Keiding S, Hansen S B, Rasmussen H H, Gee A, Kruse A, Roelsgaard K, Tage-Jensen U, Dahlerup J F
PET Center, Department of Medicine V, Aarhus University Hospital, Denmark.
Hepatology. 1998 Sep;28(3):700-6. doi: 10.1002/hep.510280316.
Primary sclerosing cholangitis (PSC) predisposes to cholangiocarcinoma (CC), which usually is widespread in the liver at the time of the diagnosis and which has a median survival of approximately 6 months. Positron emission tomography (PET) is a noninvasive scanning method that allows the assessment of metabolism in vivo by means of positron-emitting radiolabeled tracers. [18F]Fluoro-2-deoxy-D-glucose (FDG) is a glucose analogue that accumulates in various malignant tumors because of their high glucose metabolic rates. The purpose of the study was to develop a PET method to detect small CC tumors in patients with PSC. PET scanning of the liver was performed after intravenous injection of 200 MBq FDG in 9 patients with PSC, 6 patients with PSC + CC, and 5 controls. The scanning was performed at successive time intervals for a total of 90 minutes with simultaneous successive arterial blood sampling for radioactivity concentration determination. In each of the PSC + CC patients, 2 to 7 "hot spots" were seen, with volumes of 1.0 to 45 mL (median, 4.4 mL). There were no hot spots in the two other patient groups. The localization of hot spots was confirmed by single-blind evaluation. Data were analyzed by the Gjedde-Patlak plot, yielding values of the net metabolic clearance of FDG, K [mL min(-1) 100 mL(-1) tissue]. In the CC hot spots, maximum K values were 1.59 to 4.17 (median, 2.34; n = 6); in the reference liver tissues of these patients, K values were 0.40 to 0.69 (median, 0.49); in PSC patients, they were 0.23 to 0.53 (median, 0.36); and in controls, they were 0.20 to 0.34 (median, 0.31). The difference between K in CC hot spots and the other groups was statistically significant (P < .001). We conclude that FDG-PET seems to be able to detect small CC tumors and may be useful in the therapeutic management of PSC.
原发性硬化性胆管炎（PSC）易患胆管癌（CC），胆管癌在诊断时通常已在肝脏广泛扩散，其平均生存期约为6个月。正电子发射断层扫描（PET）是一种非侵入性扫描方法，可通过发射正电子的放射性示踪剂在体内评估代谢情况。[18F]氟-2-脱氧-D-葡萄糖（FDG）是一种葡萄糖类似物，由于各种恶性肿瘤的葡萄糖代谢率高，它会在这些肿瘤中蓄积。本研究的目的是开发一种PET方法来检测PSC患者中的小胆管癌肿瘤。对9例PSC患者、6例PSC + CC患者和5例对照者静脉注射200 MBq FDG后进行肝脏PET扫描。扫描在连续的时间间隔内进行，共90分钟，同时连续采集动脉血样以测定放射性浓度。在每例PSC + CC患者中，可见2至7个“热点”，体积为1.0至45 mL（中位数为4.4 mL）。其他两组患者中未发现热点。通过单盲评估确认热点的定位。数据采用Gjedde-Patlak图进行分析，得出FDG的净代谢清除率K值[mL min(-1) 100 mL(-1)组织]。在CC热点中，最大K值为1.59至4.17（中位数为2.34；n = 6）；在这些患者的肝脏参考组织中，K值为0.40至0.69（中位数为0.49）；在PSC患者中，K值为0.23至0.53（中位数为0.36）；在对照者中，K值为0.20至0.34（中位数为0.31）。CC热点中的K值与其他组之间的差异具有统计学意义（P <.001）。我们得出结论，FDG-PET似乎能够检测出小胆管癌肿瘤，可能对PSC的治疗管理有用。
