Lee Jong Jin, Chung Jin Hwa, Kim Seog-Young
Department of Nuclear Medicine, Asan Medical Center, University of Ulsan, College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Korea.
Biomedical Research Center, Asan Institute for Life Science, Asan Medical Center, Seoul, Korea.
Ann Nucl Med. 2016 Oct;30(8):525-33. doi: 10.1007/s12149-016-1090-y. Epub 2016 Jun 2.
The present study aimed to investigate the effect of (18)F-fluorodeoxyglucose (FDG) extravasation on the time taken for tumoral uptake to reach a plateau.
For the animal experiment, FDG extravasation was conducted in the tails of HCT116 tumor-bearing xenograft mice models in three groups (no extravasation, 40 % extravasation, and 80 % extravasation; n = 5, each). Dynamic positron emission tomography (PET) images were acquired over a period of 2 h following injection. Time-activity curves for FDG in the tails and tumors were calculated. For the clinical experiment, 22 patients (male:female, 14:8; age range, 70.8 ± 9.2 years) were subjected to PET/computed tomography (PET/CT) 1 h after the injection of FDG. The inclusion criteria were as follows: (1) submitted to both whole-body and subsequent regional scanning; (2) entire extravasation activity visualized in the whole-body images; (3) tumor visualized on both whole-body and additional regional images; and (4) status of tumor either confirmed by biopsy or clinically suspected for malignancy. The standardized uptake values (SUVs) of the tumors (on the whole-body and additional PET images) and extravasation sites were recorded.
There were no significant differences in the time taken for tumoral uptake to reach a plateau and that to reach minimum activity at the extravasation site among the three groups of mice. However, the mean tumoral activity and activity at the extravasation site were negatively correlated at 1 h post-injection. According to the clinical PET findings, the differences in SUV between the whole-body and regional images were not significantly correlated with the interval between injection of FDG and start of whole-body scanning, interval between the start of whole-body scanning and start of regional scanning, extravasation volume, maximum SUV of the extravasation site, or total activity at the extravasation site.
The time taken for tumoral uptake to reach a plateau is not affected by extravasation, even at extensive degrees. Thus, in routine practice, the imaging time of approximately 60 min post-injection need not be modified even if extravasation is identified. However, tumor SUV may be underestimated in cases of extravasation.
本研究旨在探讨（18）F-氟脱氧葡萄糖（FDG）外渗对肿瘤摄取达到平台期所需时间的影响。
在动物实验中，对三组荷HCT116肿瘤的异种移植小鼠模型（无外渗、40%外渗和80%外渗；每组n = 5）的尾巴进行FDG外渗操作。注射后2小时内采集动态正电子发射断层扫描（PET）图像。计算尾巴和肿瘤中FDG的时间-活性曲线。在临床实验中，22例患者（男:女 = 14:8；年龄范围70.8 ± 9.2岁）在注射FDG 1小时后接受PET/计算机断层扫描（PET/CT）。纳入标准如下：（1）接受全身及后续局部扫描；（2）全身图像中可见整个外渗活性；（3）全身及额外局部图像上均可见肿瘤；（4）肿瘤状态经活检证实或临床怀疑为恶性。记录肿瘤（在全身及额外PET图像上）和外渗部位的标准化摄取值（SUV）。
三组小鼠中，肿瘤摄取达到平台期的时间以及外渗部位达到最小活性的时间无显著差异。然而，注射后1小时，肿瘤平均活性与外渗部位活性呈负相关。根据临床PET结果，全身图像和局部图像之间SUV的差异与FDG注射至全身扫描开始的间隔、全身扫描开始至局部扫描开始的间隔、外渗体积、外渗部位的最大SUV或外渗部位的总活性均无显著相关性。
即使外渗程度较大，肿瘤摄取达到平台期所需的时间也不受外渗影响。因此，在常规实践中，即使发现外渗，注射后约60分钟的成像时间也无需调整。然而，在外渗情况下，肿瘤SUV可能会被低估。
