Sasaki M, Kuwabara Y, Yoshida T, Nakagawa M, Fukumura T, Mihara F, Morioka T, Fukui M, Masuda K
Department of Radiology, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Eur J Nucl Med. 1998 Sep;25(9):1261-9. doi: 10.1007/s002590050294.
Thallium-201, carbon-11 methionine (MET) and fluorine-18 fluorodeoxyglucose (FDG) have all been used to assess brain tumours. The aim of this study was to determine which of these tracers are of use for evaluating the histological grade and the extent of astrocytoma. 201Tl single-photon emission tomography (SPET), MET positron emission tomography (PET) and FDG PET were all performed in 23 patients (13 men, 10 women) with newly diagnosed astrocytic tumours [seven with astrocytoma (grade II), ten with anaplastic astrocytoma (grade III) and six with glioblastoma (grade IV)]. The 201Tl uptake of the tumours was evaluated by a lesion-to-normal region count ratio. Both MET and FDG uptake of the tumours was evaluated by a semiquantitative analysis using the standardized uptake value. 201Tl uptake was found to increase in rank order with histological grade and was significantly different among the three groups (grade II: 1.51+/-0.36; grade III: 2.58+/-1.50; grade IV: 7. 65+/-3.84). MET uptake in grade II (1.49+/-0.44) was also significantly lower than that in both grade III (3.29+/-1.44) and grade IV (3.20+/-0.92). FDG uptake was not significantly different among the three groups (grade II: 2.90+/-0.45; grade III: 3.86+/-1. 56; grade IV: 3.57+/-0.83). No significant correlation was observed between 201Tl uptake and either MET uptake or FDG uptake. In most patients, the extent of the increased MET uptake was the largest while that of the increased FDG uptake was the smallest. In patients with positive 201Tl uptake, the extent of the 201Tl uptake was equal to or smaller than that of gadolinium enhancement. For evaluation of histological grade of astrocytic tumours. 201Tl is therefore considered to be useful though the 201Tl uptake in some grade III astrocytomas was not different from that in grade II astrocytomas. MET was found to be highly useful for detecting astrocytomas, for differentiating between benign and malignant astrocytomas, and for evaluating the extent of astrocytomas; however, it was not sufficiently useful permit evaluation of the histological grade. FDG was not found to be useful either for evaluating the histological grade or for differentiating between benign and malignant astrocytomas.
铊 - 201、碳 - 11蛋氨酸（MET）和氟 - 18氟脱氧葡萄糖（FDG）都已被用于评估脑肿瘤。本研究的目的是确定这些示踪剂中哪些可用于评估星形细胞瘤的组织学分级和范围。对23例新诊断为星形细胞瘤的患者（13例男性，10例女性）进行了201Tl单光子发射断层扫描（SPET）、MET正电子发射断层扫描（PET）和FDG PET检查[7例为星形细胞瘤（二级），10例为间变性星形细胞瘤（三级），6例为胶质母细胞瘤（四级）]。通过病变与正常区域计数比评估肿瘤的201Tl摄取。通过使用标准化摄取值的半定量分析评估肿瘤的MET和FDG摄取。发现201Tl摄取随组织学分级呈升序增加，且三组之间有显著差异（二级：1.51±0.36；三级：2.58±1.50；四级：7.65±3.84）。二级（1.49±0.44）的MET摄取也显著低于三级（3.29±1.44）和四级（3.20±0.92）。三组之间的FDG摄取无显著差异（二级：2.90±0.45；三级：3.86±1.56；四级：3.57±0.83）。未观察到201Tl摄取与MET摄取或FDG摄取之间存在显著相关性。在大多数患者中，MET摄取增加的范围最大，而FDG摄取增加的范围最小。在201Tl摄取阳性的患者中，201Tl摄取的范围等于或小于钆增强的范围。因此，对于评估星形细胞瘤的组织学分级，尽管一些三级星形细胞瘤的201Tl摄取与二级星形细胞瘤无差异，但201Tl仍被认为是有用的。发现MET对于检测星形细胞瘤、区分良性和恶性星形细胞瘤以及评估星形细胞瘤的范围非常有用；然而，它对于评估组织学分级并不足够有用。未发现FDG对于评估组织学分级或区分良性和恶性星形细胞瘤有用。
