Holthoff V A, Herholz K, Berthold F, Widemann B, Schröder R, Neubauer I, Heiss W D
Max-Planck-Institut für Neurologische Forschung, Köln, Germany.
Cancer. 1993 Aug 15;72(4):1394-403. doi: 10.1002/1097-0142(19930815)72:4<1394::aid-cncr2820720440>3.0.co;2-d.
Despite an increasing interest in the clinical application of positron emission tomography (PET) in tumors of the adult patient as a diagnostic and prognostic tool, only a few studies have been concerned with the usefulness of PET with [18F]2-deoxy-2-fluoro-D-glucose (FDG) in childhood tumors.
Fifteen children and young adults (0.5-26.0 years of age) with histologically confirmed brain tumors were studied with PET and FDG. Seven children with medulloblastoma (n = 5) or primitive neuroectodermal tumor (PNET) (n = 2) underwent repeated PET studies during their therapy. The other eight children with medulloblastoma (n = 5) or astrocytoma (n = 3) were studied only once before initiation of treatment. A close clinical follow-up was performed in every case.
Comparison of local glucose metabolic rates obtained in the various tumor lesions revealed that the mean rates found in medulloblastomas (mean glucose metabolic rate, 42.8 +/- 14.03 mumol/100 g/min) were twice as high as the rates measured in either PNET (17.3 +/- 4.5 mumol/100g/min) or infratentorial gliomas (21.8 +/- 4.2 mumol/100g/min). The high metabolism of medulloblastomas enabled the observer to identify the tumor more easily and to clearly separate it from the surrounding unaffected brain tissue. In the seven patients with follow-up PET studies during therapy, decreasing or increasing ratios of tumor-to-white matter metabolic rate were not only commensurate with neuroradiologically defined tumor reduction or growth, but also corresponded to the duration of initial clinical improvement.
These preliminary results suggest that PET with FDG may be a useful tool to evaluate metabolic activity of pediatric brain tumors over time and to assess response to treatment.
尽管正电子发射断层扫描（PET）作为一种诊断和预后工具在成年患者肿瘤的临床应用中越来越受到关注，但只有少数研究关注PET与[18F]2-脱氧-2-氟-D-葡萄糖（FDG）在儿童肿瘤中的应用价值。
对15例经组织学确诊为脑肿瘤的儿童和青年（0.5 - 26.0岁）进行了PET和FDG研究。7例患有髓母细胞瘤（n = 5）或原始神经外胚层肿瘤（PNET）（n = 2）的儿童在治疗期间接受了多次PET研究。另外8例患有髓母细胞瘤（n = 5）或星形细胞瘤（n = 3）的儿童在开始治疗前仅进行了一次研究。对每个病例都进行了密切的临床随访。
对不同肿瘤病变中获得的局部葡萄糖代谢率进行比较发现，髓母细胞瘤中的平均代谢率（平均葡萄糖代谢率，42.8 +/- 14.03 μmol/100 g/min）是PNET（17.3 +/- 4.5 μmol/100g/min）或幕下神经胶质瘤（21.8 +/- 4.2 μmol/100g/min）中测量值 的两倍。髓母细胞瘤的高代谢使观察者能够更轻松地识别肿瘤，并将其与周围未受影响的脑组织清晰区分开来。在7例治疗期间进行PET随访研究的患者中，肿瘤与白质代谢率的降低或升高比例不仅与神经放射学定义的肿瘤缩小或生长相称，而且与初始临床改善的持续时间相对应。
这些初步结果表明，FDG-PET可能是一种有用的工具，可用于评估儿童脑肿瘤随时间的代谢活性并评估治疗反应。
