Department of Nuclear Medicine and Tracer Kinetics, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
Institute for Radiation Sciences, Osaka University, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
Ann Nucl Med. 2022 Nov;36(11):951-963. doi: 10.1007/s12149-022-01784-y. Epub 2022 Sep 3.
To investigate whether whole-body dynamic positron emission tomography (PET) is useful for differentiating benign and malignant lesions.
In this retrospective study, data from a cohort of 146 lesions from 187 patients who consecutively underwent whole-body dynamic PET scans at our hospital for suspected lesions in the lung, lymph nodes, liver, bone, esophagus, and colon were analyzed. Patients with malignant lymphomas, accumulations > 5 cm in length along the long axis of the esophagus, or lesions in the colon in which the site of accumulation moved during the imaging period were excluded. Patients were administered 3.7 MBq/kg of fluorine-18-fluorodeoxyglucose (F-18 FDG), and dynamic imaging was initiated 60 min after administration. We defined the 60-65, 65-70, 70-75, and 75-80 min time mark as the first, second, third, and fourth pass, respectively. The static image is the summed average of all the four pass images. We measured the accumulation in the mean image of the whole-body dynamic PET scan, which was arithmetically similar to the maximum standardized uptake value (SUVmax) throughout the whole-body static images obtained during 20 min of imaging (S-SUVmax). The ratio of SUVmax in the dynamic first pass(60-65 min after FDG administration) and fourth pass(75-80 min after FDG administration) was calculated as R-SUVmax.
The S-SUVmax in the lung, lymph nodes, and bone did not differ significantly between the benign and malignant groups. However, there was a significant difference in R-SUVmax, which was > 1 in most malignant lesions indicating an increase in accumulation during routine scan time. Significant differences were observed between benign and malignant lesions of the liver in both S-SUVmax and R-SUVmax values, with the latter being > 1 in most malignant lesions.
Whole-body dynamic PET for 20 min starting 1 h after FDG administration improved the accuracy of malignant lesion detection in the liver, lymph nodes, lung, and bone. The incremental improvement was small, and the FDG dynamics in the distribution of values between benign and malignant overlapped. Additional information from whole-body dynamic imaging can help detect malignant lesions in these sites without increasing patient burden or prolonging imaging time.
研究全身动态正电子发射断层扫描（PET）是否有助于鉴别良恶性病变。
本回顾性研究分析了在我院因疑似肺部、淋巴结、肝脏、骨骼、食管和结肠病变而连续进行全身动态 PET 扫描的 187 例患者的 146 个病灶的数据。排除恶性淋巴瘤、食管沿长轴积聚长度>5cm 或在成像期间积聚部位移动的结肠病变患者。患者给予 3.7MBq/kg 氟-18-氟代脱氧葡萄糖（F-18 FDG），给药后 60 分钟开始动态成像。我们将 60-65、65-70、70-75 和 75-80 分钟标记分别定义为第一、第二、第三和第四通过。静态图像是所有四个通过图像的总和平均值。我们测量了全身动态 PET 扫描的整个身体动态图像的积聚，这与整个身体在 20 分钟的成像期间获得的静态图像的最大标准化摄取值（SUVmax）的算术平均值相似（S-SUVmax）。动态第一通过（FDG 给药后 60-65 分钟）和第四通过（FDG 给药后 75-80 分钟）的 SUVmax 比计算为 R-SUVmax。
肺部、淋巴结和骨骼的 S-SUVmax 在良性和恶性组之间无显著差异。然而，R-SUVmax 存在显著差异，大多数恶性病变的 R-SUVmax>1，表明在常规扫描时间内积聚增加。肝脏、淋巴结和肺部的良性和恶性病变之间在 S-SUVmax 和 R-SUVmax 值上均存在显著差异，大多数恶性病变的 R-SUVmax>1。
FDG 给药后 1 小时开始的 20 分钟全身动态 PET 提高了肝脏、淋巴结、肺和骨骼中恶性病变检测的准确性。增量改善很小，良性和恶性之间的 FDG 分布值重叠。全身动态成像的其他信息可以帮助检测这些部位的恶性病变，而不会增加患者负担或延长成像时间。
