^(18)F-FDG和^(18)F-FET PET脑显像诊断垂体腺瘤

The diagnosis of pituitary adenomas with ^(18)F-F DG and ^(18)F-FET PET brain imaging

目的 比较18F 脱氧葡萄糖 (FDG)和18F 酪氨酸 (FET)PET显像对垂体腺瘤的诊断价值。方法 正常对照者 7例同期行18F FDGPET脑显像和13 N NH3 PET脑血流显像。 2 0例垂体腺瘤患者行18F FDGPET脑显像 ,其中 10例同期行18F FETPET脑显像 ,并参照近期MRI结果进行分析。 2 0例患者均行经口鼻蝶窦垂体腺瘤切除术 ,术后行病理检查及免疫组织化学分型。结果 ①正常对照组垂体18F FDG摄取明显低于周围组织。②对于分泌激素和无分泌功能的垂体腺瘤 ,18F FDGPET和18F FETPET均可显示病灶。③垂体腺瘤在18F FDG显像中多表现为均匀的放射性摄取增高 ,而18F FET显像则多表现为散在的摄取增高 ,与MRI所示等T1长T2 或稍长T1长T2 信号的肿瘤组织分布相似。④ 7例微腺瘤 18F FDGPET检出 5例 ,MRI检出 3例。⑤不同激素分泌型和无分泌功能垂体腺瘤的瘤体大小、激素水平与18F FDG或18F FET显像标准摄取值 (SUV)间无明显相关。结论 18F FDG和18F FETPET脑显像均可显示垂体腺瘤 。

Objective To make comparison between different features of 18 F-fluorodeoxyg lucose (FDG) and O -2- 18 F-fluoroethyl- L -tyrosine ( 18 F-F ET) PET images in the diagnosis of pituitary adenomas. Meth ods Seven normal controls were studied using 18 F-FDG PET and 13 N-NH 3 PET brain imaging. Twenty patients with pituitary a denomas were studied with 18 F-FDG PET and 10 of them also with 18 F-FET PET imaging at the same period. The diagnoses of all patien ts were verified by transsphenoidal adenomectomy and pathological work-up inclu ding immunohistochemistry. Results ①The pituitary 18 F-FDG uptake in the pituitary of normal controls was lower than that in the sur rounding tissues. ②Both 18 F-FDG and 18 F-FET PET d etected all types of hormone-secreting and nonfunctioning pituitary adenomas.③ The adenomas showed homogeneous uptake of radioactivity in 18 F-FD G images but scattered radioactivity in 18 F-FET images which was somewhat similar to the tumor signal distribution in MRI.④For 7 pituitary micro adenomas 18 F-FDG PET detected 5 and MRI 3 cases; for pituitary ma croadenomas the sensitivity of MRI was 100%, the same as that of 18 F-FDG and 18 F-FET PET. ⑤There was no positive correlation betw een the tumor size, hormone level and 18 F-FDG or 18 F-FET uptake in all types of hormone-secreting or nonfunctioning adenomas. Conclusions Both 18 F-FDG and 18 F-FET PET brain imaging can localize pituitary adenomas, but the images with 18 F-FDG are better. For localization of pituitary microadenomas the sensitivi ty and accuracy of 18 F-FDG PET are significantly higher than thos e of MRI.