Husby Trine, Johannessen Knut, Berntsen Erik Magnus, Johansen Håkon, Giskeødegård Guro Fanneløb, Karlberg Anna, Fagerli Unn-Merete, Eikenes Live
Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Postboks 8905, Trondheim, Norway.
Department of Oncology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
EJNMMI Rep. 2024 Jan 31;8(1):2. doi: 10.1186/s41824-024-00189-6.
This PET/MRI study compared contrast-enhanced MRI, F-FACBC-, and F-FDG-PET in the detection of primary central nervous system lymphomas (PCNSL) in patients before and after high-dose methotrexate chemotherapy. Three immunocompetent PCNSL patients with diffuse large B-cell lymphoma received dynamic F-FACBC- and F-FDG-PET/MRI at baseline and response assessment. Lesion detection was defined by clinical evaluation of contrast enhanced T1 MRI (ce-MRI) and visual PET tracer uptake. SUVs and tumor-to-background ratios (TBRs) (for F-FACBC and F-FDG) and time-activity curves (for F-FACBC) were assessed.
At baseline, seven ce-MRI detected lesions were also detected with F-FACBC with high SUVs and TBRs (SUV:mean, 4.73, TBR: mean, 9.32, SUV: mean, 3.21, TBR:mean: 6.30). High TBR values of F-FACBC detected lesions were attributed to low SUV. Baseline F-FDG detected six lesions with high SUVs (SUV: mean, 13.88). In response scans, two lesions were detected with ce-MRI, while only one was detected with F-FACBC. The lesion not detected with F-FACBC was a small atypical MRI detected lesion, which may indicate no residual disease, as this patient was still in complete remission 12 months after initial diagnosis. No lesions were detected with F-FDG in the response scans.
F-FACBC provided high tumor contrast, outperforming F-FDG in lesion detection at both baseline and in response assessment. F-FACBC may be a useful supplement to ce-MRI in PCNSL detection and response assessment, but further studies are required to validate these findings. Trial registration ClinicalTrials.gov. Registered 15th of June 2017 (Identifier: NCT03188354, https://clinicaltrials.gov/study/NCT03188354 ).
本正电子发射断层扫描/磁共振成像（PET/MRI）研究比较了对比增强磁共振成像（MRI）、18F-氟代乙酰基半胱氨酸（F-FACBC）和18F-氟代脱氧葡萄糖（F-FDG）PET在大剂量甲氨蝶呤化疗前后患者原发性中枢神经系统淋巴瘤（PCNSL）检测中的应用。三名免疫功能正常的弥漫性大B细胞淋巴瘤PCNSL患者在基线期和疗效评估时接受了动态F-FACBC和F-FDG PET/MRI检查。通过对比增强T1加权MRI（ce-MRI）的临床评估和PET示踪剂摄取的视觉观察来定义病变检测。评估了SUV（标准化摄取值）和肿瘤与本底比值（TBR）（针对F-FACBC和F-FDG）以及时间-活性曲线（针对F-FACBC）。
在基线期，F-FACBC检测到7个ce-MRI检测到的病变，SUV和TBR值较高（SUV：平均值4.73，TBR：平均值9.32；SUV：平均值3.21，TBR：平均值6.30）。F-FACBC检测到的病变TBR值高归因于SUV值低。基线期F-FDG检测到6个SUV值高的病变（SUV：平均值13.88）。在疗效评估扫描中，ce-MRI检测到2个病变，而F-FACBC仅检测到1个病变。F-FACBC未检测到的病变是ce-MRI检测到的一个小的非典型病变，这可能表明无残留疾病，因为该患者在初始诊断后1年仍处于完全缓解状态。在疗效评估扫描中F-FDG未检测到任何病变。
F-FACBC提供了高肿瘤对比度，在基线期和疗效评估的病变检测方面均优于F-FDG。F-FACBC在PCNSL检测和疗效评估中可能是ce-MRI的有用补充，但需要进一步研究来验证这些发现。试验注册ClinicalTrials.gov。于2017年6月15日注册（标识符：NCT03188354，https://clinicaltrials.gov/study/NCT03188354 ）。
