^(11)C-MET PET/CT诊断脑胶质瘤术后复发残留的初步研究  

A preliminary study of ^(11)C-methionine PET/CT in diagnosis of recurrence or residue after glioma surgery

作　　者：高玉杰[1] 周妮娜[2] 李囡[2] 范洋 杨志[2] Gao Yujie;Zhou Nina;Li Nan;Fan Yang;Yang Zhi(Department of Nuclear Medicine,Chifeng Municipal Hospital,Chifeng 024000,China;Department of Nuclear Medicine,Peking University Cancer Hospital,Beijing 100142,China)

机构地区：[1]赤峰市医院核医学科,内蒙古自治区赤峰024000 [2]北京大学肿瘤医院核医学科,北京100142

出　　处：《实用肿瘤杂志》2021年第2期154-159,共6页Journal of Practical Oncology

摘　　要：目的探讨^(11)C标记的蛋氨酸(^(11)C-methionine,^(11)C-MET)PET/CT在诊断脑胶质瘤术后复发残留的应用价值。方法回顾性分析因胶质瘤术后行CT或MRI检查可疑术后复发残留的患者17例。患者均行^(11)C-MET PET/CT检查,均经二次手术病理或临床随访证实为脑胶质瘤术后复发残留(postoperative relapse and residue, PORR)或治疗后相关良性病变(therapy-related benign changes, TRBC)。双盲法由2名>5年PET/CT诊断经验的医师测量病灶最大标准摄取值(maximum standardized uptake value,SUV_(max))及靶/本底比值(target/normal background ratio,T/N:病灶SUV_(max)/对侧正常额叶SUV_(mean))并作出定性诊断。比较2位医师之间病灶半定量测量和定性诊断的一致性。计算^(11)C-MET PET/CT诊断胶质瘤术后复发残留的敏感度、特异度和准确率。比较PORR组与TRBC组SUV_(max)及T/N值的差异。胶质瘤PORR组病灶SUV_(max)及T/N值与胶质瘤WHO初次手术病理分级行相关分析。结果在半定量测量方面(SUV_(max)及T/N值),2位医师测量值比较,差异均无统计学意义(均P>0.05);在定性诊断上,2名医师诊断一致率为100%。17例胶质瘤术后患者中,PORR 14例,TRBC 3例。^(11)C-MET PET/CT诊断胶质瘤术后复发的敏感度85.7%(12/14),特异度为100%(3/3),准确率88.2%(15/17)。PORR组与TRBC组SUV_(max)及T/N值比较,差异均具有统计学意义(均P<0.05)。14例胶质瘤术后复发残留患者中WHO分级Ⅰ级1例,Ⅱ级6例,Ⅲ级5例,Ⅳ级2例。复发残留病灶的SUV_(max)与T/N值有相关性(r=0.86,P<0.01);SUV_(max)与肿瘤WHO分级无相关性(r=0.102,P=0.728);T/N值与肿瘤WHO分级无相关性(r=0.056,P=0.848)。结论 ^(11)C-MET PET/CT能清楚显示复发残留病灶,不同医师之间诊断有很高的一致性,诊断准确率高,易于胶质瘤术后复发残留的检出。病灶的^(11)C-MET摄取程度与肿瘤分级无相关性,有利于低级别肿瘤复发的检出。Objective To evaluate the value of ^(11) C-methionine(MET)PET/CT in the diagnosis of postoperative recurrence or residue of brain glioma.Methods A retrospective analysis was performed on 17 patients who underwent CT or MRI examination for suspected postoperative recurrence or residue due to glioma.^(11) C-MET PET/CT was performed.All the patients were confirmed to have postoperative recurrence or residue(PORR)or therapy-related benign changes(TRBC)of brain glioma via the pathology of second operation or clinical follow-up.The maximum standardized uptake value(SUVmax)and target/nomal background ratio(T/N):lesion SUVmax/contralateral normal frontal lobe SUVmean)values were measured by two doctors with more than 5 years of diagnostic experience in PET/CT,and qualitative diagnosis was made.The consistency of semi-quantitative measurement and qualitative diagnosis was compared between the two doctors.The sensitivity,specificity and accuracy of ^(11) C-MET PET/CT in the diagnosis of postoperative recurrence and residue were calculated.The differences of SUVmax value and T/N ratio between the PORR group and TRBC group were compared.Correlation analysis was performed between the value of SUVmax and T/N of the lesion and the primary operative pathological tumor grade in the PORR group.Results In terms of the semi-quantitative measurement(SUVmax value and T/N ratio),there were no significant differences between the measurement values of doctor 1 and doctor 2(both P>0.05).In terms of qualitative diagnosis,the diagnosis consistency rate between the two doctors was 100%.There were 17 patients with glioma,14 in the PORR group and 3 in the TRBC group.The sensitivity,specificity and accuracy of ^(11) C-MET PET/CT in the diagnosis of postoperative recurrence or residue of glioma were 85.7%(12/14),100%(3/3),and 88.2%(15/17).SUVmax and T/N were statistically different between the PORR group and TRBC group(both P<0.05).Of the 14 patients in the PORR group,there was 1 patient in tumor gradeⅠ,6 patients in gradeⅡ,5 patients in gra

关 键 词：胶质瘤 ~(11)C-蛋氨酸PET/CT 脑胶质瘤切除术 肿瘤复发 

分 类 号：R739.41[医药卫生—肿瘤]