From the Departments of Otorhinolaryngology and Head and Neck Surgery.
Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India.
Clin Nucl Med. 2021 Aug 1;46(8):e398-e405. doi: 10.1097/RLU.0000000000003583.
Because prostate-specific membrane antigen (PSMA) expression is universal in juvenile nasal angiofibroma (JNA), PSMA PET/CT is commonly used in the postoperative setting using the postoperative angiofibroma radionuclide imaging study protocol. Our study aims to illustrate physiological PSMA ligand uptake distribution characteristics in the salivary glands, specifically the tubarial glands with tumor, to aid in accurate PSMA PET/CT analysis.
Forty-three consecutive patients who underwent a dedicated head and neck spot PSMA PET/CT for JNA were evaluated retrospectively. PSMA SUVmax values in the tumor, tubarial, parotid, submandibular, and sublingual salivary glands were determined visually and quantitatively.
All the tumors and the salivary glands showed increased tracer uptake. The median SUVmax ± SD ratios of the tumor, right and left tubarial gland, right and left parotid gland, right and left submandibular gland, and right and left sublingual gland were 2.7 ± 0.8 (range, 0.5-7.5), 3.8 ± 1.9 (range, 0.9-8.1), 4.7 ± 2.1 (range, 0.8-7.4), 9.5 ± 4.8 (range, 3.2-21.9), 9.2 ± 4.7 (range, 2.9-18.9), 10.4 ± 5.7 (range, 3.5-25.4), 10.4 ± 5.5 (range, 3.7-26.4), 6 ± 4.1 (range, 1.3-20.6), and 6.5 ± 4.2 (range, 1.8-19.7), respectively. The uptake in the tubarial glands was comparable with that of the tumor but less compared with other major salivary glands.
Ours is the first study demonstrating the quantitative uptake of tubarial salivary glands in detail. Because the tubarial glands uptake and the anatomical location are similar to that of the tumor, these physiological uptakes must be borne in mind to circumvent false-positive interpretations and care must be given during the planning of stereotactic radiotherapy for JNAs.
由于前列腺特异性膜抗原（PSMA）在青少年鼻血管纤维瘤（JNA）中普遍表达，因此通常使用术后血管纤维瘤放射性核素成像研究方案在术后使用 PSMA PET/CT。我们的研究旨在说明唾液腺（特别是带有肿瘤的 tubarial 腺）中 PSMA 配体摄取的生理性分布特征，以帮助进行准确的 PSMA PET/CT 分析。
回顾性评估了 43 例连续接受专门的头颈部点 PSMA PET/CT 检查的 JNA 患者。通过视觉和定量方法确定肿瘤、tuberial、腮腺、颌下腺和舌下腺的 PSMA SUVmax 值。
所有肿瘤和唾液腺均显示出放射性示踪剂摄取增加。肿瘤、右侧和左侧 tubarial 腺、右侧和左侧腮腺、右侧和左侧颌下腺以及右侧和左侧舌下腺的中位数 SUVmax ± SD 比值分别为 2.7 ± 0.8（范围，0.5-7.5）、3.8 ± 1.9（范围，0.9-8.1）、4.7 ± 2.1（范围，0.8-7.4）、9.5 ± 4.8（范围，3.2-21.9）、9.2 ± 4.7（范围，2.9-18.9）、10.4 ± 5.7（范围，3.5-25.4）、10.4 ± 5.5（范围，3.7-26.4）、6 ± 4.1（范围，1.3-20.6）和 6.5 ± 4.2（范围，1.8-19.7）。tuberial 腺的摄取与肿瘤相当，但与其他主要唾液腺相比则较少。
这是第一项详细显示 tubarial 唾液腺定量摄取的研究。由于 tubarial 腺的摄取及其解剖位置与肿瘤相似，因此必须考虑到这些生理性摄取，以避免假阳性解释，并在为 JNA 进行立体定向放射治疗时必须小心。
