Xu Xiaoxia, Zhu Hua, Liu Fei, Zhang Yan, Yang Jianhua, Zhang Lifang, Xie Qing, Zhu Lin, Li Nan, Kung Hank F, Yang Zhi
Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Nuclear Medicine, Peking University Cancer Hospital & Institute, Beijing, 100142, China.
Key Laboratory of Radiopharmaceuticals, Ministry of Education, College of Chemistry, Beijing Normal University, Beijing, 100875, China.
Eur J Nucl Med Mol Imaging. 2020 Sep;47(10):2280-2292. doi: 10.1007/s00259-019-04543-w. Epub 2020 Mar 12.
The purpose of this study was to compare dynamic F-FGln PET/CT images of healthy subjects and cancer patients and explore the best imaging phase for different cancers.
Thirteen healthy volunteers and 31 cancer patients separately underwent F-FGln and F-FDG PET/CT scans within 1 week. The distributions of F-FGln and F-FDG in the whole body and the tumor avidity were analyzed and compared. The tumor maximum standardized uptake values (SUVmax) and tumor-to-nontumor SUV ratio (SUR) of F-FGln/PET at different scan phases were compared.
Compared to the healthy subjects, the cancer patients had lower F-FGln activity (SUVmean) in most normal organs, especially in the lung, muscle, spleen, and heart (p < 0.05). Additionally, the FGln-avid tumors did not necessarily manifest as FDG-avid and vice versa. Overall, among the 31 primary malignant lesions confirmed by biopsy or postoperative pathological analysis, 29 showed increased radioactive uptake on all F-FGln PET/CT imaging phases. The peak of SUVmax in breast and thyroid cancers was within 10 min, while in lung cancers, the plateau of SUVmax was within 30 min to 60 min. The SURs of lung cancer (p = 0.046) and thyroid cancer (p = 0.794) increased from the early-phase to the late-phase acquisition; however, a significant decrease was observed in the breast lesions (p = 0.022).
F-FGln images may further supplement the diagnostic ability of F-FDG in cancer patients and detect metabolic changes in different tumors. Furthermore, the imaging time for F-FGln PET/CT needs to be optimized for different cancer types to improve the contrast resolution of tumors.
本研究旨在比较健康受试者和癌症患者的动态F-FGln PET/CT图像，并探索不同癌症的最佳成像阶段。
13名健康志愿者和31名癌症患者在1周内分别接受F-FGln和F-FDG PET/CT扫描。分析并比较F-FGln和F-FDG在全身的分布以及肿瘤摄取情况。比较不同扫描阶段F-FGln/PET的肿瘤最大标准化摄取值（SUVmax）和肿瘤与非肿瘤SUV比值（SUR）。
与健康受试者相比，癌症患者在大多数正常器官中的F-FGln活性（SUVmean）较低，尤其是在肺、肌肉、脾脏和心脏（p < 0.05）。此外，F-FGln摄取高的肿瘤不一定表现为F-FDG摄取高，反之亦然。总体而言，在经活检或术后病理分析确诊的31个原发性恶性病变中，29个在所有F-FGln PET/CT成像阶段均显示放射性摄取增加。乳腺癌和甲状腺癌的SUVmax峰值在10分钟内，而肺癌的SUVmax平台期在30分钟至60分钟内。肺癌（p = 0.046）和甲状腺癌（p = 0.794）的SUR从早期采集到晚期采集增加；然而，在乳腺病变中观察到显著下降（p = 0.022）。
F-FGln图像可能进一步补充F-FDG对癌症患者的诊断能力，并检测不同肿瘤的代谢变化。此外，需要针对不同癌症类型优化F-FGln PET/CT的成像时间，以提高肿瘤的对比分辨率。
