Stecker F F, Schierz J-H, Opfermann T, Driesch D, Hofmann G O, Winkens T, Freesmeyer M
Dr. Martin Freesmeyer, Jena University Hospital, Clinic of Nuclear Medicine, Bachstraße 18, 07740 Jena, Germany, Tel. +49/(0)36 41/93 32 20; Fax +49/(0)36 41/93 32 44, E-mail:
Nuklearmedizin. 2014;53(3):117-22. doi: 10.3413/Nukmed-0572-13-03. Epub 2013 Jun 19.
The study investigates whether early dynamic PET/CT (edPET/CT) using 18F-fluorodeoxyglucose (FDG) discriminates between affected versus non-affected sites in patients with complicated, protracted fracture healing and suspected COM in the lower extremities.
PATIENTS, METHODS: In nine consecutive patients (1 woman, 8 men; age 54 ± 13 years), before standard late FDG-PET/CT, altogether 10 edFDG-PET/CT examinations were performed in list mode over 5 min starting with radiopharmaceutical injection. Eight consecutive time intervals (frames), four 15-s, then four 60-s, were reconstructed. For every patient, several volumes-of-interest were selected. To measure early FDG influx and accumulation, maximum and mean ed standardized uptake values (respectively, edSUVmax, edSUVmean) were calculated in each volume-of-interest during each frame. Results were compared between affected and non-affected (contralateral) bone.
Starting in the 31-45s frame, the affected bone area showed significantly higher edSUVmax and edSUVmean than did the healthy contralateral region. In conventional PET/CT, affected bone areas also significantly differed from non-affected contralateral regions.
This pilot study suggests that edFDG-PET may offer a less time consuming add on to standard FDG-PET/CT while being equally accurate. The results should be validated prospectively in larger trials.
本研究调查使用18F-氟脱氧葡萄糖（FDG）的早期动态PET/CT（edPET/CT）能否区分下肢复杂、迁延性骨折愈合且疑似存在骨不连的患者中受影响部位与未受影响部位。
患者、方法：连续纳入9例患者（1名女性，8名男性；年龄54±13岁），在进行标准的晚期FDG-PET/CT检查前，从注射放射性药物开始，以列表模式在5分钟内共进行10次edFDG-PET/CT检查。重建8个连续的时间间隔（帧），4个15秒的，然后是4个60秒的。为每位患者选择了几个感兴趣区。为测量早期FDG流入和积聚情况，在每一帧期间计算每个感兴趣区内的最大和平均ed标准化摄取值（分别为edSUVmax、edSUVmean）。比较受影响骨与未受影响（对侧）骨的结果。
从第31 - 45秒的帧开始，受影响的骨区域显示出比健康对侧区域显著更高的edSUVmax和edSUVmean。在传统PET/CT中，受影响的骨区域与未受影响的对侧区域也有显著差异。
这项初步研究表明，edFDG-PET可能是一种耗时较少的补充检查，可用于标准FDG-PET/CT，且准确性相同。结果应在更大规模的试验中进行前瞻性验证。
