Herrmann Ken, Krause Bernd Joachim, Bundschuh Ralph A, Dechow Tobias, Schwaiger Markus
Department of Nuclear Medicine, Technische Universität München, Munich, Germany.
Semin Nucl Med. 2009 May;39(3):210-32. doi: 10.1053/j.semnuclmed.2008.12.001.
Positron emission tomography (PET) and PET/computed tomography (CT) with the glucose analog (18)F-fluorodeoxyglucose (FDG) are increasingly used to assess response to therapy in patients, and there is converging evidence that changes in glucose utilization during therapy can be used to predict clinical outcome. Today, integrated PET/CT systems have mainly replaced stand-alone PET devices, providing the opportunity to integrate morphologic information and functional information. However, the use of PET/CT systems also gives rise to methodological challenges for the quantitative analysis of PET scans for treatment monitoring. Recently published single-center studies demonstrate that FDG-PET and FDG-PET/CT have been successfully used for monitoring of tumor response to cytotoxic therapy in a variety of tumor entities. The potential early identification of nonresponding tumors provides an opportunity to alter treatment regimens according to the individual chemosensitivity of the tumor tissue. In this article, we review the methodological background to monitoring of cancer treatment with PET/CT, the diagnostic and prognostic performance of PET/CT for predicting tumor response with the glucose analog FDG in various tumor entities, and the clinical potential of new imaging probes. In addition, the future direction of research and clinical applications is discussed.
正电子发射断层扫描（PET）以及使用葡萄糖类似物（18）F-氟脱氧葡萄糖（FDG）的PET/计算机断层扫描（CT）越来越多地用于评估患者的治疗反应，并且越来越多的证据表明治疗期间葡萄糖利用的变化可用于预测临床结果。如今，集成式PET/CT系统已主要取代了独立的PET设备，提供了整合形态学信息和功能信息的机会。然而，PET/CT系统的使用也给用于治疗监测的PET扫描定量分析带来了方法学挑战。最近发表的单中心研究表明，FDG-PET和FDG-PET/CT已成功用于监测多种肿瘤实体中肿瘤对细胞毒性治疗的反应。对无反应肿瘤的潜在早期识别为根据肿瘤组织的个体化学敏感性改变治疗方案提供了机会。在本文中，我们回顾了用PET/CT监测癌症治疗的方法学背景、PET/CT在各种肿瘤实体中使用葡萄糖类似物FDG预测肿瘤反应的诊断和预后性能以及新型成像探针的临床潜力。此外，还讨论了研究和临床应用的未来方向。
