使用 18F-FLT PET 对再生障碍性贫血和骨髓增生异常综合征进行骨髓活性的定量评估。

Quantitative Assessment of Bone Marrow Activity Using 18 F-FLT PET in Aplastic Anemia and Myelodysplastic Syndromes.

机构信息

From the Department of Hematology and Oncology, Faculty of Medical Sciences.

Biomedical Imaging Research Center, University of Fukui, Fukui, Japan.

出版信息

Clin Nucl Med. 2022 Dec 1;47(12):1048-1055. doi: 10.1097/RLU.0000000000004419. Epub 2022 Oct 3.

DOI:10.1097/RLU.0000000000004419

PMID:36190714

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9653112/

Abstract

PURPOSE

Peripheral cytopenias are typical of blood test abnormalities associated with a variety of conditions, including aplastic anemia (AA) and myelodysplastic syndromes (MDSs). We prospectively investigated the feasibility of quantitative analysis of whole-body bone marrow activity using PET with 3'-deoxy-3'- 18 F-fluorothymidine ( 18 F-FLT) in AA and MDS.

PATIENTS AND METHODS

Sixty-eight patients with cytopenia underwent 18 F-FLT PET/MRI scan, with simultaneous bone marrow aspiration and biopsy for hematopoiesis evaluation. SUVs were measured in the vertebrae (Th3, 6, and 9 and L3), bilateral iliac crests, and extremities. SUV and bone marrow pathology were compared between AA and MDS and analyzed in relation to severity of AA and prognosis of MDS.

RESULTS

Of the 68 patients with cytopenia, 12 were diagnosed with AA, 27 with MDS, 12 with bone marrow neoplasia, 2 with myelofibrosis, and 15 with other conditions. Iliac 18 F-FLT SUVs were significantly correlated with bone marrow cell numbers and cell density ( r = 0.47, P < 0.001 and ρ = 0.65, P < 0.001, respectively). There was a significant positive correlation between iliac and vertebral SUVs in AA and MDS ( r = 0.65, P < 0.05 and r = 0.70, P < 0.001, respectively), and the slope of the regression line was significantly steeper in AA than in MDS ( P < 0.05). In AA patients, vertebral 18 F-FLT SUVs significantly decreased with disease progression, and in MDS patients, higher whole-body 18 F-FLT uptake was associated with shorter overall survival (hazards ratio, 3.18; 95% confidence interval, 1.07-9.47; P = 0.037).

CONCLUSIONS

Quantitative whole-body bone marrow imaging using 18 F-FLT PET helps distinguish AA from MDS and assess the severity of AA and prognosis of MDS.

摘要

目的

外周血细胞减少是与多种疾病相关的血液测试异常的典型表现，包括再生障碍性贫血（AA）和骨髓增生异常综合征（MDSs）。我们前瞻性地研究了使用 3'-脱氧-3'- 18 F-氟代胸腺嘧啶（ 18 F-FLT）进行全身骨髓活性定量分析在 AA 和 MDS 中的可行性。

方法

68 例血细胞减少症患者行 18 F-FLT PET/MRI 扫描，同时进行骨髓抽吸和活检以进行造血评估。在椎体（Th3、6 和 9 以及 L3）、双侧髂嵴和四肢测量 SUV。比较 AA 和 MDS 之间的 SUV 和骨髓病理学，并分析与 AA 严重程度和 MDS 预后的关系。

结果

在 68 例血细胞减少症患者中，12 例诊断为 AA，27 例诊断为 MDS，12 例诊断为骨髓肿瘤，2 例诊断为骨髓纤维化，15 例诊断为其他疾病。髂骨 18 F-FLT SUV 与骨髓细胞数量和细胞密度呈显著正相关（ r = 0.47，P < 0.001 和 ρ = 0.65，P < 0.001）。AA 和 MDS 中髂骨和椎体 SUV 之间存在显著正相关（ r = 0.65，P < 0.05 和 r = 0.70，P < 0.001），AA 的回归线斜率明显高于 MDS（ P < 0.05）。在 AA 患者中，椎体 18 F-FLT SUV 随着疾病进展而显著降低，而在 MDS 患者中，全身摄取较高的 18 F-FLT 与总生存期较短相关（危险比，3.18；95%置信区间，1.07-9.47；P = 0.037）。