Barber Thomas W, Veysey Duncan, Billah Baki, Francis Peter
Department of Nuclear Medicine and PET, The Alfred Hospital.
Departments of Medicine.
Nucl Med Commun. 2018 Nov;39(11):1022-1032. doi: 10.1097/MNM.0000000000000912.
The aim was to investigate normal patterns of brain metabolism determined by F-fluorodeoxyglucose positron emission tomography (FDG PET)/MRI during childhood and adolescence.
A retrospective analysis was carried out on all paediatric patients who underwent FDG PET/MRI at our institution between March 2016 and August 2017. Exclusion criteria were neurological disease, central nervous system metastases, previous chemotherapy/radiotherapy, general anaesthesia/sedation and medications suspected to affect cerebral metabolism. Standardized uptake value (SUV)mean and SUVmax were calculated for 12 brain grey matter regions. Subgroup analysis of childhood (≤10 years old) and adolescence (≥11 years old) was also carried out.
From 492 PET/MRI scans, 28 patients (11 children, 17 adolescents) were deemed representative of normal brain metabolism. SUVmean and SUVmax increased with age in all regions. The highest rates of increasing SUVmean were in the thalamus, basal ganglia, frontal lobes, insula and occipital lobes. Higher SUVmean was found in the right frontal, right lateral temporal, right temporal pole, right cingulate/paracingulate, right thalamus, left occipital, left basal ganglia, left insula and left cerebellum compared with the contralateral side. This SUVmean asymmetry was present in both childhood and adolescence in the majority of regions. The highest rates of increasing SUVmax with age were in the occipital lobes, frontal lobes, thalamus and central region. There was no asymmetry in SUVmax in the majority of regions.
This FDG PET/MRI study shows that normal brain metabolism measured by SUVmean and SUVmax increases with age in all regions, proceeding at different rates between distinct anatomical sites. Our results suggest that there is mild asymmetry in SUVmean, but mostly symmetric SUVmax during normal development.
本研究旨在调查儿童期和青春期通过氟脱氧葡萄糖正电子发射断层扫描（FDG PET）/磁共振成像（MRI）测定的大脑代谢正常模式。
对2016年3月至2017年8月期间在本机构接受FDG PET/MRI检查的所有儿科患者进行回顾性分析。排除标准为神经系统疾病、中枢神经系统转移、既往化疗/放疗、全身麻醉/镇静以及怀疑影响脑代谢的药物。计算12个脑灰质区域的标准化摄取值（SUV）均值和SUV最大值。还对儿童期（≤10岁）和青春期（≥11岁）进行了亚组分析。
在492次PET/MRI扫描中，28例患者（11名儿童，17名青少年）被认为具有正常脑代谢代表性。所有区域的SUV均值和SUV最大值均随年龄增长。SUV均值增加率最高的区域是丘脑、基底神经节、额叶、岛叶和枕叶。与对侧相比，右侧额叶、右侧颞叶外侧、右侧颞极、右侧扣带回/旁扣带回、右侧丘脑、左侧枕叶、左侧基底神经节、左侧岛叶和左侧小脑的SUV均值更高。这种SUV均值不对称在大多数区域的儿童期和青春期均存在。随年龄增长SUV最大值增加率最高的区域是枕叶、额叶、丘脑和中央区域。大多数区域的SUV最大值不存在不对称。
这项FDG PET/MRI研究表明，通过SUV均值和SUV最大值测量的正常脑代谢在所有区域均随年龄增长，不同解剖部位的增长速度不同。我们的结果表明，在正常发育过程中，SUV均值存在轻度不对称，但SUV最大值大多对称。
