应用贝可（Bq）作为定量测量手段的围手术期氟代脱氧葡萄糖引导成像，优化晚期恶性肿瘤患者的手术切除。

Perioperative (18)F-fluorodeoxyglucose-guided imaging using the becquerel as a quantitative measure for optimizing surgical resection in patients with advanced malignancy.

机构信息

Department of Radiology, The Ohio State University, Columbus, OH, USA.

出版信息

Am J Surg. 2009 Dec;198(6):834-40. doi: 10.1016/j.amjsurg.2009.08.014.

DOI:10.1016/j.amjsurg.2009.08.014

PMID:19969138

Abstract

BACKGROUND

(18)F-fluorodeoxyglucose ((18)F-FDG) positron emission tomography/computed tomography (PET/CT) scanning is a widely accepted preoperative tumor imaging modality. Herein, we evaluate the becquerel (Bq) as a potential novel quantitative PET measure for application of surgical specimen imaging.

METHODS

Retrospectively, PET-avid lesions that could be followed from preoperative imaging, confidently identified in the operating room, imaged ex vivo, and correlated with histopathology were included in this study. Bq counts from both in vivo (preoperative) and ex vivo (surgical specimen) PET/CT images were measured and correlated with histopathology.

RESULTS

Fifty-five PET-avid lesions in 37 patients were included. Forty-six of 55 PET-avid lesions identified were found to contain malignancy on histopathology. Mean Bq counts for the PET-avid lesions were significantly higher that the adjacent PET-nonavid areas (background) within both in vivo and ex vivo imaging (P < .001 and P < .001, respectively). When analyzing all 55 lesions, we found significant increases in Bq levels. PET-avid lesions from in vivo to ex vivo images (P < .001) without significant increases in Bq levels in PET-nonavid lesions from in vivo to ex vivo images (P = .06). When comparing Bq levels between the 2 groups (malignant and benign), we found significantly higher Bq counts in the malignant group on in vivo imaging (P = .02) as well as significantly lower Bq counts in FDG-nonavid areas on ex vivo imaging (P = .04) within the malignant group. Significant differences in PET-avid to PET-nonavid Becquerels ratios within both in vivo and ex vivo images (P = .004, P = .002 respectively) were found, with ex vivo ratio being significantly higher (P < .001).

CONCLUSIONS

(18)F-FDG PET/CT imaging using Bqs is the potential to discern malignant lesions from benign tissues within both in vivo and ex vivo scans.

摘要

背景

（18）F-氟代脱氧葡萄糖（（18）F-FDG）正电子发射断层扫描/计算机断层扫描（PET/CT）扫描是一种广泛接受的术前肿瘤成像方式。在此，我们评估贝克勒尔（Bq）作为一种潜在的新型定量 PET 测量方法，用于手术标本成像。

方法

回顾性地，纳入了术前成像可追踪、术中明确识别、离体成像并与组织病理学相关的 PET 阳性病变。测量了来自体内（术前）和离体（手术标本）PET/CT 图像的 Bq 计数，并与组织病理学相关。

结果

纳入了 37 名患者的 55 个 PET 阳性病变。55 个 PET 阳性病变中，46 个在组织病理学上被发现含有恶性肿瘤。PET 阳性病变的平均 Bq 计数在体内和离体成像中均显著高于 PET 非阳性病变（背景）（分别为 P <.001 和 P <.001）。当分析所有 55 个病变时，我们发现 Bq 水平显著升高。PET 阳性病变从体内到离体图像（P <.001），而 PET 非阳性病变从体内到离体图像（P =.06）Bq 水平无显著升高。当比较 2 组（恶性和良性）的 Bq 水平时，我们发现恶性组在体内成像中 Bq 计数显著升高（P =.02），在恶性组的 FDG 非阳性区域中 Bq 计数显著降低（P =.04）。在体内和离体图像中，PET 阳性与 PET 非阳性 Bq 比值均有显著差异（P =.004，P =.002），离体比值显著升高（P <.001）。