18F-FDG PET在鉴别诊断胰腺肿块的良恶性中的价值

为评价1 8F -FDGPET在鉴别诊断胰腺肿块的良恶性中的价值 ,对 1 2例 (胰腺癌 7例 ,胰腺炎 5例 )有临床症状 ,并经B超、CT/MR显像检查证实为有胰腺占位性病变的病人进行了1 8F -FDGPET显像检查。在经过衰减校正的图像上进行视觉分析和勾画ROI计算病灶 /肝脏 (T/L)的放射性计数比值的半定量分析。结果显示 ,9例阳性患者中有 7例最终诊断为胰腺癌 ,2例为胰腺炎引起的包块 ,3例阴性病人均经随访证实为胰腺炎。胰腺癌病人和胰腺炎病人的平均病灶 /肝脏比值为 2 .5 8± 0 .95和 1 .2 9± 0 .87,其差异具有显著性 (p =0 .0 3 7)。以T/L比值 =1 .5为分界值 ,所有 7例胰腺癌病人的T/L比值均高于 1 .5 ,5例胰腺炎患者中的 4例T/L低于 1 .5。表明1 8F -FDGPET对鉴别诊断胰腺良恶性病变是有帮助的。尤其是其阴性预期值较高 ,但特异性有限 ,须注意假阳性。半定量分析可提高诊断的准确性。     

18F-FDG符合线路成像在肿瘤及其转移灶探测中的临床应用

为评价^18氟-脱氧葡萄糖(^18F-FDG)符合线路成像在诊断肿瘤性质或肿瘤转移的临床应用价值，对87例临床怀疑为恶性肿瘤或肿瘤转移复发的患者，空腹肘静脉注射^18F-FDG259—298MBq后40-60min，采用GEHAWKEYE符合线路单光子发射型计算机断层(SPECT)进行卧位显像；经迭代法处理和重建，获得经X线衰减校正后的横断面、冠状面和矢状面三维断层图像；以目测双盲阅片进行诊断分析，并与手术病理或CT／MRI以及临床随访作出的最后诊断进行了对比。结果显示：87例患者中显像阳性61例，其中假阳性5例，真阳性56例；阴性26例，其中假阴性2例，真阴性24例。87例患者中共检出病灶136个，其中淋巴结和远处转移灶41个。符合线路成像对肿瘤或其转移灶诊断的灵敏度为96．6％(56／58)，特异性为82．8％(24／29)，阳性预测值91．8％(56／61)，阴性预测值92．3％(24／26)，诊断准确率92．0％(80／87)。表明 ^18F-FDG符合线路成像对于肿瘤的诊断具有较高的灵敏度和特异性；在肿瘤定性、肿瘤复发和转移灶的寻找方面有着独特的优势，是临床肿瘤诊断研究的有效手段。     

固相萃取柱上水解法合成18F-FDG

研究了一种新的固相萃取柱水解^18F—FDG中间体1，3，4，6-四-O-乙酰基-2-^18F—β—D-葡萄糖(^18F—FDG-DAc4)的方法。用活化过的C-18萃取柱捕获中间体^18F—FDG—Ac4，向柱中加入1mL 2mol／L的NaOH，室温下2min时99％以上的中间体可转化为^18F-FDG，加入磷酸缓冲液，再经C-18柱和三氧化铝柱纯化得到供注射用^18F—FDG。     

18F-FDG PET/CT显像在食管癌分期中的应用

对30例食管癌初诊患者于手术或放化疗前一周内进行18F-FDG PET/CT检查,将15例手术治疗患者的130枚区域淋巴结的PET/CT结果与病理学检查相比较.所有患者的远处转移灶及15例非手术治疗患者的区域淋巴结转移根据活组织病理学检查、多种影像学检查临床随访而定,随访时间均大于6个月.结果显示:30例食管癌患者,原发病灶18F-FDG PET/CT均为高代谢病灶(100%),病灶界限显示清晰.以患者为单位计算,30例食管癌患者,20例(66.7%)证实有区域淋巴结转移,18F-FDG PET/CT真阳性18例,假阳性2例,假阴性2例,诊断的灵敏度、特异性和准确性分别为90.0%、80.0%、86.7%.以淋巴结为单位计算,在15例手术治疗患者的共130枚淋巴结中,病理学检查证实为淋巴结转移33枚(25.4%),PET/CT真阳性23枚.18F-FDG PET/CT对区域淋巴结转移诊断的灵敏度、特异性及准确性分别为69.7%、97.9%、90.8%.检出远处转移4例(13.3%),分布于肝脏、肺及骨骼.30例PET/CT显像后,16例提高了临床分期;1例降低了临床分期;13例与18F-FDG PET/CT显像前的临床分期一致.     

胆碱代谢PET显像的临床应用

2—^18F—2—脱氧—D—葡萄糖(FDG)是一种常用的肿瘤正电子显像剂，但在鉴别诊断肿瘤时，很难区分炎症和肿瘤病灶，可能造成肿瘤诊断的假阳性结果。胆碱代谢正电子发射断层(PET)显像能够弥补FDG某些不足。已用于各类肿瘤的鉴别诊断，特别在前列腺癌、脑瘤和膀胱癌的鉴别诊断方面明显优于FDG PET。本文对胆碱代谢PET显像的基本原理、常用正电子显像剂及其临床应用进行了概述。     

(S-18F-氟代甲基)-L-半胱氨酸的半自动化合成及其初步炎症PET显像

改进现有合成模块,研究(S)8F-氟代甲基)-L-半胱氨酸(18F-MCYS)的自动化合成工艺,并对无菌炎症模型进行正电子发射断层(PET)显像.以CH2Br2为前体,经氟化反应制备甲基化试剂18F-CH2Br,后者与溶解在二甲基亚砜(DMSO)中的L-半胱氨酸充分反应,用Sep-Pak C18小柱分离纯化,得到18F...     

18F-FDG PET/CT早期监测小剂量顺铂在体化疗敏感性的实验研究

42只双侧前胸壁荷瘤的VX2兔模型(共计84个肿瘤)随机分为治疗组(n=32)和对照组(n=10).治疗组静脉给予4mg/kg顺铂前(Pre-therapy)和给药后95-100min(Day 0)、Day 1、Day7、Day 14行PET/CT显像;对照组不给化疗药物,其余与实验组相同.取葡萄糖摄取最大值(SUVmax)进行分析,CT测量肿瘤大小.按肿瘤体积分组,Day 7时治疗组肿瘤体积增长>1倍则为不敏感,反之为敏感.结果显示:(1)Day 0敏感组SUVmax减低率为(-48.96±12.27)%,而不敏感组和对照组为(21.26±18.26)%和(7.16±13.47)%,三组SUVmax变化有显著差异(P<0.05).(2)Pre-therapy、Day 0、Day 1、Day 14两组肿瘤体积无显著性差异(P>0.05),但Day 7敏感组肿瘤体积小于不敏感组及对照组,差异有显著性(P<0.05).(3)Day 7、Day 14敏感组肿瘤坏死率大于不敏感组及对照组,差异有显著性(P<0.05).(4)HE染色观察不同时间点切除的肿瘤标本发现:Day 7、Day 14时敏感组肿瘤细胞数少而炎性和坏死细胞数增加.表明根据化疗药物给予后FDG减低程度,18F-FDG PET/CT能在体、早期、灵敏检出肿瘤对化疗药物的敏感性.     

18F-FDG对小鼠Lewis肺癌移植瘤抑制作用的实验研究

建立Lewis肺癌C57BL/6小鼠皮下移植瘤模型18只,按随机数字法分为高剂量18F-FDG治疗组、低剂量18F-FDG治疗组和对照组,每组6只,分别给予18F-FDG 18.5×107Bq、9.25×107Bq和0.2 mL等体积的生理盐水,于接种后第7天腹腔内一次给药,观察18F-FDG对Lewis肺癌移植瘤体积变化和瘤重的影响。22天后用流式细胞仪检测细胞凋亡,以免疫组化法检测bcl-2及Survivin基因的蛋白表达。发现18F-FDG高、低剂量组肿瘤抑瘤率及凋亡率明显高于对照组,Bcl-2及Survivin蛋白的表达明显低于对照组(P<0.05),与低剂量组相比,高剂量组与对照间差异更为显著(P<0.01)。这表明18F-FDG可明显抑制小鼠Lewis肺癌移植瘤生长,其机制可能与下调Bcl-2及Survivin蛋白的表达促进细胞凋亡有关。     

18F-FDG PET/CT for malignant small intestinal neoplasms

In this paper, 18F-FDG PET/CT data of 19 malignant SINs (small intestinal neoplasms) were consecutively reviewed. Nnine patients accepted PET/CT scan for preoperative diagnosis and staging, while ten patients presented follow-up after treatment and restaging. The results were correlated with abdomen enhanced CT and surgical pathological findings. Abdominal pain and weight loss were the most common findings. About 16% SINs located in the duodenum, 52% in the jejunum and 32% in the ileum. Lymphoma was the most frequent neoplasms. PET/CT revealed residual or recurrent malignant SINs in 5 patients who had negative or non-definite findings by abdomen CT and demonstrated extra-abdomen metastasis in 3 patients. Clinical decisions of treatment were changed for 6 patients after PET/CT examinations. The 18F-FDG PET/CT were better than CT in accuracy, negative predictive value and positive predictive value (89.5% vs 68.4%, 100% vs 66.7%, and 81.8% vs 69.2%, respectively). Whole body 18F-FDG PET/CT may be an effective molecular imaging method for staging and restaging of malignant SINs.     

Metabolic assessement of spleen infiltration by non-Hodgkin lymphoma using ^18F-FDG PET/CT： Preliminary clinical results

infiltration without morphology changes, which may not be diagnosed exactly by conventional image.     

The ^18F—FDG uptake in non small cell lung carcinoma correlates with the DNA—grading of malignancy

In order to evaluate correlation of glucose metabolism and DNA Ploidity of tumors,the uptake of ^18F-Deoxyglucose(FDG) by PET prior to surgery and the DNA cotent and DNA-grading of malignancy (DNA-MG) of Schiff-Stained nuclei obtained from fresh tumor fragments by means of image cytometry were studied,and thereafter the correlation between standardized uptake value(SUV) and (DNA-MG) was analysed in forty-nine patients with histologically proven non-small cell lung carcinoma(NSCLC),As a result of the DNA higtograms of these 49 patients,46(93.88%) wrer aneuploid and only 3(6.12%) were tetraploid.A linear correlation of the SUV versus the (DNA-MG)(r=0.336,p=0.024)was found demonstrating that ^18F-FDG PET as a non-invasive metabolic imaging technique,may also provide information correlated to malignant DNA patterns which may be valuable in malignant differentiation and prognostic prediction.     

18F标记的脑受体PET显像剂的制备研究进展

脑受体的PET显像剂制备研究具有重要意义 ,其中以18F标记的药物研究最多。介绍了18F标记的脑受体PET显像剂制备的一般方法 ,对亲核取代法进行了较为详细的讨论 ,分析了主要影响因素 ;按照脑受体功能进行分类 ,回顾了近年来脑受体的PET显像剂制备研究的一些进展。     

Non-FDG PET imaging of brain tumors

Due to relatively high uptake of glucose in the brain cortex, the use of FDG PET imaging is greatly limited in brain tumor imaging, especially for low-grade gliomas and some metastatic tumours. More and more tracers with higher specificity were developed lately for brain tumor imaging. There are 3 main types of non-FDG PET tracers： amino acid tracers, choline tracers and nucleic acid tracers. These tracers are now widely applied in many aspects of brain tumor imaging. This article summarized the general use of non-FDG PET in different aspects of brain tumor imaging.