18F-FET正电子发射断层显像（PET）与18F-氟代脱氧葡萄糖（FDG）PET及计算机断层扫描（CT）在头颈癌患者中的比较

18F-FET PET compared with 18F-FDG PET and CT in patients with head and neck cancer.

作者信息

Pauleit Dirk, Zimmermann Andre, Stoffels Gabriele, Bauer Dagmar, Risse Jörn, Flüss Michael O, Hamacher Kurt, Coenen Heinz H, Langen Karl-Josef

机构信息

Institute of Medicine and Brain Imaging Center West, Research Center Jülich, Jülich, Germany.

出版信息

J Nucl Med. 2006 Feb;47(2):256-61.

PMID:16455631

Abstract

UNLABELLED

Recent studies suggest a somewhat selective uptake of O-(2-[18F]fluoroethyl)-L-tyrosine (FET) in cerebral gliomas and in squamous cell carcinoma (SCC) and a good distinction between tumor and inflammation. The aim of this study was to investigate the diagnostic potential of 18F-FET PET in patients with SCC of the head and neck region by comparing that tracer with 18F-FDG PET and CT.

METHODS

Twenty-one patients with suspected head and neck tumors underwent 18F-FET PET, 18F-FDG PET, and CT within 1 wk before operation. After coregistration, the images were evaluated by 3 independent observers and an ROC analysis was performed, with the histopathologic result used as a reference. Furthermore, the maximum standardized uptake values (SUVs) in the lesions were determined.

RESULTS

In 18 of 21 patients, histologic examination revealed SCC, and in 2 of these patients, a second SCC tumor was found at a different anatomic site. In 3 of 21 patients, inflammatory tissue and no tumor were identified. Eighteen of 20 SCC tumors were positive for both 18F-FDG uptake and 18F-FET uptake, one 0.3-cm SCC tumor was detected neither with 18F-FDG PET nor with 18F-FET PET, and one 0.7-cm SCC tumor in a 4.3-cm ulcer was overestimated as a 4-cm tumor on 18F-FDG PET and missed on 18F-FET PET. Inflammatory tissue was positive for 18F-FDG uptake (SUV, 3.7-4.7) but negative for 18F-FET uptake (SUV, 1.3-1.6). The SUVs of 18F-FDG in SCC were significantly higher (13.0 +/- 9.3) than those of 18F-FET (4.4 +/- 2.2). The ROC analysis showed significantly superior detection of SCC with (18)F-FET PET or 18F-FDG PET than with CT. No significant difference (P = 0.71) was found between 18F-FDG PET and 18F-FET PET. The sensitivity of 18F-FDG PET was 93%, specificity was 79%, and accuracy was 83%. 18F-FET PET yielded a lower sensitivity of 75% but a substantially higher specificity of 95% (accuracy, 90%).

CONCLUSION

18F-FET may not replace 18F-FDG in the PET diagnostics of head and neck cancer but may be a helpful additional tool in selected patients, because 18F-FET PET might better differentiate tumor tissue from inflammatory tissue. The sensitivity of 18F-FET PET in SCC, however, was inferior to that of 18F-FDG PET because of lower SUVs.

摘要

未标注

近期研究表明，O-(2-[18F]氟乙基)-L-酪氨酸（FET）在脑胶质瘤和鳞状细胞癌（SCC）中存在一定程度的选择性摄取，且在肿瘤与炎症之间有良好的区分度。本研究旨在通过将该示踪剂与18F-FDG PET及CT进行比较，探讨18F-FET PET对头颈部区域鳞状细胞癌患者的诊断潜力。

方法

21例疑似头颈部肿瘤患者在术前1周内接受了18F-FET PET、18F-FDG PET及CT检查。图像配准后，由3名独立观察者进行评估，并以组织病理学结果为参考进行ROC分析。此外，还测定了病变部位的最大标准化摄取值（SUV）。

结果

21例患者中，18例经组织学检查确诊为SCC，其中2例在不同解剖部位发现了第二个SCC肿瘤。21例患者中有3例未发现肿瘤，仅见炎性组织。20例SCC肿瘤中有18例对18F-FDG摄取和18F-FET摄取均呈阳性，1例0.3 cm的SCC肿瘤在18F-FDG PET和18F-FET PET检查中均未被检测到，1例位于4.3 cm溃疡内的0.7 cm SCC肿瘤在18F-FDG PET上被高估为4 cm肿瘤，而在18F-FET PET上未被发现。炎性组织对18F-FDG摄取呈阳性（SUV，3.7 - 4.7），但对18F-FET摄取呈阴性（SUV，1.3 - 1.6）。SCC中18F-FDG的SUV（13.0±9.3）显著高于18F-FET（4.4±2.2）。ROC分析显示，(18)F-FET PET或18F-FDG PET对SCC的检测明显优于CT。18F-FDG PET与18F-FET PET之间未发现显著差异（P = 0.71）。18F-FDG PET的敏感性为93%，特异性为79%，准确性为83%。18F-FET PET的敏感性较低，为75%，但特异性显著更高，为95%（准确性为90%）。