Rinehardt Hannah N, Longo Sadie, Gilbert Ryan, Shoaf Jennifer N, Edwards Wilson B, Kohanbash Gary, Malek Marcus M
Department of General Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA.
Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA.
Cancers (Basel). 2022 Apr 29;14(9):2221. doi: 10.3390/cancers14092221.
18F-fluorodeoxyglucose (FDG) is a glucose analog that acts as a marker for glucose uptake and metabolism. FDG PET scans are used in monitoring pediatric cancers. The handheld PET probe localization of FDG-avid lesions is an emerging modality for radio-guided surgery (RGS). We sought to assess the utility of PET probe in localizing occult FDG-avid tumors in pediatric patients. PET probe functionality was evaluated by using a PET/CT scan calibration phantom. The PET probe was able to detect FDG photon emission from simulated tumors with an expected decay of the radioisotope over time. Specificity for simulated tumor detection was lower in a model that included background FDG. In a clinical model, eight pediatric patients with FDG-avid primary, recurrent or metastatic cancer underwent a tumor excision, utilizing IV FDG and PET probe survey. Adequate tissue for diagnosis was present in 16 of 17 resected specimens, and pathology was positive for malignancy in 12 of the 17 FDG-avid lesions. PET probe gamma counts per second were higher in tumors compared with adjacent benign tissue in all operations. The median ex vivo tumor-to-background ratio (TBR) was 4.0 (range 0.9-12). The PET probe confirmed the excision of occult FDG-avid tumors in eight pediatric patients.
18F-氟脱氧葡萄糖（FDG）是一种葡萄糖类似物，可作为葡萄糖摄取和代谢的标志物。FDG正电子发射断层扫描（PET）用于监测儿童癌症。手持PET探头对FDG摄取阳性病变进行定位是放射性引导手术（RGS）的一种新兴模式。我们试图评估PET探头在定位儿科患者隐匿性FDG摄取阳性肿瘤中的效用。通过使用PET/CT扫描校准体模评估PET探头的功能。PET探头能够检测模拟肿瘤发出的FDG光子发射，并随着时间推移检测到放射性同位素的预期衰变。在包含背景FDG的模型中，模拟肿瘤检测的特异性较低。在一个临床模型中，8例患有FDG摄取阳性原发性、复发性或转移性癌症的儿科患者接受了肿瘤切除，采用静脉注射FDG和PET探头探测。17个切除标本中有16个有足够的组织用于诊断，17个FDG摄取阳性病变中有12个病理结果为恶性。在所有手术中，肿瘤的PET探头每秒伽马计数均高于相邻良性组织。离体肿瘤与背景比值（TBR）中位数为4.0（范围0.9 - 12）。PET探头证实8例儿科患者隐匿性FDG摄取阳性肿瘤被切除。
