Tagliabue Luca, Del Sole Angelo
Department of Diagnostic Services, Unit of Nuclear Medicine, San Paolo Hospital, Via Antonio di Rudinì, 8, 20142 Milan, Italy.
Department of Diagnostic Services, Unit of Nuclear Medicine, San Paolo Hospital, Via Antonio di Rudinì, 8, 20142 Milan, Italy; Department of Health Sciences and Center of Molecular and Cellular Imaging (IMAGO), University of Milan, Italy.
Eur J Intern Med. 2014 Jan;25(1):6-11. doi: 10.1016/j.ejim.2013.06.012. Epub 2013 Jul 30.
Positron emission tomography (PET) was developed in the mid-1970, and its initial applications were for heart and brain imaging research. Nowadays, this technology is aimed mainly at staging or restaging tumours as it allows the assessment of biochemical processes that are either specific or associated with tumour biology. The full appreciation of PET potentials and limitations among general practitioners and internists cannot be considered achieved and the appropriate use of PET especially when coupled to X-ray computed tomography (CT) is still suboptimal. The majority of PET studies rely on the use of fluorodeoxyglucose labelled with fluorine-18 (FDG), which is a radiopharmaceutical specific for glucose transport and metabolism. PET with FDG is amenable for studying most type of tumours, including those of the head and neck, lung, oesophagus, colo-rectal, gastrointestinal stromal tumours, pancreas, some types of lymphomas and melanoma, whereas in some tumours, including those of the reproductive system, brain, breast and bones, there is a limited role for PET and there is no substantial role for FDG-PET for the bronchoalveolar, hepatocellular, urinary system, testicular, neuroendocrine, carcinoids and adrenal tumours, differentiated thyroid cancers, and several subtypes of malignant lymphoma. Thus, the limits of FDG have stimulated the use and development of other radiopharmaceuticals. These tracers represent the opportunity for expanding the use of PET to other areas in oncology in the near future.
正电子发射断层扫描（PET）于20世纪70年代中期研发出来，其最初应用于心脏和脑成像研究。如今，这项技术主要用于肿瘤分期或再分期，因为它能够评估特定的或与肿瘤生物学相关的生化过程。普通科医生和内科医生对PET的潜力和局限性尚未完全了解，PET的合理使用，尤其是与X射线计算机断层扫描（CT）结合使用时，仍未达到最佳状态。大多数PET研究依赖于使用用氟-18标记的氟脱氧葡萄糖（FDG），这是一种针对葡萄糖转运和代谢的放射性药物。FDG-PET适用于研究大多数类型的肿瘤，包括头颈部、肺、食管、结直肠、胃肠道间质瘤、胰腺、某些类型的淋巴瘤和黑色素瘤，而在某些肿瘤中，包括生殖系统、脑、乳腺和骨骼的肿瘤，PET的作用有限，FDG-PET对支气管肺泡癌、肝细胞癌、泌尿系统肿瘤、睾丸肿瘤、神经内分泌肿瘤、类癌和肾上腺肿瘤、分化型甲状腺癌以及几种恶性淋巴瘤亚型没有实质性作用。因此，FDG的局限性促使了其他放射性药物的使用和研发。这些示踪剂为在不久的将来将PET的应用扩展到肿瘤学的其他领域提供了机会。
