^(99)Tc^m-tetrofosmin肺癌显像的临床研究(与^(18)F-FDG PET对比)

Tc m tetrofosmin imaging in patients with lung cancer: comparison with CT and 18 F FDG PET studies

目的评价９９Ｔｃｍｔｅｔｒｏｆｏｓｍｉｎ（ＴＦ）显像在肺癌诊断中的临床意义。方法用９９ＴｃｍＴＦ对１６例已证实的肺癌患者进行平面和断层显像研究。所有病人均行ＣＴ和１８Ｆ脱氧葡萄糖（ＦＤＧ）ＰＥＴ检查。用感兴趣区分析法对９９ＴｃｍＴＦ和１８ＦＦＤＧ图像进行定性及定量分析，计算肿瘤及非肿瘤内放射性比。结果ＣＴ共检出１４个肿瘤病灶，２个因胸膜广泛渗出未能检出。此外８例患者，ＣＴ显示了２１个受累纵隔淋巴结（＞１５ｃｍ）。９９ＴｃｍＴＦ平面和断层显像诊断肺癌病灶的灵敏度分别为８８％（１４／１６）和９４％（１５／１６）。所有肺癌病灶均有１８ＦＦＤＧ摄取增高。定量分析示１８ＦＦＤＧ在肺癌的摄取明显高于９９ＴｃｍＴＦ（４５２±１５０与１５５±０３０，ｔ＝４０２９，Ｐ＜０００１）。ＣＴ和病理活检示中心坏死的２个肺癌病灶，９９ＴｃｍＴＦ和１８ＦＦＤＧ显像均示肿瘤中心放射性缺损。对于异常淋巴结，平面显像只发现３例病人中的４个淋巴结，而ＳＰＥＣＴ显像检出１７个淋巴结有９９ＴｃｍＴＦ异常摄取。ＣＴ所示的２１个异常淋巴结，１８ＦＦＤＧ摄取均增高。结论９９ＴｃｍＴＦ显像用于肺癌患者的诊断有其临床?

Objective 99 Tc m tetrofosmin (TF) imaging has been proposed recently in nuclear oncology Methods 16 patients (9 squamous cell carcinoma, 4 adenocarcinoma, 2 metastasis and 1 small cell carcinoma of lung) were studied using 99 Tc m TF imaging (740 MBq iv, plannar and SPECT imaging) All patients also underwent computer tomography (CT) and 18 F deoxyglucose (FDG) PET studies TF and FDG images were qualitatively and quantitatively analyzed using region of interest analysis; in particular, quantitative evaluation of TF and FDG activities was performed with calculating the tumor/non tumor ratios Results On CT, 14 lung tumors were detected, while 2 lesions were not localized since they were obscured by the presence of extensive pleural effusion; furthermore, 21 mediastinal lymph nodes were found (>1 5 cm) involved in 8 patients For the lung lesions, the diagnostic sensitivities of planar and SPECT TF imaging were respectively 88% (14/16) and 94% (15/16); increased FDG uptake was found in all lung tumors; however, the quantitative analysis of TF and FDG activities in lung tumors showed that FDG uptake was significantly (P<0 001) higher than that of TF (4 52±1 50 vs 1 55±0 30); furthermore, concordant findings of FDG and TF images in two lung lesions with central necrosis were confirmed by pathology and CT For lymph node abnormalities, TF planar scanning only detected 4 lesions in 3 patients, while TF SPECT identified 17 lesions in 8 patients Increased FDG uptake was found in all lymph node abnormalities detected on CT Conclusions These priliminary data suggest that 99m Tc TF imaging is a useful technique for assessing the patients with lung cancers In particular, similar TF SPECT and FDG PET images were observed; however, FDG uptake of lung tumor was significantly higher comparing with TF uptake and this suggests a high tumor glucose metabolism