^(68)Ga-DOTATATE与^(18)F-FDG PET/CT显像探测神经内分泌肿瘤骨转移的对比研究  

Comparative study of^(68)Ga-DOTATATE and^(18)F-FDG PET/CT imaging in the detection of bone metastasis in neuroendocrine neoplasm

作　　者：杜长治 谢卿[1] 翟士桢[1] 张岩[1] 陆明[1] 朱华[1] 李囡[1] 杨志[1] 于江媛[1] Du Changzhi;Xie Qing;Zhai Shizhen;Zhang Yan;Lu Ming;Zhu Hua;Li Nan;Yang Zhi;Yu Jiangyuan(Key Laboratory of Carcinogenesis and Translational Research(Ministry of Education),Key Laboratory for Research and Evaluation of Radiopharmaceuticals(National Medical Products Administration),Department of Nuclear Medicine,Peking University Cancer Hospital&Institute,Beijing 100142,China)

机构地区：[1]北京大学肿瘤医院暨北京市肿瘤防治研究所核医学科、国家药监局放射性药物研究与评价重点实验室、恶性肿瘤发病机制及转化研究教育部重点实验室,100142

出　　处：《中华核医学与分子影像杂志》2021年第9期520-524,共5页Chinese Journal of Nuclear Medicine and Molecular Imaging

摘　　要：目的对比^(68)Ga-1,4,7,10-四氮杂环十二烷-1,4,7,10-四乙酸-D-苯丙氨酸1-酪氨酸3-苏氨酸8-奥曲肽(DOTATATE)与^(18)F-脱氧葡萄糖(FDG)PET/CT显像在神经内分泌肿瘤(NEN)骨转移检测方面的表现。方法回顾性分析北京大学肿瘤医院2014年1月至2019年7月间经病理和临床随访证实的29例伴有骨转移的NEN患者(男19例、女10例,年龄35~76岁)的^(68)Ga-DOTATATE和^(18)F-FDG PET/CT显像结果。根据肿瘤增殖活性分为细胞增殖核抗原Ki-67≤20%组和Ki-67>20%组;根据骨转移灶CT表现分为溶骨、成骨和无变化3组。比较2种显像在骨转移检出数目及放射性摄取程度[骨病灶与正常骨的最大标准摄取值(SUVmax)比值(SUVT/B)]的差异,采用χ2检验和Mann-Whitney U检验分析数据。结果^(68)Ga-DOTATATE与^(18)F-FDG PET/CT显像的灵敏度分别为75.9%(22/29)和82.8%(24/29),差异无统计学意义(χ2=0.42,P>0.05)。^(68)Ga-DOTATATE PET/CT显像对骨盆、脊柱、肋骨、四肢骨近端、胸锁肩胛骨、颅骨检出骨病灶的病例数高于^(18)F-FDG PET/CT显像(分别为23、22、20、14、14、10与12、19、13、11、10、6例),对骨病灶的检出数目[9(3,36)与3(0,18)个]及病灶SUVT/B[11.10(3.35,22.30)与1.60(1.05,2.70)]也高于^(18)F-FDG PET/CT显像(U值:281.000、77.000,均P<0.001)。^(68)Ga-DOTATATE PET/CT显像对于分化较好的NEN(Ki-67≤20%组)[11(2,38)与2(0,13)个]以及CT示成骨性改变组[31(3,100)与3(0,31)个]骨病灶的检出数目多于^(18)F-FDG显像(U值:105.500、69.500,均P<0.05);所有组^(68)Ga-DOTATATE所示骨病灶SUVT/B均高于^(18)F-FDG(U值:3.000~22.000,均P<0.05)。结论^(68)Ga-DOTATATE在NEN骨转移灶的检出数目、摄取程度方面均优于^(18)F-FDG。Objective To compare the value of^(68)Ga-1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid-D-Phe1-Tyr3-Thr8-octreotide(DOTATATE)and^(18)F-fluorodeoxyglucose(FDG)PET/CT imaging in the detection of bone metastasis in neuroendocrine neoplasm(NEN).Methods From January 2014 to July 2019,29 NEN patients(19 males,10 females,age:35-76 years)with bone metastasis who underwent^(68)Ga-DOTATATE and^(18)F-FDG PET/CT imaging within one month in Peking University Cancer Hospital&Institute were retrospectively enrolled.Patients were divided into Ki-67≤20%and Ki-67>20%groups according to the tumor proliferation activity,and osteolysis,osteogenesis and no change groups according to the CT findings of bone metastases.The differences of the number and radioactive uptake(maximum standardized uptake value(SUVmax)ratio of bone lesion to normal bone(SUVT/B))of detected bone metastases between^(68)Ga-DOTATATE and^(18)F-FDG PET/CT imaging were analyzed.χ2 and Mann-Whitney U tests were used to analyze the data.Results The sensitivity of^(68)Ga-DOTATATE and^(18)F-FDG PET/CT imaging were 75.9%(22/29)and 82.8%(24/29)respectively,and there was no significant difference between the two modalities(χ2=0.42,P>0.05).The numbers of cases with bone lesions detected by^(68)Ga-DOTATATE PET/CT imaging in pelvis,spine,ribs,proximal limbs,sternoclavicular scapula and skull were all higher than those of^(18)F-FDG PET/CT imaging(23,22,20,14,14,10 vs 12,19,13,11,10,6,respectively).The^(68)Ga-DOTATATE PET/CT imaging was significantly superior to^(18)F-FDG imaging in detecting bone metastases(9(3,36)and 3(0,18))and SUVT/B(11.10(3.35,22.30)and 1.60(1.05,2.70);U values:281.000,77.000,both P<0.001).^(68)Ga-DOTATATE PET/CT imaging found more bone lesions in well differentiated NEN(Ki-67≤20%)group(11(2,38)and 2(0,13))and osteogenic bone metastasis group(31(3,100)and 3(0,31);U values:105.500,69.500,both P<0.05).SUVT/B of^(68)Ga-DOTATATE PET/CT imaging was significantly higher than^(18)F-FDG PET/CT imaging in all subgroups(U values:3.000-22.000,all P<0.0

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

分 类 号：R73-37[医药卫生—肿瘤] R730.44[医药卫生—临床医学]