Doyle W K, Budinger T F, Valk P E, Levin V A, Gutin P H
J Comput Assist Tomogr. 1987 Jul-Aug;11(4):563-70. doi: 10.1097/00004728-198707000-00001.
Nine radiation-treated brain tumor patients were studied by positron emission tomography (PET) in an attempt to differentiate tumor recurrence from radiation necrosis. Rubidium-82 was used to define the region of absent or disturbed blood-brain barrier and [18F]2-fluoro-2-deoxy-D-glucose ([18F]FDG) was used to evaluate the metabolic state of the brain. By comparing glucose utilization in the pathologic region with utilization in the adjacent tissue, a diagnosis of recurrent tumor (increased [18F]FDG accumulation) or necrosis (decreased FDG accumulation) was made. In the seven patients who underwent surgery the PET diagnosis was confirmed by histologic examination of resected tissue. The two patients who did not undergo surgery have had a clinical course consistent with the PET diagnosis of necrosis. Dynamic 82Rb imaging showed that the rate of 82Rb accumulation was greater in tumor than in normal brain. However, this finding alone did not differentiate tumor from necrosis, as some necrotic tissue also showed high rates of 82Rb accumulation, and washout kinetics were similarly nonspecific. The differentiation of radiation necrosis from tumor recurrence is reliably achieved by [18F]FDG PET examination and is aided by information obtained from a 82Rb PET study done immediately prior to the [18F]FDG injection.
对9名接受过放射治疗的脑肿瘤患者进行了正电子发射断层扫描（PET）研究，以试图区分肿瘤复发与放射性坏死。使用铷-82来界定血脑屏障缺失或受损的区域，并用[18F]2-氟-2-脱氧-D-葡萄糖（[18F]FDG）来评估脑的代谢状态。通过比较病变区域与相邻组织的葡萄糖利用情况，做出复发性肿瘤（[18F]FDG积聚增加）或坏死（FDG积聚减少）的诊断。在接受手术的7名患者中，PET诊断经切除组织的组织学检查得以证实。未接受手术的2名患者的临床病程与PET诊断的坏死相符。动态82Rb成像显示，肿瘤中82Rb的积聚速率高于正常脑。然而，仅凭这一发现并不能区分肿瘤与坏死，因为一些坏死组织也显示出较高的82Rb积聚速率，且洗脱动力学同样缺乏特异性。通过[18F]FDG PET检查可可靠地实现放射性坏死与肿瘤复发的鉴别，在[18F]FDG注射前立即进行的82Rb PET研究所获得的信息对此有辅助作用。
