Department of Nuclear Medicine and PET Research, VU University Medical Center, Amsterdam, The Netherlands.
PLoS One. 2012;7(10):e48430. doi: 10.1371/journal.pone.0048430. Epub 2012 Oct 31.
To investigate whether time-trends of enhanced [(18)F]Fluoromethylcholine ([(18)F]FCH) in lymph nodes (LN) of prostate cancer (PCa) patients can help to discriminate reactive from malignant ones, and whether single time point standardized uptake value (SUV) measurements also suffice.
25 PCa patients with inguinal (presumed benign) and enlarged pelvic LN (presumed malignant) showing enhanced [(18)F]FCH uptake at dual-phase PET-CT were analyzed. Associations between LN status (benign versus malignant) and SUV(max) and SUV(meanA50), determined at 2 min (early) and 30 min (late) post injection, were assessed. We considered two time-trends of [(18)F]FCH uptake: type A (SUV early > SUV late) and type B (SUV late ≥ SUV early). Histopathology and/or follow-up were used to confirm the assumption that LN with type A pattern are benign, and LN with type B pattern malignant.
Analysis of 54 nodes showed that LN status, time-trends, and 'late' (30 min p.i.) SUV(max) and SUV(meanA50) parameters were strongly associated (P<0.0001). SUV(max) relative difference was the best LN status predictor. All but one inguinal LN showed a decreasing [(18)F]FCH uptake over time (pattern A), while 95% of the pelvic nodes presented a stable or increasing uptake (pattern B) type.
Time-trends of enhanced [(18)F]FCH uptake can help to characterize lymph nodes in prostate cancer patients. Single time-point SUV measurements, 30 min p.i., may be a reasonable alternative for predicting benign versus malignant status of lymph nodes, but this remains to be validated in non-enlarged pelvic lymph nodes.
研究前列腺癌（PCa）患者淋巴结（LN）中增强的 [(18)F]氟甲基胆碱 ([(18)F]FCH) 的时间趋势是否有助于区分反应性和恶性淋巴结，并探讨单一时点标准化摄取值（SUV）测量是否足够。
分析了 25 例腹股沟（推测为良性）和盆腔（推测为恶性）LN 增强 [(18)F]FCH 摄取的 PCa 患者。评估了 LN 状态（良性与恶性）与 SUV(max) 和 SUV(meanA50)之间的相关性，SUV(max) 和 SUV(meanA50)分别在注射后 2 分钟（早期）和 30 分钟（晚期）测定。我们考虑了两种 [(18)F]FCH 摄取时间趋势：A 型（SUV 早期 > SUV 晚期）和 B 型（SUV 晚期 ≥ SUV 早期）。组织病理学和/或随访用于证实假设，即具有 A 型模式的 LN 为良性，而具有 B 型模式的 LN 为恶性。
对 54 个淋巴结的分析表明，LN 状态、时间趋势以及“晚期”（注射后 30 分钟）SUV(max) 和 SUV(meanA50)参数之间存在很强的相关性（P<0.0001）。SUV(max) 相对差异是预测 LN 状态的最佳指标。除了一个腹股沟 LN 外，所有 LN 的 [(18)F]FCH 摄取均随时间呈下降趋势（A 型），而 95%的盆腔 LN 呈稳定或增加摄取（B 型）趋势。
增强的 [(18)F]FCH 摄取的时间趋势有助于描述前列腺癌患者的淋巴结。单一时点 SUV 测量，注射后 30 分钟，可能是预测淋巴结良性与恶性状态的合理替代方法，但这仍需在非增大的盆腔淋巴结中验证。
