Institute of Nuclear Medicine, Catholic University of the Sacred Heart, Rome, Italy.
Ann Nucl Med. 2012 Jul;26(6):451-61. doi: 10.1007/s12149-012-0602-7. Epub 2012 May 8.
To systematically review published data on the role of positron emission tomography (PET) or PET/computed tomography (PET/CT) using either Carbon-11 ((11)C) or Fluorine-18 ((18)F) choline tracer in tumors other than prostatic cancer. A comprehensive literature search of studies published in PubMed/MEDLINE and Embase databases through January 2012 and regarding (11)C-choline or (18)F-choline PET or PET/CT in patients with tumors other than prostatic cancer was carried out. Fifty-two studies comprising 1800 patients were included and discussed. Brain tumors were evaluated in 15 articles, head and neck tumors in 6, thoracic tumors (including lung and mediastinal neoplasms) in 14, liver tumors (including hepatocellular carcinoma) in 5, gynecologic malignancies (including breast tumors) in 5, bladder and upper urinary tract tumors in 5, and musculoskeletal tumors in 7. Radiolabeled choline PET or PET/CT is useful to differentiate high-grade from low-grade gliomas and malignant from benign brain lesions, to early detect brain tumor recurrences and to guide the stereotactic biopsy sampling. The diagnostic accuracy of radiolabeled choline PET is superior compared to Fluorine-18 fluorodeoxyglucose ((18)F-FDG) PET in this setting. Radiolabeled choline PET or PET/CT seems to be accurate in differential diagnosis between malignant and benign thoracic lesions and in staging lung tumors; nevertheless, a superiority of radiolabeled choline compared to (18)F-FDG has not been demonstrated in this setting, except for the detection of brain metastases. Few but significant studies on radiolabeled choline PET and PET/CT in patients with hepatocellular carcinoma (HCC) and musculoskeletal tumors are reported in the literature. The combination of radiolabeled choline and (18)F-FDG PET increases the detection rate of HCC. The diagnostic accuracy of radiolabeled choline PET or PET/CT seems to be superior compared to (18)F-FDG PET or PET/CT and conventional imaging methods in patients with bone and soft tissue tumors. Limited experience exists about the role of radiolabeled choline PET and PET/CT in patients with head and neck tumors, bladder cancer and gynecologic malignancies including breast cancer.
系统回顾已发表的文献，评估正电子发射断层扫描（PET）或 PET/计算机断层扫描（PET/CT）使用碳-11（(11)C）或氟-18（(18)F）胆碱示踪剂在前列腺癌以外的肿瘤中的作用。通过对 PubMed/MEDLINE 和 Embase 数据库中截至 2012 年 1 月的文献进行全面检索，检索关于前列腺癌以外的肿瘤中使用(11)C-胆碱或(18)F-胆碱 PET 或 PET/CT 的研究。纳入并讨论了 52 项研究，共 1800 例患者。15 篇文章评估了脑肿瘤，6 篇文章评估了头颈部肿瘤，14 篇文章评估了胸部肿瘤（包括肺癌和纵隔肿瘤），5 篇文章评估了肝脏肿瘤（包括肝细胞癌），5 篇文章评估了妇科恶性肿瘤（包括乳腺癌），5 篇文章评估了膀胱和上尿路肿瘤，7 篇文章评估了肌肉骨骼肿瘤。放射性标记胆碱 PET 或 PET/CT 可用于区分高级别和低级别胶质瘤以及恶性和良性脑病变，有助于早期发现脑肿瘤复发，并指导立体定向活检取样。在这种情况下，放射性标记胆碱 PET 的诊断准确性优于氟-18 氟代脱氧葡萄糖（(18)F-FDG）PET。放射性标记胆碱 PET 或 PET/CT 似乎可准确鉴别恶性和良性胸内病变并对肺肿瘤进行分期；然而，在这种情况下，除了检测脑转移外，尚未证明放射性标记胆碱比(18)F-FDG 具有优势。文献中仅报道了少量但有意义的关于放射性标记胆碱 PET 和 PET/CT 在肝细胞癌（HCC）和肌肉骨骼肿瘤患者中的应用研究。放射性标记胆碱与(18)F-FDG PET 的联合应用提高了 HCC 的检出率。与(18)F-FDG PET 或 PET/CT 和常规成像方法相比，放射性标记胆碱 PET 或 PET/CT 似乎在骨和软组织肿瘤患者中的诊断准确性更高。关于放射性标记胆碱 PET 和 PET/CT 在头颈部肿瘤、膀胱癌和妇科恶性肿瘤（包括乳腺癌）患者中的作用，经验有限。
