Mukherji S K, Drane W E, Tart R P, Landau S, Mancuso A A
Division of Neuroradiology/ENT Imaging, University of Florida College of Medicine, Gainesville.
AJNR Am J Neuroradiol. 1994 Nov;15(10):1837-42.
To compare the uptake of 2-[F-18] fluoro-2-deoxy-D-glucose (fludeoxyglucose F-18; F-18 FDG) and thallous chloride Tl 201, using single-photon emission CT (SPECT), for the detection and location of squamous cell carcinoma of the head and neck.
Five patients with biopsy-proved squamous cell carcinoma of the upper aerodigestive tract underwent both F-18 FDG and thallium-201 SPECT on the same day. F-18 FDG SPECT was performed using a dual-head gamma camera equipped with commercially available, extremely high-energy collimators (full width half-maximal height, 17 mm for 511 keV photons). Tumor size was estimated at 1.0 to 5.0 cm3 in these cases.
F-18 FDG SPECT showed five of five primary tumors. In two of the five cases, normal salivary gland activity severely limited thallium SPECT, and the tumors could not be definitively identified. Two of four lymph node groups that were positive for metastatic disease by CT criteria were shown by F-18 FDG SPECT. None were seen with thallium imaging. In one case, F-18 FDG SPECT was able to show a tumor that was not visible on CT.
F-18 FDG has advantages over Tl-201 as a squamous cell carcinoma imaging agent (primarily because of its reduced salivary activity). F-18 FDG SPECT has potential as a viable, less expensive alternative to F-18 FDG positron emission tomography. The ultimate value of F-18 FDG SPECT imaging for detecting occult malignancy, monitoring therapeutic effectiveness, or evaluating tumor recurrence remains to be determined in patients with squamous cell carcinoma of the head and neck.
采用单光子发射计算机断层扫描（SPECT）比较2-[F-18]氟-2-脱氧-D-葡萄糖（氟脱氧葡萄糖F-18；F-18 FDG）和氯化铊Tl 201对头颈部鳞状细胞癌的检测及定位能力。
5例经活检证实为上呼吸道消化道鳞状细胞癌的患者在同一天接受了F-18 FDG和铊-201 SPECT检查。F-18 FDG SPECT检查使用配备市售超高能准直器（半高宽，对于511 keV光子为17 mm）的双头伽马相机。这些病例中肿瘤大小估计为1.0至5.0 cm³。
F-18 FDG SPECT显示出全部5个原发性肿瘤。在5例中的2例中，正常唾液腺活性严重限制了铊SPECT检查，无法明确识别肿瘤。根据CT标准，4组转移阳性的淋巴结中，F-18 FDG SPECT显示出2组。铊显像未显示任何转移淋巴结。在1例中，F-18 FDG SPECT能够显示出CT上不可见的肿瘤。
作为鳞状细胞癌成像剂，F-18 FDG比Tl-201具有优势（主要是因为其唾液腺活性较低）。F-18 FDG SPECT有可能成为F-18 FDG正电子发射断层扫描的一种可行且成本较低的替代方法。F-18 FDG SPECT成像在检测隐匿性恶性肿瘤、监测治疗效果或评估肿瘤复发方面的最终价值，在头颈部鳞状细胞癌患者中仍有待确定。
