Giammarile Francesco, Billotey Claire, Lombard-Bohas Catherine, Le Bars Didier, Bournaud Claire, Masson Sandrine, Walter Thomas, Houzard Claire, Scoazec Jean-Yves, Hervieu Valérie, Vuillez Jean-Philippe, Cornu Catherine, Janier Marc, Borson-Chazot Françoise
Nuclear Medicine Department, Hospices Civils de Lyon, Lyon-Sud Hospital, France.
Nucl Med Commun. 2011 Feb;32(2):91-7. doi: 10.1097/MNM.0b013e3283412143.
Gastro-entero-pancreatic (GEP) endocrine tumours are a heterogenous group of tumours of variable localization and prognosis. It has been suggested that positron emission tomography (PET) using 2-[18F]fluoro-2-deoxy-D-glucose (18F-FDG) may have a prognostic value and help to identify patients at risk of progression. [18F]fluoro-3'-deoxy-3'-L-fluorothymidine (18F-FLT) has been recently developed as a PET proliferation tracer. At present, there are no studies investigating its role in GEP. The aim of this prospective study was to assess the value of 18F-FLT-PET for the evaluation of GEP.
Ten patients with biopsy-proven locally advanced or metastasized, well-differentiated GEP neuroendocrine tumours were prospectively enrolled and scheduled for 18F-FDG and 18F-FLT-PET. Images were compared with other conventional diagnostic procedures, namely computed tomography, ultrasound, somatostatin receptor scintigraphy and with clinical and diagnostic follow-up.
Evaluation criteria were interpreted in terms of assumed presence of tumoral tissue. According to the patient's status, FDG was positive in five out of the seven patients with stable disease and in two out of the three patients with progressive disease. No positive case was identified by 18F-FLT in either the primary or the metastatic tumour site, whatever the status of patients, and this was probably a reflection of the slow proliferation rate of tumours.
These preliminary data suggest that 18F-FLT-PET is not a suitable tracer for the evaluation of advanced well-differentiated GEP tumours. FDG showed good diagnostic performance but does not help to identify patients at risk of progression.
胃肠胰（GEP）内分泌肿瘤是一组异质性肿瘤，其定位和预后各不相同。有人提出，使用2-[18F]氟-2-脱氧-D-葡萄糖（18F-FDG）的正电子发射断层扫描（PET）可能具有预后价值，并有助于识别有疾病进展风险的患者。[18F]氟-3'-脱氧-3'-L-氟胸腺嘧啶核苷（18F-FLT）最近已被开发为一种PET增殖示踪剂。目前，尚无研究调查其在GEP中的作用。这项前瞻性研究的目的是评估18F-FLT-PET在评估GEP方面的价值。
前瞻性纳入10例经活检证实为局部晚期或转移性、高分化GEP神经内分泌肿瘤的患者，并安排进行18F-FDG和18F-FLT-PET检查。将图像与其他传统诊断方法进行比较，即计算机断层扫描、超声、生长抑素受体闪烁显像以及临床和诊断随访。
根据假定的肿瘤组织存在情况来解释评估标准。根据患者的病情，在7例病情稳定的患者中，5例18F-FDG呈阳性，在3例病情进展的患者中，2例呈阳性。无论患者病情如何，在原发或转移肿瘤部位，18F-FLT均未发现阳性病例，这可能反映了肿瘤的增殖速度较慢。
这些初步数据表明，18F-FLT-PET不是评估晚期高分化GEP肿瘤的合适示踪剂。18F-FDG显示出良好的诊断性能，但无助于识别有疾病进展风险的患者。
