;44(7):1051-6.

DOI:

PMID:12843219

Abstract

UNLABELLED

This study was designed to compare the value of PET using (11)C-choline with that of PET using (18)F-FDG for the diagnosis of gynecologic tumors.

METHODS

We examined 21 patients, including 18 patients with untreated primary tumors and 3 patients with suspected recurrence of ovarian cancer. (11)C-choline PET and (18)F-FDG PET were performed within 2 wk of each other on each patient. The patients fasted for at least 5 h before the PET examinations, and PET was performed 5 min ((11)C-choline) and 60 min ((18)F-FDG) after injection of each tracer. PET images were corrected for the transmission data, and the reconstructed images were visually analyzed. Then, the standardized uptake value (SUV) was calculated for quantitative assessment of tumor uptake. PET results were compared with surgical histology or >6 mo of clinical observations.

RESULTS

Of 18 untreated patients, (11)C-choline PET correctly detected primary tumors in 16 patients, whereas (18)F-FDG PET detected them in 14 patients. In 1 patient with small uterine cervical cancer and 1 diabetic patient with uterine corpus cancer, only (11)C-choline PET was true-positive. Both tracers were false-negative for atypical hyperplasia of the endometrium in 1 patient and were false-positive for pelvic inflammatory disease in 1 patient. For the diagnosis of recurrent ovarian cancer (n = 3), (11)C-choline PET and (18)F-FDG PET were true-positive in 1 patient, whereas neither tracer could detect cystic recurrent tumor and microscopic peritoneal disease in the other 2 patients. In the 15 patients with true-positive results for both tracers, tumor SUVs were significantly higher for (18)F-FDG than for (11)C-choline (9.14 +/- 3.78 vs. 4.61 +/- 1.61, P < 0.0001). In 2 patients with uterine cervical cancer, parailiac lymph node metastases were clearly visible on (18)F-FDG PET but were obscured by physiologic bowel uptake on (11)C-choline PET.

CONCLUSION

The use of (11)C-choline PET is feasible for imaging of gynecologic tumors. Unlike (18)F-FDG PET, interpretation of the primary tumor on (11)C-choline PET is not hampered by urinary radioactivity; however, variable background activity in the intestine may interfere with the interpretation.

摘要

未标注

本研究旨在比较使用（11）C-胆碱的正电子发射断层显像（PET）与使用（18）F-氟代脱氧葡萄糖（FDG）的PET对妇科肿瘤的诊断价值。

方法

我们检查了21例患者，包括18例未经治疗的原发性肿瘤患者和3例疑似卵巢癌复发的患者。对每位患者在彼此间隔2周内分别进行（11）C-胆碱PET和（18）F-FDG PET检查。患者在PET检查前至少禁食5小时，在注射每种示踪剂后5分钟（（11）C-胆碱）和60分钟（（18）F-FDG）进行PET检查。PET图像根据透射数据进行校正，并对重建图像进行视觉分析。然后，计算标准化摄取值（SUV）以定量评估肿瘤摄取情况。将PET结果与手术组织学或超过6个月的临床观察结果进行比较。

结果

在18例未经治疗的患者中，（11）C-胆碱PET正确检测出16例原发性肿瘤，而（18）F-FDG PET检测出14例。在1例子宫颈小癌患者和1例子宫体癌糖尿病患者中，只有（11）C-胆碱PET为真阳性。两种示踪剂对1例子宫内膜不典型增生均为假阴性，对1例盆腔炎均为假阳性。对于复发性卵巢癌的诊断（n = 3），（11）C-胆碱PET和（18）F-FDG PET在1例患者中为真阳性，而在另外2例患者中两种示踪剂均未能检测到囊性复发肿瘤和微小腹膜病变。在两种示踪剂结果均为真阳性的15例患者中，（18）F-FDG的肿瘤SUV显著高于（11）C-胆碱（9.14±3.78对4.61±1.61，P < 0.0001）。在2例子宫颈癌患者中，（18）F-FDG PET上髂旁淋巴结转移清晰可见，但在（11）C-胆碱PET上被生理性肠道摄取掩盖。