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正电子发射断层扫描(PET)在检测内分泌肿瘤方面的进展。

Developments in PET for the detection of endocrine tumours.

作者信息

Eriksson B, Orlefors H, Oberg K, Sundin A, Bergström M, Långström B

机构信息

Department of Endocrine Oncology, University Hospital, SE-751 85 Uppsala, Sweden.

出版信息

Best Pract Res Clin Endocrinol Metab. 2005 Jun;19(2):311-24. doi: 10.1016/j.beem.2004.11.001.

Abstract

Positron emission tomography (PET) supplies a range of labelled compounds to be used for the characterization of tumour biochemistry. Some of these have proved to be of value for clinical diagnosis, treatment follow-up, and clinical research. (18)F-fluorodeoxyglucose PET scanning is now a widely accepted imaging approach in clinical oncology, reflecting increased expression of glucose transporters in cancerous tissue. This tracer, however, does not show sufficient uptake in well-differentiated tumours such as neuroendocrine tumours. Endocrine tumours have the unique characteristics of taking up and decarboxylating amine precursors. These so-called APUD characteristics offer highly specific targets for PET tracers. Using this approach, radiopharmaceuticals such as [(11)C]-5-hydroxytryptophan and [(11)C]-L-dihydroxyphenylalanine for localization of carcinoid and endocrine pancreatic tumours, 6-[(18)F]-fluorodopamine and [(11)C]-hydroxyephedrine for phaeochromocytomas, and [(11)C]-metomidate for adrenal cortical tumours have been developed. Functional imaging with PET using these compounds is now being employed to complement rather than replace other imaging modalities. Development of new PET radiopharmaceuticals may in the future allow in vivo detection of tumour biological properties, such as malignant potential and responsiveness to treatment.

摘要

正电子发射断层扫描(PET)提供了一系列用于表征肿瘤生物化学的标记化合物。其中一些已被证明对临床诊断、治疗随访和临床研究具有价值。(18)F-氟脱氧葡萄糖PET扫描目前是临床肿瘤学中一种广泛接受的成像方法,反映了癌组织中葡萄糖转运蛋白表达的增加。然而,这种示踪剂在神经内分泌肿瘤等分化良好的肿瘤中摄取不足。内分泌肿瘤具有摄取和脱羧胺前体的独特特征。这些所谓的APUD特征为PET示踪剂提供了高度特异性的靶点。利用这种方法,已经开发出了用于类癌和内分泌胰腺肿瘤定位的放射性药物,如[(11)C]-5-羟色氨酸和[(11)C]-L-二羟基苯丙氨酸;用于嗜铬细胞瘤的6-[(18)F]-氟多巴胺和[(11)C]-羟基麻黄碱;以及用于肾上腺皮质肿瘤的[(11)C]-米托咪酯。目前正在使用这些化合物进行PET功能成像,以补充而不是取代其他成像方式。未来,新的PET放射性药物的开发可能会使体内检测肿瘤生物学特性成为可能,如恶性潜能和对治疗的反应性。

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