Wong Ching-yee Oliver, Noujaim Daniel, Fu Hungsen F, Huang Wen-sheng, Cheng Cheng-yi S, Thie Joseph, Dalal Ishani, Chang Chih-yung, Nagle Conrad
Department of Nuclear Medicine, William Beaumont Hospital, 3601 W. Thirteen Mile Road, Royal Oak, MI 48073-6769, USA.
Mol Imaging Biol. 2009 Jul-Aug;11(4):283-90. doi: 10.1007/s11307-009-0206-3. Epub 2009 Mar 27.
The aim of this study was to define and investigate the time sensitivity of tumors by variable dual-time fluorodeoxyglucose positron emission tomography (FDG PET).
Variable dual-time (t) protocol (P) FDG PET-computed tomography (CT) scans from 40 patients with pathologically proven head and neck tumors without brain metastasis were analyzed. The first protocol (P.I) consisted of 26 patients with early (E) and delayed (D) PET-CT obtained at 106 +/- 15 and 135 +/- 16 min after injection of 16.3 +/- 1.9 mCi FDG. The second protocol (P.II) recruited 14 patients with E- and D-PET performed at 54 +/- 13 and 151 +/- 28 min after injection of 9.6 +/- 1.7 mCi FDG. The maximum standardized uptake values (SUVs) were measured in the primary tumor (CA1) and the cerebellum (CBL). The time sensitivity (S) was defined as d{ln(SUV)}/d{ln(t)} and its value was obtained by linear regression of ln(D-SUV/E-SUV) vs ln(t (D)/t (E)). Patients with cerebellar variations greater than 30% in SUV between E- and D-PET was excluded from the analysis.
Two patients from P.I were excluded due to wide cerebellar SUV variations. D-SUV were significantly higher than E-SUV in CA1 for both P.I (18.9 +/- 6.9 vs 14.8 +/- 5.6, p < 0.0005) and P.II (11.5 +/- 7.9 vs 9.7 +/- 6.9, p = 0.013). The S values for CA1 in P.I and P.II were 0.67 and 0.17, respectively. The D-SUV were also higher than E-SUV in CBL for both P.I (12.5 +/- 1.6 vs 11.6 +/- 1.6, p < 0.0005) and P.II (7.6 +/- 1.6 vs 7.0 +/- 1.6, p = 0.008). The S values for CBL in P.I and P.II were 0.47 and 0.04, respectively, which were over 1.4-fold smaller than that of CA1, suggesting fundamental kinetic differences between CA1 and CBL.
The time sensitivity factor reflects another kinetic parameter of tumor metabolism besides SUV when using variable dual-time FDG PET. It offers another useful diagnostic tool in optimizing choices of dual-time protocols for oncologic PET-CT and in reducing SUV variations due to time interval differences with corrections using S.
本研究旨在通过可变双时相氟脱氧葡萄糖正电子发射断层扫描（FDG PET）来定义和研究肿瘤的时间敏感性。
分析了40例经病理证实无脑转移的头颈部肿瘤患者的可变双时相（t）方案（P）FDG PET计算机断层扫描（CT）图像。第一个方案（P.I）包括26例患者，在注射16.3±1.9 mCi FDG后的106±15分钟和135±16分钟进行早期（E）和延迟（D）PET-CT检查。第二个方案（P.II）纳入了14例患者，在注射9.6±1.7 mCi FDG后的54±13分钟和151±28分钟进行E和D PET检查。在原发肿瘤（CA1）和小脑（CBL）中测量最大标准化摄取值（SUV）。时间敏感性（S）定义为d{ln(SUV)}/d{ln(t)}，其值通过ln(D-SUV/E-SUV)对ln(t (D)/t (E))进行线性回归获得。E和D PET之间小脑SUV变化大于30%的患者被排除在分析之外。
P.I组有2例患者因小脑SUV变化较大而被排除。对于P.I组（18.9±6.9 vs 14.8±5.6，p<0.0005）和P.II组（11.5±7.9 vs 9.7±6.9，p = 0.013），CA1中的D-SUV均显著高于E-SUV。P.I组和P.II组CA1的S值分别为0.67和0.17。对于P.I组（12.5±1.6 vs 11.6±1.6，p<0.0005）和P.II组（7.6±1.6 vs 7.0±1.6，p = 0.008），CBL中的D-SUV也高于E-SUV。P.I组和P.II组CBL的S值分别为0.47和0.04，比CA1的S值小1.4倍以上，表明CA1和CBL之间存在基本的动力学差异。
当使用可变双时相FDG PET时，时间敏感性因子反映了除SUV之外的肿瘤代谢的另一个动力学参数。它为优化肿瘤PET-CT的双时相方案选择以及通过使用S进行校正来减少由于时间间隔差异导致的SUV变化提供了另一种有用的诊断工具。
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