13N-氨与 18F-FDG 在未治疗脑胶质瘤中的评估比较。

The comparison of 13N-ammonia and 18F-FDG in the evaluation of untreated gliomas.

机构信息

Department of Nuclear Medicine, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.

出版信息

Clin Nucl Med. 2013 Jul;38(7):522-6. doi: 10.1097/RLU.0b013e318295298d.

DOI:10.1097/RLU.0b013e318295298d

PMID:23698463

Abstract

OBJECTIVE

Noninvasive evaluation of glioma is of great help for clinical practice. In this study, we investigated the utility of 13N-ammonia in the evaluation of untreated gliomas and compared the results with that of 18F-FDG.

METHODS

Forty-five consecutive patients with final diagnosis of glioma were included in this study. PET/CT imaging was performed for all of them with both 18F-FDG and 13N-ammonia as tracers. Imaging results were analyzed by tumor-to-gray matter (T/G) ratios. Receiver operating characteristic curve analysis was conducted to determine the optimal T/G cutoff values of each tracer between low-grade and high-grade gliomas.

RESULTS

Forty-eight separate lesions were identified in all (grade II, n = 16; grade III, n = 12; and grade IV, n = 20). Twenty-nine out of 32 high-grade lesions (91%) showed higher uptakes than normal gray matter with N-ammonia in comparison with the result of 21 lesions (66%) with 18F-FDG. The optimal T/G cutoff values for 18F-FDG and 13N-ammonia were 0.64 and 0.86 separately with the area under each curve 0.910 and 0.943. The sensitivity and specificity of predicting high-grade gliomas with optimal cutoff values were 83% and 93% for 18F-FDG and 94% and 94% for 13N-ammonia, respectively.

CONCLUSION

13N-Ammonia is superior to 18F-FDG not only in separating low-grade gliomas from high-grade ones but also in the detection of high-grade gliomas for better tumor to normal gray matter contrast.

摘要

目的

非侵入性评估脑胶质瘤对临床实践具有重要意义。本研究旨在探讨 13N-氨在未经治疗的脑胶质瘤评估中的应用，并与 18F-FDG 的结果进行比较。

方法

本研究共纳入 45 例最终诊断为脑胶质瘤的连续患者。所有患者均进行了 18F-FDG 和 13N-氨 PET/CT 成像。通过肿瘤与灰质（T/G）比值分析图像结果。采用受试者工作特征曲线分析确定两种示踪剂在低级别和高级别胶质瘤之间的最佳 T/G 截断值。

结果

共发现 48 个单独病变（II 级，n=16；III 级，n=12；IV 级，n=20）。与 18F-FDG 相比，29 个高级别病变（91%）的 13N-氨摄取高于正常灰质，而 21 个病变（66%）的摄取低于正常灰质。18F-FDG 和 13N-氨的最佳 T/G 截断值分别为 0.64 和 0.86，曲线下面积分别为 0.910 和 0.943。最佳截断值预测高级别胶质瘤的敏感性和特异性分别为 18F-FDG 的 83%和 93%，13N-氨的 94%和 94%。