Department of Neurological Surgery, Lariboisière Hospital, Universities of Paris, France.
Mol Med. 2011 Mar-Apr;17(3-4):308-16. doi: 10.2119/molmed.2010.00218. Epub 2011 Jan 3.
Energy metabolism measurements in spinal cord tumors, as well as in osseous spinal tumors/metastasis in vivo, are rarely performed only with molecular imaging (MI) by positron emission tomography (PET). This imaging modality developed from a small number of basic clinical science investigations followed by subsequent work that influenced and enhanced the research of others. Apart from precise anatomical localization by coregistration of morphological imaging and quantification, the most intriguing advantage of this imaging is the opportunity to investigate the time course (dynamics) of disease-specific molecular events in the intact organism. Most importantly, MI represents one of the key technologies in translational molecular neuroscience research, helping to develop experimental protocols that may later be applied to human patients. PET may help monitor a patient at the vertebral level after surgery and during adjuvant treatment for recurrent or progressive disease. Common clinical indications for MI of primary or secondary CNS spinal tumors are: (i) tumor diagnosis, (ii) identification of the metabolically active tumor compartments (differentiation of viable tumor tissue from necrosis) and (iii) prediction of treatment response by measurement of tumor perfusion or ischemia. While spinal PET has been used under specific circumstances, a question remains as to whether the magnitude of biochemical alterations observed by MI in CNS tumors in general (specifically spinal tumors) can reveal any prognostic value with respect to survival. MI may be able to better identify early disease and to differentiate benign from malignant lesions than more traditional methods. Moreover, an adequate identification of treatment effectiveness may influence patient management. MI probes could be developed to image the function of targets without disturbing them or as treatment to modify the target's function. MI therefore closes the gap between in vitro and in vivo integrative biology of disease. At the spinal level, MI may help to detect progression or recurrence of metastatic disease after surgical treatment. In cases of nonsurgical treatments such as chemo-, hormone- or radiotherapy, it may better assess biological efficiency than conventional imaging modalities coupled with blood tumor markers. In fact, PET provides a unique possibility to correlate topography and specific metabolic activity, but it requires additional clinical and experimental experience and research to find new indications for primary or secondary spinal tumors.
脊髓肿瘤，以及骨脊柱肿瘤/转移的能量代谢测量，很少仅通过正电子发射断层扫描（PET）的分子成像（MI）进行。这种成像模式源自少数基础临床科学研究，随后的工作影响和增强了其他人的研究。除了通过形态成像和定量的配准进行精确的解剖定位外，这种成像最吸引人的优势是有机会研究完整机体中疾病特异性分子事件的时间过程（动态）。最重要的是，MI 代表转化分子神经科学研究的关键技术之一，有助于开发实验方案，这些方案以后可能会应用于人类患者。PET 可以帮助监测手术后患者和辅助治疗中复发性或进行性疾病的患者。对原发性或继发性 CNS 脊柱肿瘤的 MI 的常见临床适应证为：（i）肿瘤诊断，（ii）识别代谢活跃的肿瘤区室（区分存活肿瘤组织与坏死），（iii）通过测量肿瘤灌注或缺血来预测治疗反应。虽然在特定情况下已经使用了脊髓 PET，但仍存在一个问题，即 MI 在 CNS 肿瘤（特别是脊柱肿瘤）中观察到的生化改变的幅度是否可以揭示与生存相关的任何预后价值。MI 可能比传统方法更能早期发现疾病，并区分良性和恶性病变。此外，对治疗效果的充分识别可能会影响患者的管理。MI 探针可以开发成像功能而不干扰它们，或作为治疗来修饰目标的功能。因此，MI 弥合了疾病体外和体内综合生物学之间的差距。在脊柱水平，MI 可以帮助检测手术治疗后转移性疾病的进展或复发。对于非手术治疗，如化疗、激素或放疗，它可能比传统成像方式结合血液肿瘤标志物更好地评估生物学效率。事实上，PET 提供了一种独特的可能性，可以将拓扑和特定代谢活性相关联，但它需要额外的临床和实验经验和研究，以找到原发性或继发性脊柱肿瘤的新适应证。
