Hoshikawa Hiroshi, Kishino Takehito, Mori Terushige, Nishiyama Yoshihiro, Yamamoto Yuka, Inamoto Ryuhei, Akiyama Kosuke, Mori Nozomu
Departments of Otolaryngology, Faculty of Medicine, Kagawa University, Kagawa, Japan.
Acta Otolaryngol. 2012 Dec;132(12):1347-54. doi: 10.3109/00016489.2012.709319. Epub 2012 Sep 19.
Despite low uptake of tracer, 3'-deoxy-3'-(18)F-fluorothymidine (FLT) PET could detect cervical lymph node metastases as well as 2-deoxy-2-(18)F-fluoro-d-glucose (FDG) PET.
The diagnostic efficacy of FLT PET was compared with that of FDG PET regarding nodal staging of head and neck squamous cell cancers.
Twenty-three patients were examined with FLT PET and FDG PET. PET images were evaluated qualitatively for regions of focally increased metabolism and maximum standardized uptake values (SUV) were calculated for semiquantitative analysis.
The mean (± SD) FLT SUV in visualized metastatic lymph nodes was 4.8 ± 2.9 as compared with 6.9 ± 4.9 for FDG SUV (p < 0.001). Significant correlations were found between the area of metastatic lymph nodes and both FLT SUV (r = 0.8; p < 0.0001) and FDG SUV (r = 0.84; p < 0.0001). The false-positive (over-staged) and false-negative (under-staged) rates for lymph node staging by FLT PET were 4% (1/23) and 17% (4/23), respectively. Those for FDG PET were 9% (2/23) and 13% (3/23). All metastatic lymph nodes measuring more than 9 mm in short-axis diameter were correctly detected by FLT PET. However, both FLT and FDG PET had low sensitivity for detecting the lymph node metastases ≤ 9 mm in short-axis diameter and tumor deposits < 5 mm.
尽管示踪剂摄取率较低，但3'-脱氧-3'-(18)F-氟胸腺嘧啶核苷（FLT）PET在检测颈部淋巴结转移方面与2-脱氧-2-(18)F-氟-D-葡萄糖（FDG）PET效果相当。
比较FLT PET与FDG PET对头颈部鳞状细胞癌淋巴结分期的诊断效能。
对23例患者进行了FLT PET和FDG PET检查。对PET图像进行定性评估，观察代谢局部增高区域，并计算最大标准化摄取值（SUV）进行半定量分析。
可见转移淋巴结的平均（±标准差）FLT SUV为4.8±2.9，而FDG SUV为6.9±4.9（p<0.001）。转移淋巴结面积与FLT SUV（r = 0.8；p<0.0001）和FDG SUV（r = 0.84；p<0.0001）之间均存在显著相关性。FLT PET对淋巴结分期的假阳性（分期过高）和假阴性（分期过低）率分别为4%（1/23）和17%（4/23）。FDG PET的假阳性和假阴性率分别为9%（2/23）和13%（3/23）。FLT PET能正确检测出所有短轴直径大于9 mm的转移淋巴结。然而，FLT和FDG PET对检测短轴直径≤9 mm的淋巴结转移及直径<5 mm的肿瘤灶均有较低的敏感性。
