Du Yong, Cullum Ian, Illidge Tim M, Ell Peter J
Institute of Nuclear Medicine, 5th Floor, University College Hospital, London, United Kingdom.
J Clin Oncol. 2007 Aug 10;25(23):3440-7. doi: 10.1200/JCO.2007.11.2854. Epub 2007 Jun 25.
By monitoring bone metastases with sequential [(18)F]fluorodeoxyglucose positron-emission tomography/computed tomography ([(18)F]FDG-PET/CT) imaging, this study investigates the clinical relevance of [(18)F]FDG uptake features of bone metastases with various radiographic appearances.
Bone metastases were found in 67 of 408 consecutive patients with known/suspected recurrent breast cancer on [(18)F]FDG-PET/CT, characterized by CT morphology changes and/or bony [(18)F]FDG uptake. Twenty-five of the patients had sequential [(18)F]FDG-PET/CT examinations (86 studies) over an average follow-up period of 23 months. The temporal changes in [(18)F]FDG uptake and corresponding CT morphology features of 146 bone lesions identified in these 25 patients were followed up and correlated with therapeutic outcome retrospectively.
The 146 lesions were classified as osteolytic (77), osteoblastic (41), mixed-pattern (11), or no change/negative (17) on CT. The majority of the osteolytic (72; 93.5%) and mixed-pattern lesions (nine; 81.8%), but fewer of the osteoblastic lesions (25; 61%), showed increased [(18)F]FDG uptake. After treatment, 58 osteolytic lesions (80.5%) became [(18)F]FDG negative and osteoblastic on CT and only 14 relatively large lesions (19.5%) remained [(18)F]FDG avid. Of the 25 [(18)F]FDG-avid osteoblastic lesions, 13 (52%) became [(18)F]FDG negative, but 12 (48%) remained [(18)F]FDG avid and increased in size on CT. Five of the mixed-pattern lesions remained [(18)F]FDG avid after treatment. All 17 CT-negative lesions became [(18)F]FDG negative; however, nine of them became osteoblastic. None of the initially [(18)F]FDG-negative lesions showed [(18)F]FDG avidity during follow-up.
[(18)F]FDG uptake reflects the immediate tumor activity of bone metastases, whereas the radiographic morphology changes vary greatly with time among patients.
通过采用序贯[（18）F]氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（[（18）F]FDG-PET/CT）成像监测骨转移，本研究调查具有各种影像学表现的骨转移的[（18）F]FDG摄取特征的临床相关性。
在408例已知/疑似复发性乳腺癌的连续患者中，67例在[（18）F]FDG-PET/CT上发现骨转移，其特征为CT形态改变和/或骨[（18）F]FDG摄取。25例患者在平均23个月的随访期内接受了序贯[（18）F]FDG-PET/CT检查（86次研究）。对这25例患者中识别出的146个骨病变的[（18）F]FDG摄取的时间变化以及相应的CT形态特征进行随访，并回顾性地将其与治疗结果相关联。
146个病变在CT上被分类为溶骨性（77个）、成骨性（41个）、混合模式（11个）或无变化/阴性（17个）。大多数溶骨性病变（72个；93.5%）和混合模式病变（9个；81.8%），但较少的成骨性病变（25个；61%）显示[（18）F]FDG摄取增加。治疗后，58个溶骨性病变（80.5%）在CT上变为[（18）F]FDG阴性且呈成骨性，只有14个相对较大的病变（19.5%）仍为[（18）F]FDG摄取阳性。在25个[（18）F]FDG摄取阳性的成骨性病变中，13个（52%）变为[（18）F]FDG阴性，但12个（48%）仍为[（18）F]FDG摄取阳性且在CT上增大。5个混合模式病变在治疗后仍为[（18）F]FDG摄取阳性。所有17个CT阴性病变均变为[（18）F]FDG阴性；然而，其中9个变为成骨性。最初[（18）F]FDG阴性的病变在随访期间均未显示[（18）F]FDG摄取阳性。
[（18）F]FDG摄取反映骨转移的即时肿瘤活性，而影像学形态变化在患者之间随时间差异很大。
