AIM: To compare 2-deoxy-2-(<sup>18</sup>F)fluoro-D-glucose(<sup>18</sup>F-FDG) and <sup>18</sup>F-sodium (<sup>18</sup>F-NaF) positron emission tomography/computed tomog...AIM: To compare 2-deoxy-2-(<sup>18</sup>F)fluoro-D-glucose(<sup>18</sup>F-FDG) and <sup>18</sup>F-sodium (<sup>18</sup>F-NaF) positron emission tomography/computed tomography (PET/CT) accuracy in breast cancer patients with clinically/radiologically suspected or known bone metastases.METHODS: A total of 45 consecutive patients with breast cancer and the presence or clinical/biochemical or radiological suspicion of bone metastatic disease underwent <sup>18</sup>F-FDG and <sup>18</sup>F-fluoride PET/CT. Imaging results were compared with histopathology when available, or clinical and radiological follow-up of at least 1 year. For each technique we calculated: Sensitivity (Se), specificity (Sp), overall accuracy, positive and negative predictive values, error rate, and Youden’s index. McNemar’s χ<sup>2</sup> test was used to test the difference in sensitivity and specificity between the two diagnostic methods. All analyses were computed on a patient basis, and then on a lesion basis, with consideration ofthe density of independent lesions on the co-registered CT (sclerotic, lytic, mixed, no-lesions) and the divergent site of disease (skull, spine, ribs, extremities, pelvis). The impact of adding <sup>18</sup>F-NaF PET/CT to the work-up of patients was also measured in terms of change in their management due to <sup>18</sup>F-NaF PET/CT findings.RESULTS: The two imaging methods of <sup>18</sup>F-FDG and <sup>18</sup>F-fluoride PET/CT were significantly different at the patient-based analysis: Accuracy was 86.7% and 84.4%, respectively (McNemar’s χ<sup>2</sup> = 6.23, df = 1, P = 0.01). Overall, 244 bone lesions were detected in our analysis. The overall accuracy of the two methods was significantly different at lesion-based analysis (McNemar’s χ<sup>2</sup> = 93.4, df = 1, P < 0.0001). In the lesion density-based and site-based analysis, <sup>18</sup>F-FDG PET/CT provided more accurate results in the detection of CT-negative metastasis (P < 0.002) and vertebral localizations (P < 0.002); <sup>18</sup>F-NaF PET/CT was more accurate in detecting sclerotic (P < 0.005) and rib lesions (P < 0.04). <sup>18</sup>F-NaF PET/CT led to a change of management in 3 of the 45 patients (6.6%) by revealing findings that were not detected at <sup>18</sup>F-FDG PET/CT.CONCLUSION: <sup>18</sup>F-FDG PET/CT is a reliable imaging tool in the detection of bone metastasis in most cases, with a diagnostic accuracy that is slightly, but significantly, superior to that of <sup>18</sup>F-NaF PET/CT in the general population of breast cancer patients. However, the extremely high sensitivity of <sup>18</sup>F-fluoride PET/CT can exploit its diagnostic potential in specific clinical settings (i.e., small CT-evident sclerotic lesions, high clinical suspicious of relapse, and negative <sup>18</sup>F-FDG PET and conventional imaging).展开更多
AIM: To investigating the relationship between thoracic and cardiac <sup>18</sup>F-Natrium-Fluoride (18F-NaF) uptake, as a marker of ongoing calcification and cardiovascular risk factors.METHODS: Seventy-e...AIM: To investigating the relationship between thoracic and cardiac <sup>18</sup>F-Natrium-Fluoride (18F-NaF) uptake, as a marker of ongoing calcification and cardiovascular risk factors.METHODS: Seventy-eight patients (44 females, mean age 63, range 44-83) underwent whole body 18F-NaF positron emission tomography/computed tomography. Cardiovascular risk (CVR) was used to divide these patients in three categories: Low (LR), medium (MR) and high risk (HR). 18F-NaF uptake was measured by manually drawing volumes of interest on the ascending aorta, on the aortic arch, on the descending aorta and on the myocardium; average standardized uptake value was normalized for blood-pool, to obtain target-to-background ratio (TBR). Values from the three aortic segments were then averaged to obtain an index of the whole thoracic aorta.RESULTS: A significant difference in whole thoracic aorta TBR was detected between HR and LR (1.84 ± 0.76 vs 1.07 ± 0.3, P < 0.001), but also between MR and HR-LR (1.4 ± 0.4, P < 0.02 and P < 0.01, respectively). Significance of this TBR stratification strongly varied among thoracic aorta subsegments and the lowest P values were reached in the descending aorta (P < 0.01). Myocardial uptake provided an effective CVR classes stratification (P < 0.001).Correlation between TBR and CVR was appreciable when the whole thoracic aorta was considered (R = 0.67), but it peaked when correlating the descending thoracic segment (R = 0.75), in comparison with the aortic arch and the ascending segment (R = 0.55 and 0.53, respectively).CONCLUSION: Fluoride uptake within the thoracic aorta wall effectively depicts patients’ risk class and correlates with cardiovascular risk. Descending aorta is the most effective in CVR determination.展开更多
Much research effort has been made to understand various biological processes at levels of molecules using molecular imaging techniques. Because of great sensitivity, high resolution, and rapid detection, positron emi...Much research effort has been made to understand various biological processes at levels of molecules using molecular imaging techniques. Because of great sensitivity, high resolution, and rapid detection, positron emission tomography （PET） imaging is becoming one of the most used imaging techniques for medical diagnose and pre-clinical studies. Here we provide a review on molecular imaging and PET imaging. An introduction is also provided on ~SF-fluorine labeling techniques for the preparation of PET imaging probes. A summary and comparison of currently available ~SF-fluorine labeling methods is provided. The per- spectives for 18F-fluorine labeling techniques are also given.展开更多
文摘AIM: To compare 2-deoxy-2-(<sup>18</sup>F)fluoro-D-glucose(<sup>18</sup>F-FDG) and <sup>18</sup>F-sodium (<sup>18</sup>F-NaF) positron emission tomography/computed tomography (PET/CT) accuracy in breast cancer patients with clinically/radiologically suspected or known bone metastases.METHODS: A total of 45 consecutive patients with breast cancer and the presence or clinical/biochemical or radiological suspicion of bone metastatic disease underwent <sup>18</sup>F-FDG and <sup>18</sup>F-fluoride PET/CT. Imaging results were compared with histopathology when available, or clinical and radiological follow-up of at least 1 year. For each technique we calculated: Sensitivity (Se), specificity (Sp), overall accuracy, positive and negative predictive values, error rate, and Youden’s index. McNemar’s χ<sup>2</sup> test was used to test the difference in sensitivity and specificity between the two diagnostic methods. All analyses were computed on a patient basis, and then on a lesion basis, with consideration ofthe density of independent lesions on the co-registered CT (sclerotic, lytic, mixed, no-lesions) and the divergent site of disease (skull, spine, ribs, extremities, pelvis). The impact of adding <sup>18</sup>F-NaF PET/CT to the work-up of patients was also measured in terms of change in their management due to <sup>18</sup>F-NaF PET/CT findings.RESULTS: The two imaging methods of <sup>18</sup>F-FDG and <sup>18</sup>F-fluoride PET/CT were significantly different at the patient-based analysis: Accuracy was 86.7% and 84.4%, respectively (McNemar’s χ<sup>2</sup> = 6.23, df = 1, P = 0.01). Overall, 244 bone lesions were detected in our analysis. The overall accuracy of the two methods was significantly different at lesion-based analysis (McNemar’s χ<sup>2</sup> = 93.4, df = 1, P < 0.0001). In the lesion density-based and site-based analysis, <sup>18</sup>F-FDG PET/CT provided more accurate results in the detection of CT-negative metastasis (P < 0.002) and vertebral localizations (P < 0.002); <sup>18</sup>F-NaF PET/CT was more accurate in detecting sclerotic (P < 0.005) and rib lesions (P < 0.04). <sup>18</sup>F-NaF PET/CT led to a change of management in 3 of the 45 patients (6.6%) by revealing findings that were not detected at <sup>18</sup>F-FDG PET/CT.CONCLUSION: <sup>18</sup>F-FDG PET/CT is a reliable imaging tool in the detection of bone metastasis in most cases, with a diagnostic accuracy that is slightly, but significantly, superior to that of <sup>18</sup>F-NaF PET/CT in the general population of breast cancer patients. However, the extremely high sensitivity of <sup>18</sup>F-fluoride PET/CT can exploit its diagnostic potential in specific clinical settings (i.e., small CT-evident sclerotic lesions, high clinical suspicious of relapse, and negative <sup>18</sup>F-FDG PET and conventional imaging).
文摘AIM: To investigating the relationship between thoracic and cardiac <sup>18</sup>F-Natrium-Fluoride (18F-NaF) uptake, as a marker of ongoing calcification and cardiovascular risk factors.METHODS: Seventy-eight patients (44 females, mean age 63, range 44-83) underwent whole body 18F-NaF positron emission tomography/computed tomography. Cardiovascular risk (CVR) was used to divide these patients in three categories: Low (LR), medium (MR) and high risk (HR). 18F-NaF uptake was measured by manually drawing volumes of interest on the ascending aorta, on the aortic arch, on the descending aorta and on the myocardium; average standardized uptake value was normalized for blood-pool, to obtain target-to-background ratio (TBR). Values from the three aortic segments were then averaged to obtain an index of the whole thoracic aorta.RESULTS: A significant difference in whole thoracic aorta TBR was detected between HR and LR (1.84 ± 0.76 vs 1.07 ± 0.3, P < 0.001), but also between MR and HR-LR (1.4 ± 0.4, P < 0.02 and P < 0.01, respectively). Significance of this TBR stratification strongly varied among thoracic aorta subsegments and the lowest P values were reached in the descending aorta (P < 0.01). Myocardial uptake provided an effective CVR classes stratification (P < 0.001).Correlation between TBR and CVR was appreciable when the whole thoracic aorta was considered (R = 0.67), but it peaked when correlating the descending thoracic segment (R = 0.75), in comparison with the aortic arch and the ascending segment (R = 0.55 and 0.53, respectively).CONCLUSION: Fluoride uptake within the thoracic aorta wall effectively depicts patients’ risk class and correlates with cardiovascular risk. Descending aorta is the most effective in CVR determination.
基金supported by the National Natural Science Foundation of China(11304156)the General Financial Grant fromthe China Postdoctoral Science Foundation(2013M531312)
文摘Much research effort has been made to understand various biological processes at levels of molecules using molecular imaging techniques. Because of great sensitivity, high resolution, and rapid detection, positron emission tomography （PET） imaging is becoming one of the most used imaging techniques for medical diagnose and pre-clinical studies. Here we provide a review on molecular imaging and PET imaging. An introduction is also provided on ~SF-fluorine labeling techniques for the preparation of PET imaging probes. A summary and comparison of currently available ~SF-fluorine labeling methods is provided. The per- spectives for 18F-fluorine labeling techniques are also given.
