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正电子发射断层扫描在泌尿系统恶性肿瘤管理中的应用

PET in the management of urologic malignancies.

作者信息

Kumar Rakesh, Zhuang Hongming, Alavi Abass

机构信息

Division of Nuclear Medicine, Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, 110 Donner Building, Philadelphia, PA 19104, USA.

出版信息

Radiol Clin North Am. 2004 Nov;42(6):1141-53, ix. doi: 10.1016/j.rcl.2004.08.007.

Abstract

FDG-PET has a limited role in diagnosis of prostate cancer mainly because of the low uptake of FDG in the tumor and normal excretion of FDG through urine. FDG-PET has shown some promise in the assessment of lymph nodes and bone metastases. There is a large degree of variability when FDG-PET is compared with bone scintigraphy. New C11-labeled radiotracers (acetate, choline, and methionine) have shown promising initial results but further studies are required to determine their role in such settings. These radiotracers provide a unique opportunity for dynamic, multitracer, and quantitative studies, which improve the sensitivity and specificity on PET in this population. Short half-lives and of C-11, however with the limits to their use requires an on-site cyclotron. Recent synthesis schemes with [18F]-labeling, however, may overcome this limitation. FDG-PET has a significant potential to assist with the diagnosis and management of testicular cancer. PET has been most useful in defining the presence or absence of disease in patients with residual masses. PET has shown promising results for the initial diagnosis of this cancer, but further for studies ar required to determine its role in the management of this malignancy. PET can be used in conjunction with conventional imaging techniques to diagnose retroperitoneal masses in patients with primary testicular cancer. FDG-PET has shown very encouraging results in a limited number of studies, and has also demonstrated a good sensitivity for initial staging. FDG-PET seems to be superior to conventional imaging modalities for detecting local disease and recurrence, and distant metastases.

摘要

氟代脱氧葡萄糖正电子发射断层扫描(FDG-PET)在前列腺癌诊断中的作用有限,主要原因是肿瘤对FDG摄取较低以及FDG通过尿液正常排泄。FDG-PET在评估淋巴结和骨转移方面已显示出一些前景。与骨闪烁显像相比,FDG-PET存在很大程度的变异性。新的C11标记放射性示踪剂(醋酸盐、胆碱和蛋氨酸)已显示出有前景的初步结果,但需要进一步研究以确定它们在此类情况下的作用。这些放射性示踪剂为动态、多示踪剂和定量研究提供了独特机会,可提高该人群PET检查的敏感性和特异性。然而,C-11半衰期短,其使用受限需要现场回旋加速器。不过,最近的[18F]标记合成方案可能克服这一限制。FDG-PET在协助睾丸癌的诊断和管理方面具有巨大潜力。PET在确定残留肿块患者中疾病的有无方面最为有用。PET在该癌症的初始诊断中已显示出有前景的结果,但需要进一步研究以确定其在这种恶性肿瘤管理中的作用。PET可与传统成像技术联合用于诊断原发性睾丸癌患者的腹膜后肿块。在有限数量的研究中,FDG-PET已显示出非常令人鼓舞的结果,并且在初始分期方面也表现出良好的敏感性。在检测局部疾病、复发和远处转移方面,FDG-PET似乎优于传统成像方式。

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