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正电子发射断层扫描在妊娠相关癌症评估中的应用:综述

Use of Positron Emission Tomography for Pregnancy-Associated Cancer Assessment: A Review.

作者信息

Parpinel Giulia, Laudani Maria Elena, Giunta Francesca Paola, Germano Chiara, Zola Paolo, Masturzo Bianca

机构信息

Unit of Gynecology and Obstetrics 2U, Sant'Anna Hospital, Città della Salute e della Scienza di Torino, University of Turin, 10126 Turin, Italy.

Unit of Nuclear Medicine, Department of Medical Sciences, Città della Salute e della Scienza di Torino, University of Turin, 10126 Turin, Italy.

出版信息

J Clin Med. 2022 Jul 1;11(13):3820. doi: 10.3390/jcm11133820.

Abstract

. Positron emission tomography (PET) has proven clinical utility both in the initial and relapse staging phase, but this technique is controversial during pregnancy. The objective of this review is to provide a compendium of available information on the use of PET during pregnancy. . A systematic literature review was conducted from 1 January 2004 until 20 May 2021. A total of 4 small series and 9 case reports consisting of 25 cases were selected. . During the first trimester, the fetus is most sensitive to ionization damage, so lower doses are recommended (2.6E-02 mGy/MBq). Fetal-effective doses are higher in this period and the average fetal dose (4.06 ± 3.22 mGy) remains significantly below the threshold for deterministic effects. During the second and third trimesters, recommended doses are higher (1.4E-02 mGy/MBq at 6 months, and 6.9E-03 mGy/MBq at 9 months of gestation). F-FDG activity was distributed to the whole fetus with a prevalence of myocardial tissue in seven cases. The use of special precautions, such as PET-magnetic resonance (MR) and urinary bladder catheterization, reduces the amount of radioactive tracer. Breastfeeding interruption is not recommended. . F-FDG PET is not contraindicated in pregnancy, but multidisciplinary discussion is necessary and strict precautions are recommended.

摘要

正电子发射断层扫描(PET)在初始分期和复发分期阶段已被证明具有临床实用性,但该技术在孕期存在争议。本综述的目的是提供有关孕期使用PET的现有信息汇总。

进行了一项从2004年1月1日至2021年5月20日的系统文献综述。共选取了4个小系列和9篇病例报告,包含25例病例。

在孕早期,胎儿对电离损伤最为敏感,因此建议使用较低剂量(2.6E-02 mGy/MBq)。在此期间胎儿有效剂量较高,平均胎儿剂量(4.06±3.22 mGy)仍显著低于确定性效应阈值。在孕中期和孕晚期,建议剂量较高(妊娠6个月时为1.4E-02 mGy/MBq,妊娠9个月时为6.9E-03 mGy/MBq)。在7例病例中,F-FDG活性分布于整个胎儿,心肌组织中含量较高。采取特殊预防措施,如PET-磁共振(MR)和膀胱插管,可减少放射性示踪剂的用量。不建议中断母乳喂养。

F-FDG PET在孕期并非禁忌,但需要多学科讨论,并建议采取严格的预防措施。

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