L-3-[¹⁸F]-氟-α-甲基酪氨酸（FMT）PET用于颌面部肿瘤的诊断：与FDG-PET的对比研究

Diagnosis of maxillofacial tumor with L-3-[18f]-fluoro-alpha-methyltyrosine (FMT) PET: a comparative study with FDG-PET.

作者信息

Miyakubo Mitsuyuki, Oriuchi Noboru, Tsushima Yoshito, Higuchi Tetsuya, Koyama Keiko, Arai Kiyokazu, Paudyal Bishnuhari, Iida Yasuhiko, Hanaoka Hirofumi, Ishikita Tomohiro, Nakasone Yoshiki, Negishi Akihide, Mogi Kenji, Endo Keigo

机构信息

Department of Stomatology and Maxillofacial Surgery, Gunma University Graduate School of Medicine, Japan.

出版信息

Ann Nucl Med. 2007 Feb;21(2):129-35. doi: 10.1007/BF03033991.

DOI:10.1007/BF03033991

PMID:17424980

Abstract

OBJECTIVES

To compare L-3-[18F]-fluoro-a-methyltyrosine (FMT)-positron emission tomography (PET) and 2-[18F]-fluoro-2-deoxy-D-glucose (FDG)-PET in the differential diagnosis of maxillofacial tumors.

METHODS

This study included 36 patients (16 males, 20 females; 31-90 years old) with untreated malignant tumors (34 squamous cell carcinoma, one mucoepidermoid carcinoma, one rhabdomyosarcoma) and seven patients (five males, two females; 32-81 years old) with benign lesions. In all patients, both FMT-PET and FDG-PET were performed within two weeks before biopsy or treatment of the lesions. To evaluate the diagnostic usefulness of FMT-PET and FDG-PET, visual interpretation and semiquantitative analysis were performed. PET images were rated according to the contrast of tumor uptake as compared with background, and were statistically analyzed. As a semiquantitative analysis, standardized uptake values (SUV) of the primary tumors were measured, and the SUV data were analyzed using receiver operating characteristic (ROC) curves.

RESULTS

The mean SUV of the malignant lesions were significantly higher than those of the benign lesions in both FMT-PET (2.62 +/- 1.58 vs. 1.20 +/- 0.30, p < 0.01) and FDG-PET (9.17 +/- 5.06 vs. 3.14 +/- 1.34, p < 0.01). A positive correlation (r = 0.567, p < 0.0001, n = 46) was noted between FMT and FDG. ROC analysis revealed that there was no statistically significant difference in SUVs between FMT and FDG for differentiating malignant tumors. In 27 of 36 patients, FMT-PET had better contrast of malignant tumor visualization to the surrounding normal structures by visual assessment (p < 0.005, binomial proportion test).

CONCLUSIONS

Differential diagnosis of FMT-PET based on the uptake in maxillofacial tumors is equivalent to FDG-PET. However, the contrast of FMT uptake between maxillofacial tumors and the surrounding normal structures is higher than that of FDG, indicating the possibility of accurate diagnosis of maxillofacial tumors by FMT-PET.

摘要

目的

比较L-3-[18F]-氟-α-甲基酪氨酸（FMT）-正电子发射断层扫描（PET）和2-[18F]-氟-2-脱氧-D-葡萄糖（FDG）-PET在颌面部肿瘤鉴别诊断中的应用。

方法

本研究纳入36例未经治疗的恶性肿瘤患者（男16例，女20例；年龄31 - 90岁）（34例鳞状细胞癌、1例黏液表皮样癌、1例横纹肌肉瘤）和7例良性病变患者（男5例，女2例；年龄32 - 81岁）。所有患者在病变活检或治疗前两周内均接受了FMT-PET和FDG-PET检查。为评估FMT-PET和FDG-PET的诊断价值，进行了视觉解读和半定量分析。根据肿瘤摄取与背景的对比对PET图像进行评分，并进行统计学分析。作为半定量分析，测量了原发肿瘤的标准化摄取值（SUV），并使用受试者工作特征（ROC）曲线对SUV数据进行分析。

结果

在FMT-PET（2.62±1.58 vs. 1.20±0.30，p<0.01）和FDG-PET（9.17±5.06 vs. 3.14±1.34，p<0.01）中，恶性病变的平均SUV均显著高于良性病变。FMT与FDG之间存在正相关（r = 0.567，p<0.0001，n = 46）。ROC分析显示，FMT和FDG在鉴别恶性肿瘤的SUV方面无统计学显著差异。在36例患者中的27例中，通过视觉评估，FMT-PET对恶性肿瘤与周围正常结构的可视化对比更好（p<0.005，二项式比例检验）。