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18F-氟化物正电子发射断层扫描及正电子发射断层扫描/计算机断层扫描

18F-Fluoride positron emission tomography and positron emission tomography/computed tomography.

作者信息

Even-Sapir Einat, Mishani Eyal, Flusser Gideon, Metser Ur

机构信息

Department of Nuclear Medicine, Osteoradioiology Unit, Tel-Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.

出版信息

Semin Nucl Med. 2007 Nov;37(6):462-9. doi: 10.1053/j.semnuclmed.2007.07.002.

Abstract

(18)F-Fluoride is a positron-emitting bone-seeking agent, the uptake of which reflects blood flow and remodeling of bone. Assessment of (18)F-fluoride kinetics using quantitative positron emission tomography (PET) methods allows the regional characterization of lesions of metabolic bone diseases and the monitoring of their response to therapy. It also enables the assessment of bone viability and discrimination of uneventful and impaired healing processes of fractures, bone grafts and osteonecrosis. Taking advantage of the favorable pharmacokinetic properties of the tracer combined with the high performance of PET technology, static (18)F-fluoride PET is a highly sensitive imaging modality for detection of benign and malignant osseous abnormalities. Although (18)F-fluoride uptake mechanism corresponds to osteoblastic activity, it is also sensitive for detection of lytic and early marrow-based metastases, by identifying their accompanying reactive osteoblastic changes, even when minimal. The instant fusion of increased (18)F-fluoride uptake with morphological data of computed tomography (CT) using hybrid PET/CT systems improves the specificity of (18)F-fluoride PET in cancer patients by accurately differentiating between benign and malignant sites of uptake. The results of a few recent publications suggest that (18)F-fluoride PET/CT is a valuable modality in the diagnosis of pathological osseous conditions in patients also referred for nononcologic indications. (18)F-fluoride PET and PET/CT are, however, not widely used in clinical practice. The limited availability of (18)F-fluoride and of PET and PET/CT systems is a major factor. At present, there are not enough data on the cost-effectiveness of (18)F-fluoride PET/CT. However, it has been stated by some experts that (18)F-fluoride PET/CT is expected to replace (99m)Tc-MDP bone scintigraphy in the future.

摘要

(18)F - 氟化物是一种发射正电子的亲骨剂,其摄取反映了骨血流和重塑情况。使用定量正电子发射断层扫描(PET)方法评估(18)F - 氟化物动力学,可对代谢性骨病病变进行区域特征分析,并监测其对治疗的反应。它还能够评估骨活力,区分骨折、骨移植和骨坏死的愈合过程是否顺利及有无受损。利用该示踪剂良好的药代动力学特性以及PET技术的高性能,静态(18)F - 氟化物PET是检测良性和恶性骨异常的高灵敏度成像方式。尽管(18)F - 氟化物摄取机制与成骨细胞活性相对应,但它对溶骨性和早期骨髓转移灶的检测也很敏感,通过识别其伴随的反应性成骨细胞变化,即使这种变化很轻微。使用PET/CT混合系统将增加的(18)F - 氟化物摄取与计算机断层扫描(CT)的形态学数据即时融合,通过准确区分良性和恶性摄取部位,提高了(18)F - 氟化物PET在癌症患者中的特异性。最近一些出版物的结果表明,(18)F - 氟化物PET/CT在诊断因非肿瘤适应症转诊患者的病理性骨疾病方面是一种有价值的方式。然而,(18)F - 氟化物PET和PET/CT在临床实践中并未广泛应用。(18)F - 氟化物以及PET和PET/CT系统的可及性有限是一个主要因素。目前,关于(18)F - 氟化物PET/CT成本效益的数据还不够。然而,一些专家表示,(18)F - 氟化物PET/CT有望在未来取代(99m)Tc - MDP骨闪烁显像。

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