摘要
目的肾细胞癌(RCC)的诊断主要依赖传统影像学检查,但鉴别诊断仍存在一定困难。有研究指出,11C-乙酸(11C-AC)在RCC的原发病灶中存在高摄取,而另一项类似研究则认为RCC的摄取与正常肾实质相仿。本研究旨在探讨其在肾占位鉴别诊断中的应用价值。方法对34例肾脏单发占位者分别行20 min 11C-AC PET动态采集及18F-脱氧葡萄糖(18F-FDG)、11C-AC PET/CT局部静态显像,勾画肾占位及健侧肾实质感兴趣区(ROI),以靶本(T/B值)比值为指标,定义T/B比值>1为阳性,≤1为阴性。观察肾占位放射性摄取特征和动态曲线差异,并比较两种示踪剂诊断RCC的阳性率。结果 34例肾占位者中,26例手术、8例穿刺。其中26例为RCC,11C-AC和18F-FDG PET/CT诊断RCC的阳性率分别为88.5%和38.5%,两者差异有统计学意义(P<0.001)。AC动态显像的时间-放射性曲线(TAC)显示,RCC与良性病变的放射性计数达峰时间及曲线走势均存在一定差异。结论 11C-AC PET/CT显像探测RCC的阳性率明显高于18F-FDG。TAC可能有助于肾占位性质的鉴别。
Objective The conventional imaging examinations are contributed to the diagnosis of renal cell carcinoma（RCC）, but are still limited in differential diagnosis of renal masses. Some reports demonstrated the high 11C-acetate（11C-AC） uptake in RCC while the contradictory viewpoint in another similar research indicated that in most kidney tumors the 11C-AC accumulation was not higher than that in normal kidney parenchyma. The aim of this research is to investigate the value of 11C-AC PET/CT in the differential diagnosis of renal masses. Methods A total of 34 patients with renal masses underwent dynamic PET imaging of the kidney for 20 min after injection of 11C-AC and time-activity curve（TAC） was obtained in those positive lesions. The static images of 11C-AC and 18F-fluorodeoxyglucose（18F-FDG） were acquired, and then the kidney lesions were scored positive or negative according to the ratio of tumor to background（T/R） 〉1 or ≤1. The PET results were correlated with the histological diagnosis. The positive rates of dual tracers were compared. Results Among all the renal masses, 26 cases were diagnosed by surgery, and 8 cases by biopsy. 26 patients were confirmed the diagnosis of RCC, the positive rates were 88.5% and 38.5% by 11C-AC and 18F-FDG PET/CT with statistic difference（P〈0.001）. The peak time and tendency of TAC between RCC and benign renal mass were obviously different. Conclusion The detective rate for RCC with 11C-AC PET/CT is higher than with 18F-FDG. TAC might be useful in the differential diagnosis of renal masses.
出处
《肿瘤影像学》
2014年第2期137-142,共6页
Oncoradiology
