CAJ | 학술논문

目的通过与18F-FDG PET/CT显像对比,探讨18 F-FLT PET/CT检测鼻咽癌原发灶和颈部淋巴结转移灶的可行性.方法 12例初治且经病理确诊的鼻咽癌患者(年龄22～62岁)自愿进入该前瞻性临床研究.每位患者先行18F-FDG PET/CT检查,次日行18F-FLF PET/CT检查.至少有2位核医学科和放射科医师阅片,比较18F-FDG PET/CT和18F-FLT PET/CT图像,采用ROI技术计算鼻咽肿瘤、颈部淋巴结转移灶、正常组织对18F-FDG、18F-FLT的SUVmax、SUVmean和MTV.采用非参数Wilcoxon秩和检验比较组间摄取和MTV差异.结果 12例鼻咽癌患者病灶均明显摄取18F-FLT.18F-FLT PET/CT和18F-FDG PET/CT均可准确诊断该组病例,二者对原发灶和淋巴结转移灶的检测结果无明显差别.鼻咽癌病灶的18F-FDG和18F-FLT SUVmax分别为10.7±5.8和6.0±2.4,SUVmean分别为5.8±3.0和3.6±1.5；SUVmax和SUVmean组间差异均有统计学意义(Z=-2.589和-2.353,P均＜0.05),而 MTV在18F-FDG和8F-FLT PET/CT 2种显像方法之问的差异无统计学意义(15.9±9.2和18.1±11.1;Z=-0.786,P＞0.05).6例有颈部淋巴结转移灶患者的SUVmax、SUVmean和MTV在2种显像方法间差异均无统计学意义(8.5±6.2比6.4±2.5、5.3±4.2比3.8±1.4、6.5 ±4.8比6.0±4.4;Z=-0.734、-0.734和-0.674,P均＞0.05).18F-FLT在颞叶摄取(SUVmax 0.7±0.3)明显低于18F-FDG(SUVmax 8.3±2.7;Z=-3.062,P＜0.01),其对于原发灶颅内浸润显示较18F-FDG更清晰.结论 18F-FLT PET/CT在鼻咽癌原发灶和淋巴结转移灶的诊断效能与18F-FDG PET/CT相当,对于显示原发灶的颅底附近侵犯更有利,其临床应用值得进一步研究.
목적 통과여18F-FDG PET/CT현상대비,탐토18 F-FLT PET/CT검측비인암원발조화경부림파결전이조적가행성.방법 12례초치차경병리학진적비인암환자(년령22～62세)자원진입해전첨성림상연구.매위환자선행18F-FDG PET/CT검사,차일행18F-FLF PET/CT검사.지소유2위핵의학과화방사과의사열편,비교18F-FDG PET/CT화18F-FLT PET/CT도상,채용ROI기술계산비인종류、경부림파결전이조、정상조직대18F-FDG、18F-FLT적SUVmax、SUVmean화MTV.채용비삼수Wilcoxon질화검험비교조간섭취화MTV차이.결과 12례비인암환자병조균명현섭취18F-FLT.18F-FLT PET/CT화18F-FDG PET/CT균가준학진단해조병례,이자대원발조화림파결전이조적검측결과무명현차별.비인암병조적18F-FDG화18F-FLT SUVmax분별위10.7±5.8화6.0±2.4,SUVmean분별위5.8±3.0화3.6±1.5；SUVmax화SUVmean조간차이균유통계학의의(Z=-2.589화-2.353,P균＜0.05),이 MTV재18F-FDG화8F-FLT PET/CT 2충현상방법지문적차이무통계학의의(15.9±9.2화18.1±11.1;Z=-0.786,P＞0.05).6례유경부림파결전이조환자적SUVmax、SUVmean화MTV재2충현상방법간차이균무통계학의의(8.5±6.2비6.4±2.5、5.3±4.2비3.8±1.4、6.5 ±4.8비6.0±4.4;Z=-0.734、-0.734화-0.674,P균＞0.05).18F-FLT재섭협섭취(SUVmax 0.7±0.3)명현저우18F-FDG(SUVmax 8.3±2.7;Z=-3.062,P＜0.01),기대우원발조로내침윤현시교18F-FDG경청석.결론 18F-FLT PET/CT재비인암원발조화림파결전이조적진단효능여18F-FDG PET/CT상당,대우현시원발조적로저부근침범경유리,기림상응용치득진일보연구.
Objective To investigate the value of 18F-FLT compared to 18F-FDG in PET/CT diagnosis of nasopharyngeal carcinoma (NPC).Methods Twelve newly biopsy-proven NPC patients (age range:22-62 years) were prospectively enrolled into this study after obtaining patient consent.They underwent 18F-FDG PET/CT first,followed by 18F-FLT PET/CT on the consecutive day before treatment.ROIs were drawn on the primary tumor,involved lymph nodes and normal tissues.Wilcoxon rank sum test was used to compare the uptake differences between 18F-FLT and 18F-FDG for both the primary tumor and metastatic lymph nodes.Results All 12 patients showed increased uptake of 18F-FLT by the primary tumor and metastatic lymph nodes,which were consistent with the findings by 18F-FDG PET/CT.The SUVmax and SUVmean of 18F-FLT in the primary NPC (SUVmax 6.0 ± 2.4,SUVmean 3.6 ± 1.5) were lower than those of 18F-FDG (SUVmax 10.7±5.8,SUVmean 5.8±3.0;Z=-2.589 and-2.353,bothP＜0.05).However,the MTV on 18F-FDG and 18F-FLT PET/CT showed no significant difference (15.9 ±9.2 vs 18.1 ± 11.1,Z=-0.786,P ＞ 0.05).The SUVmax SUVmean and MTV of the metastatic cervical lymph nodes in 6 patients showed no significant difference between the 2 tracers (8.5 ± 6.2 vs 6.4 ± 2.5,5.3 ± 4.2 vs 3.8 ± 1.4,6.5±4.8 vs6.0±4.4; Z=-0.734,-0.734,-0.674,respectively,allP＞0.05).The 18F-FLT uptake in the normal temporal lobe (SUVmax 0.7 ± 0.3) Was significantly lower than that of 18F-FDG (SUVmax 8.3 ±2.7,Z =-3.062,P ＜ 0.01).The skull base involvement by NPC could be better delineated on 18F-FLT PET/CT.Conclusions 18F-FLT PET/CT has comparable diagnostic efficacy for primary NPC and metastatic cervical lymph nodes to 18F-FDG PET/CT.It might be better than 18F-FDG for the evaluation of skull base involvement in NPC patients.