功能成像在支气管肿块鉴别诊断中的应用：（18）F-FDG PET-CT 扫描与（68）Ga DOTA-TOC PET-CT 扫描联合应用的初步经验。
Functional imaging in differentiating bronchial masses: an initial experience with a combination of (18)F-FDG PET-CT scan and (68)Ga DOTA-TOC PET-CT scan.
机构信息
Department of Surgical Disciplines, All India Institute of Medical Sciences, New Delhi, 110029, India.
出版信息
Ann Nucl Med. 2009 Oct;23(8):745-51. doi: 10.1007/s12149-009-0302-0. Epub 2009 Sep 29.
OBJECTIVE
To evaluate the role of combination of (18)F-FDG PET-CT scan and (68)Ga DOTA-TOC PET-CT scan in differentiating bronchial tumors observed in contrast enhanced computed tomography scan of chest.
STUDY DESIGN
Prospective observational study. Place of study: All India Institute of Medical Sciences, New Delhi, India.
METHODS
7 patients with bronchial mass detected in computed tomography scan of the chest were included in this study. All patients underwent (18)F-FDG PET-CT scan, (68)Ga DOTA-TOC PET-CT scan and fiberoptic bronchoscope guided biopsy followed by definitive surgical excision. The results of functional imaging studies were analyzed and the results are correlated with the final histopathology of the tumor.
RESULTS
Histopathological examination of 7 bronchial masses revealed carcinoid tumors (2 typical, 1 atypical), inflammatory myofibroblastic tumor (1), mucoepidermoid carcinoma (1), hamartoma (1), and synovial cell sarcoma (1). The typical carcinoids had mild (18)F-FDG uptake and high (68)Ga DOTA-TOC uptake. Atypical carcinoid had moderate uptake of (18)F-FDG and high (68)Ga DOTA-TOC uptake. Inflammatory myofibroblastic tumor showed high uptake of (18)F-FDG and no uptake of (68)Ga DOTA-TOC. Mucoepidermoid carcinoma showed mild (18)F-FDG uptake and no (68)Ga DOTA-TOC uptake. Hamartoma showed no uptake on either scans. Synovial cell sarcoma showed moderate (18)F-FDG uptake and mild focal (68)Ga DOTA-TOC uptake.
CONCLUSION
This initial experience with the combined use of (18)F-FDG and (68)Ga DOTA-TOC PET-CT scan reveals different uptake patterns in various bronchial tumors. Bronchoscopic biopsy will continue to be the gold standard; however, the interesting observations made in this study merits further evaluation of the utility of the combination of (18)F-FDG PET-CT scan and (68)Ga DOTA-TOC PET-CT scan in larger number of patients with bronchial masses.
目的
评估（18）F-FDG PET-CT 扫描和（68）Ga DOTA-TOC PET-CT 扫描在区分胸部增强 CT 扫描中观察到的支气管肿瘤中的作用。
研究设计
前瞻性观察性研究。研究地点：印度新德里全印度医学科学研究所。
方法
本研究纳入了 7 例胸部 CT 扫描发现的支气管肿块患者。所有患者均行（18）F-FDG PET-CT 扫描、（68）Ga DOTA-TOC PET-CT 扫描和纤维支气管镜引导下活检，然后行确定性手术切除。分析功能影像学研究结果，并将结果与肿瘤的最终组织病理学进行相关性分析。
结果
7 个支气管肿块的组织病理学检查结果显示类癌肿瘤（2 例典型，1 例不典型）、炎性肌纤维母细胞瘤（1 例）、黏液表皮样癌（1 例）、错构瘤（1 例）和滑膜肉瘤（1 例）。典型类癌的（18）F-FDG 摄取轻度，（68）Ga DOTA-TOC 摄取较高。不典型类癌的（18）F-FDG 摄取中度，（68）Ga DOTA-TOC 摄取较高。炎性肌纤维母细胞瘤（18）F-FDG 摄取较高，（68）Ga DOTA-TOC 摄取为零。黏液表皮样癌（18）F-FDG 摄取轻度，（68）Ga DOTA-TOC 摄取为零。错构瘤两种扫描均无摄取。滑膜肉瘤（18）F-FDG 摄取中度，（68）Ga DOTA-TOC 摄取轻度局灶性。
结论
本研究初步尝试联合应用（18）F-FDG 和（68）Ga DOTA-TOC PET-CT 扫描，结果显示不同支气管肿瘤的摄取模式存在差异。支气管镜活检仍将是金标准；然而，本研究中的有趣观察结果值得进一步评估（18）F-FDG PET-CT 扫描和（68）Ga DOTA-TOC PET-CT 扫描在更多支气管肿块患者中的应用价值。
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