Trampal Carlos, Engler Henry, Juhlin Claes, Bergström Mats, Långström Bengt
Uppsala University PET Centre, Sweden and Surgery Department, University Hospital, Uppsala, Sweden.
Radiology. 2004 Feb;230(2):423-8. doi: 10.1148/radiol.2302021678.
To evaluate the accuracy of carbon 11 (11C) hydroxyephedrine (HED) positron emission tomography (PET) in the detection of pheochromocytomas.
Nineteen patients (12 women, seven men; mean age, 53 years) suspected of having pheochromocytoma were evaluated. Patients had enlarged adrenal glands at computed tomography and either increased urinary catecholamine levels (n = 18) or normal biochemistry (n = 1). Dynamic PET examination in the adrenal region was performed after injection of 800 MBq 11C HED. PET data were analyzed visually and semiquantitatively. Time-activity curves were generated for different organs. PET results were validated with histologic evaluation (n = 16) or clinical follow-up (n = 3). The diagnostic value of HED PET was evaluated by calculating the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy.
In 12 patients, 13 pheochromocytomas were verified at surgery and histologic evaluation. All but one of the pheochromocytomas were detected with HED PET, which demonstrated elevated uptake. The rest of the patients (n = 7) did not have pheochromocytomas. In these patients, HED PET did not show any abnormal uptake in the suspicious tumors (confirmed at surgery in four patients and at clinical follow-up in three). Mean standardized uptake value of the tumors was 21.4 (range, 11.1-40.9). The time-activity curves for pheochromocytomas showed early uptake after injection, and the activity increased with the time of examination. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of HED PET in the detection of pheochromocytomas were 92% (12 of 13), 100% (seven of seven), 100% (12 of 12), 87.5% (seven of eight), and 95% (19 of 20), respectively.
HED PET is useful in the detection of pheochromocytomas, providing a high level of accuracy.
评估碳-11（11C）羟基麻黄碱（HED）正电子发射断层扫描（PET）检测嗜铬细胞瘤的准确性。
对19例疑似嗜铬细胞瘤的患者（12例女性，7例男性；平均年龄53岁）进行评估。患者在计算机断层扫描中肾上腺增大，尿儿茶酚胺水平升高（n = 18）或生化指标正常（n = 1）。注射800 MBq 11C HED后，对肾上腺区域进行动态PET检查。对PET数据进行视觉和半定量分析。生成不同器官的时间-活性曲线。PET结果通过组织学评估（n = 16）或临床随访（n = 3）进行验证。通过计算敏感性、特异性、阳性预测值、阴性预测值和准确性来评估HED PET的诊断价值。
12例患者经手术和组织学评估证实有13个嗜铬细胞瘤。除1个嗜铬细胞瘤外，其余均被HED PET检测到，表现为摄取增加。其余患者（n = 7）无嗜铬细胞瘤。在这些患者中，HED PET在可疑肿瘤中未显示任何异常摄取（4例经手术证实，3例经临床随访证实）。肿瘤的平均标准化摄取值为21.4（范围11.1 - 40.9）。嗜铬细胞瘤的时间-活性曲线显示注射后早期摄取，且活性随检查时间增加。HED PET检测嗜铬细胞瘤的敏感性、特异性、阳性预测值、阴性预测值和准确性分别为92%（13个中的12个）、100%（7个中的7个）、100%（12个中的12个）、87.5%（8个中的7个）和95%（20个中的19个）。
HED PET在嗜铬细胞瘤的检测中很有用，准确性较高。
