Döbert N, Hamscho N, Menzel C, Neuss L, Kovács A F, Grünwald F
Department of Nuclear Medicine, Hospital of the JW-Goethe University of Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany.
Nuklearmedizin. 2004 Oct;43(5):143-9. doi: 10.1267/nukl04050143.
For the evaluation of the diagnostic potential of dual time point FDG positron emission tomography (PET) in patients with suspicious focal abdominal uptake, dual time point PET imaging was compared with clinical findings.
PATIENTS, METHODS: In a prospective study, 56 patients exhibiting a solitary suspicious, intense abdominal FDG uptake, underwent dual time point PET imaging for staging or restaging of different malignant tumors, maximal standardized uptake value (SUVmax) measurements included. The first acquisition was started 64.8 +/- 19.5, the second 211.3 +/- 52.5 min after FDG injection. The final diagnosis based on CT or MRT imaging and a follow-up period of 12.6 +/- 2.8 months. Additionally, colonoscopy was done in 6 patients. In another 6 patients histopathology was obtained from CT guided biopsy.
Malignant focal abdominal lesions with a SUVmax <2.5 (n = 4) showed an uptake increase of > or =30%. In the remaining malignant cases with an uptake of > or =2.5 (n = 11), uptake increased in 64% and decreased in 36%. Malignant lesions showing FDG uptake decrease (n = 4) had an initial SUVmax value > or =2.5 and remained with a SUVmax > or =2.5 in the second imaging. In benign lesions with an initial SUVmax > or =2.5 (n = 31), the uptake increased in 17 patients (55%) and decreased in 14 patients (45%). All lesions which changed configuration (33%) were confirmed as benign (n = 5).
Using dual time point PET abdominal lesions show a very hetergenous uptake pattern regardless of their dignity. Malignancy can only be reliably excluded in lesions which change their configuration and in lesions with an initial SUVmax value <2.5 combined with an SUV decrease in the delayed imaging. Particularly abdominal lesions which show an initial SUVmax > or =2.5 combined with a SUV increase in the delayed imaging are suspicious for malignancy and need further clarification.
为评估双时相氟代脱氧葡萄糖正电子发射断层扫描（PET）对腹部局灶性摄取可疑患者的诊断潜力，将双时相PET成像与临床结果进行比较。
患者、方法：在一项前瞻性研究中，56例腹部FDG摄取呈孤立性可疑且强烈的患者接受了双时相PET成像，用于不同恶性肿瘤的分期或再分期，包括测量最大标准化摄取值（SUVmax）。首次采集在注射FDG后64.8±19.5分钟开始，第二次在211.3±52.5分钟后开始。最终诊断基于CT或MRT成像以及12.6±2.8个月的随访期。另外，6例患者进行了结肠镜检查。另有6例患者通过CT引导活检获得了组织病理学结果。
SUVmax＜2.5的恶性腹部局灶性病变（n = 4）摄取增加≥30%。其余摄取≥2.5的恶性病例（n = 11）中，64%摄取增加，36%摄取减少。显示FDG摄取减少的恶性病变（n = 4）初始SUVmax值≥2.5，在第二次成像中SUVmax仍≥2.5。初始SUVmax≥2.5的良性病变（n = 31）中，17例患者（55%）摄取增加，14例患者（45%）摄取减少。所有形态改变的病变（33%）均被确认为良性（n = 5）。
使用双时相PET，腹部病变无论其性质如何，摄取模式都非常不均匀。只有形态改变的病变以及初始SUVmax值＜2.5且延迟成像中SUV降低的病变才能可靠地排除恶性。特别是初始SUVmax≥2.5且延迟成像中SUV增加的腹部病变怀疑为恶性，需要进一步明确。
