Minamimoto Ryogo, Mosci Camila, Jamali Mehran, Barkhodari Amir, Habte Frezghi, Jackson Tatianie, Mittra Erik, Gambhir Sanjiv Sam, Iagaru Andrei
Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Stanford University, Stanford, California; and Department of Radiology, Molecular Imaging Program at Stanford, Stanford University, Stanford, California.
Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Stanford University, Stanford, California; and.
J Nucl Med. 2015 May;56(5):688-94. doi: 10.2967/jnumed.115.153767. Epub 2015 Apr 3.
In this study, we evaluated the biodistribution of the (18)F(-)/(18)F-FDG administration, compared with separate (18)F-NaF and (18)F-FDG administrations. We also estimated the interaction of (18)F-NaF and (18)F-FDG in the (18)F(-)/(18)F-FDG administration by semiquantitative analysis.
We retrospectively analyzed the data of 49 patients (39 men, 10 women; mean age ± SD, 59.3 ± 15.2 y) who underwent separate (18)F-FDG PET/CT and (18)F-NaF PET/CT scans as well as (18)F(-)/(18)F-FDG PET/CT sequentially. The most common primary diagnosis was prostate cancer (n = 28), followed by sarcoma (n = 9) and breast cancer (n = 6). The mean standardized uptake values (SUVs) were recorded for 18 organs in all patients, and maximum SUV and mean SUV were recorded for all the identified malignant lesions. We also estimated the (18)F(-)/(18)F-FDG uptake as the sum of (18)F-FDG uptake and adjusted (18)F-NaF uptake based on the ratio of (18)F-NaF injected dose in (18)F(-)/(18)F-FDG PET/CT. Lastly, we compared the results to explore the interaction of (18)F-FDG and (18)F-NaF uptake in the (18)F(-)/(18)F-FDG scan.
The (18)F(-)/(18)F-FDG uptake in the cerebral cortex, cerebellum, parotid grand, myocardium, and bowel mostly reflected the (18)F-FDG uptake, whereas the uptake in the other analyzed structures was influenced by both the (18)F-FDG and the (18)F-NaF uptake. The (18)F(-)/(18)F-FDG uptake in extraskeletal lesions showed no significant difference when compared with the uptake from the separate (18)F-FDG scan. The (18)F(-)/(18)F-FDG uptake in skeletal lesions reflected mostly the (18)F-NaF uptake. The tumor-to-background ratio of (18)F(-)/(18)F-FDG in extraskeletal lesions showed no significant difference when compared with that from (18)F-FDG alone (P = 0.73). For skeletal lesions, the tumor-to-background ratio of (18)F(-)/(18)F-FDG was lower than that from (18)F-NaF alone (P < 0.001); however, this difference did not result in missed skeletal lesions on the (18)F(-)/(18)F-FDG scan.
The understanding of the biodistribution of radiopharmaceuticals and the lesion uptake of the (18)F(-)/(18)F-FDG scan as well as the variations compared with the uptake on the separate (18)F-FDG PET/CT and (18)F-NaF PET/CT are valuable for more in-depth evaluation of the combined scanning technique.
在本研究中，我们评估了（18）F（-）/（18）F - FDG给药后的生物分布，并与单独给予（18）F - NaF和（18）F - FDG的情况进行了比较。我们还通过半定量分析估计了（18）F - NaF和（18）F - FDG在（18）F（-）/（18）F - FDG给药中的相互作用。
我们回顾性分析了49例患者（39例男性，10例女性；平均年龄±标准差，59.3±15.2岁）的数据，这些患者依次接受了单独的（18）F - FDG PET/CT和（18）F - NaF PET/CT扫描以及（18）F（-）/（18）F - FDG PET/CT扫描。最常见的原发性诊断为前列腺癌（n = 28），其次是肉瘤（n = 9）和乳腺癌（n = 6）。记录了所有患者18个器官的平均标准化摄取值（SUV），并记录了所有已识别恶性病变的最大SUV和平均SUV。我们还根据（18）F（-）/（18）F - FDG PET/CT中（18）F - NaF注射剂量的比例，将（18）F（-）/（18）F - FDG摄取量估计为（18）F - FDG摄取量与调整后的（18）F - NaF摄取量之和。最后，我们比较了结果，以探讨（18）F（-）/（18）F - FDG扫描中（18）F - FDG和（18）F - NaF摄取的相互作用。
大脑皮层、小脑、腮腺、心肌和肠道中的（18）F（-）/（18）F - FDG摄取主要反映（18）F - FDG摄取，而其他分析结构中的摄取则受（18）F - FDG和（18）F - NaF摄取两者的影响。与单独的（18）F - FDG扫描摄取相比，骨外病变中的（18）F（-）/（18）F - FDG摄取无显著差异。骨病变中的（18）F（-）/（18）F - FDG摄取主要反映（18）F - NaF摄取。骨外病变中（18）F（-）/（18）F - FDG的肿瘤与本底比值与单独的（18）F - FDG相比无显著差异（P = 0.73）。对于骨病变，（18）F（-）/（18）F - FDG的肿瘤与本底比值低于单独的（18）F - NaF（P < 0.001）；然而，这种差异并未导致在（18）F（-）/（18）F - FDG扫描中漏诊骨病变。
了解放射性药物的生物分布、（18）F（-）/（18）F - FDG扫描的病变摄取以及与单独的（18）F - FDG PET/CT和（18）F - NaF PET/CT摄取相比的变化，对于更深入评估联合扫描技术具有重要价值。
