Jacquet-Francillon Nicolas, Prevot Nathalie
Nuclear Medicine Department, Hospices Civils de Lyon, Université Claude Bernard Lyon 1, Hopital Lyon Sud, 165 Chemin du Grand Revoyet, 69495, Pierre-Bénite, France.
Department of Nuclear Medicine, University Hospital of Saint-Etienne, Saint-Étienne, France.
Ann Nucl Med. 2023 May;37(5):255-270. doi: 10.1007/s12149-023-01832-1. Epub 2023 Mar 18.
Brown tumors (BT) are abnormal bone-repair processes and a consequence of hyperparathyroidism. The diagnosis of these lytic lesions in nuclear medicine, while a challenge, is not so rare, because functional imaging is used both in the management of cancer and hyperparathyroidism. The main objective of this review is to summarize the knowledge and the evidence concerning BT and the different imaging modalities in nuclear medicine. A systematic review was performed in Embase, PubMed and Google Scholar from 2005 to 2022. We included articles describing BT in the following imaging modalities: [F]-fluorodeoxyglucose PET/CT, [F]-fluorocholine or [C]-fluorocholine PET/CT, [Tc]-Sestamibi scintigraphy, bone scan, [F]-sodium fluoride PET/CT, [Ga]-FAPI PET/CT; [Ga]-DOTATATE PET/CT; [C]-methionine PET/CT. For each modality, appearance, avidity for radiotracer, available quantitative parameters and imaging evolution after parathyroidectomy were collected and analyzed. Fifty-two articles were included for a total of 392 BT lesions. If the diagnosis of BT is evoked on a known lesion, performing a [F]-fluorocholine PET/CT imaging seems the most appropriate. In [F]-fluorodeoxyglucose, [F]-fluorocholine, [F]-sodium fluoride PET/CT and bone scan, BT can mimic metastatic disease. BT uptakes appear reversible after parathyroidectomy, with a more or less rapid decrease depending on the imaging modality used.
棕色瘤（BT）是异常的骨修复过程，也是甲状旁腺功能亢进的结果。在核医学中，诊断这些溶骨性病变虽然具有挑战性，但并不罕见，因为功能成像在癌症和甲状旁腺功能亢进的管理中都有应用。本综述的主要目的是总结关于棕色瘤以及核医学中不同成像方式的知识和证据。我们在Embase、PubMed和谷歌学术上对2005年至2022年期间进行了系统综述。我们纳入了以下成像方式下描述棕色瘤的文章：[F] - 氟脱氧葡萄糖PET/CT、[F] - 氟胆碱或[C] - 氟胆碱PET/CT、[Tc] - 甲氧基异丁基异腈闪烁扫描、骨扫描、[F] - 氟化钠PET/CT、[Ga] - FAPI PET/CT；[Ga] - 多柔比星PET/CT；[C] - 蛋氨酸PET/CT。对于每种成像方式，收集并分析了其表现、对放射性示踪剂的摄取、可用的定量参数以及甲状旁腺切除术后的影像演变。共纳入52篇文章，涉及392个棕色瘤病变。如果在已知病变上怀疑棕色瘤的诊断，进行[F] - 氟胆碱PET/CT成像似乎是最合适的。在[F] - 氟脱氧葡萄糖、[F] - 氟胆碱、[F] - 氟化钠PET/CT和骨扫描中，棕色瘤可模仿转移性疾病。甲状旁腺切除术后，棕色瘤的摄取似乎是可逆的，根据所使用的成像方式，摄取或多或少会迅速下降。
