神经内分泌肿瘤转移灶PET／CT生长抑素受体显像特点分析  

Characteristics of neuroendocrine neoplasm metastasis in somatostatin receptor PET/CT imaging： a retrospective analysis

作　　者：王玲 胡桂兰 乔真[2] 张静静 张伟 邢海群 王瞳 霍力 李方 

机构地区：[1]中国医学科学院、北京协和医学院北京协和医院核医学科、核医学分子靶向诊疗北京市重点实验室,100730 [2]首都医科大学附属北京天坛医院核医学科,100050 [3]西南医科大学附属医院核医学科,泸州646000

出　　处：《中华核医学与分子影像杂志》2017年第3期132-136,共5页Chinese Journal of Nuclear Medicine and Molecular Imaging

摘　　要：目的探讨NEN转移灶。Ga—DOTA-TATEPET／CT（TATE．PET）显像特点及其与病理和18F—FDGPET／CT（FDG—PET）显像关系。方法回顾性分析2011年11月至2016年8月间43例NEN患者（男18例，女25例；年龄26-74岁）资料。患者静脉注射。Ga—DOTA．TATE44．4—229．4MBq后40-60min显像．28例在1周内按常规方法行FDG—PET。31例患者的转移灶经病理证实，余为临床诊断。病灶显像剂摄取高于本底为阳性，用ROI法测量病灶直径、suVmax和SUVmean.采用疋。检验和Pearson相关分析处理数据。结果（1）TATE—PET对43例患者的肝、淋巴结、骨及肺转移灶总检出率分别为85．7％（30／35）、12／13、7／7及2／3，SUV-分别为18．1（11．3-23．3）、10．8（5．4—15．6）、7．7（4．2—9．9）和1．8（1．3-2．3）。骨转移灶SUV-与直径存在相关性（r=0．233，P〈0．05）。（2）31例转移灶有病理结果的患者中，TATE．PET对G1、G2、G3的检出率分别为1／2、23／24（95．8％）和5／5。转移灶为G1的NEN仅发现于肝脏。（3）28例患者行2种显像，TATE—PET与FDG—PET对转移灶总检出率分别为89．2％（25／28）和71．4％（20／28），差异无统计学意义（X。2．389，P〉0．05）。TATE—PET对肝、骨转移灶检出率高于FDG—PET[70．0％（14／20）与65．0％（13／20），3／3与2／3]，而FDG—PET对淋巴结转移检出效果好（10／10与9／10），两者对肺转移灶检出能力相当（均为2／3）。结论TATE-PET对不同脏器及不同病理分级的NEN转移灶检出效果不同，TATE—PET与FDG—PET显像结果互补，但与病理分级无明显关系。Objective To investigate the characteristics of NEN metastasis with SSTR PET/CT and to correlate the results with FDG-PET and pathology. Methods From November 2011 to August 2016, a total of 43 patients with NEN （ 18 males, 25 females; age range： 26-74 years） were recruited into this retrospective study; they underwent 6SGa-DOTA-TATE PET/CT （TATE-PET） imaging 40-60 min after 44.4-229.4 MBq 6s Ga- DOTA-TATE administration. Metastases in 31 patients were confirmed by histopathology and in 12 patients by follow-up and other imaging modalities. Twenty-eight of 43 patients finished routine FDG-PET in a week after TATE-PET. PET/CT results were considered positive when the metastatic lesions were tracer-avid. ROI was drawn over each lesion for size and SUV measurement. X2 test and Pearson correlation analysis were used for statistical analysis. Results （1） Of 43 patients, TATE-PET detection rates of metastasis in the liver, lymph nodes, bones and lungs were 85.7% （30/35）, 12/13, 7/7, 2/3, respectively, with their correspondingSUV of 18.1（ 11.3-23.3）, 10.8（5.4-15.6）, 7.7（4.2-9.9） and 1.8（ 1.3-2. 3）, respectively. Statistical correlation between size and SUV was found in metastatic bone lesions（r=0. 233, P〈0.05）. （2） In 31 patients with histopathologieally proven metastasis, TATE-PET detected 23/24 （95.8%） G2, 1/2 G1 and 5/5 G3 metastases. G1 metastases were only found in the liver. （3）Among 28 patients underwent both TATE-PET and FDG-PET, there was no significant difference between the detecting rate of metastasis： 89. 2% （ 25/28 ） vs 71.4% （ 20/28 ） ; X2 = 2.389, P〉0.05. Compared with FDG-PET, TATE-PET was supe- rior in demonstrating metastasis in the liver and bones （70.0% （14/20） vs 65.0% （13/20）, 3/3 vs 2/3）, equal in detecting lung metastasis （both 2/3 ） but inferior in demonstrating metastasis in lymph nodes （9/10 vs 10/10）. Conclusions The capability of TATE-PET in revealing NEN metastasis varies depending on le- sion localization

关 键 词：神经内分泌瘤 癌 神经内分泌 肿瘤转移 正电子发射断层显像术 体层摄影术 X线计算机 镓放射性同位素 奥曲肽 脱氧葡萄糖 

分 类 号：R730.44[医药卫生—肿瘤] R739.4[医药卫生—临床医学]