胶质瘤PET分子影像的应用进展  

Application of PET molecular imaging in gliomas

作　　者：孔艳艳[1] 管一晖[1] 

机构地区：[1]复旦大学附属华山医院PET中心,上海200235

出　　处：《肿瘤影像学》2016年第3期196-208,共13页Oncoradiology

基　　金：国家自然科学基金(No:81271516;81571345);上海市科委项目(No:13JC1401503;14DZ1930400;14DZ1930402);上海市科委资助项目(No:16411968700);复旦大学老年医学专项支持计划青年学者创新研究项目(No:IDF151006)

摘　　要：无创PET检查灵敏度高,能反映活体的代谢和分子水平,可通过糖代谢、氨基酸代谢、胆碱代谢、核酸代谢及乏氧等检测胶质瘤的代谢功能改变,在胶质瘤诊断、治疗和预后中发挥重要作用。^(18)F-脱氧葡萄糖(18F-fluorodeoxyglucose,^(18)F-FDG)显像的灵敏度高,但特异度较差。氨基酸显像可提供较好的肿瘤细胞增殖情况,胆碱、核酸显像能更敏感地从代谢方面反映胶质瘤的细胞增殖情况,乏氧显像则更有效地反映胶质瘤放化疗后的耐受情况。因此,PET能更好地指导胶质瘤活检取材、手术方案制订、放疗计划实施、疗效监测、鉴别复发与治疗后改变等。每一种显像剂均有各自优缺点,需综合应用于胶质瘤诊治研究。本综述总结了各类PET显像剂及其在胶质瘤诊断、预后、治疗及疗效监测中的作用。Non-invasive positron emission tomography(PET) enables the measurement of metabolic and molecular processes with high sensitivity. PET plays a significant role in the diagnosis, prognosis, and treatment of gliomas and predominantly detects gliomas by detecting their metabolic alterations, including energy metabolism, amino acid metabolism, choline metabolism, nucleic acid metabolism, and hypoxic metabolism, etc. Glucose metabolic tracers are related to tumor cell energy and exhibit good sensitivity but poor specificity for gliomas. Amino acid metabolic tracers provide a better delineation of tumors and cellular proliferation. Choline and nucleic acid metabolic tracers have high sensitivity for gliomas and cellular proliferation. Hypoxic metabolism tracers are useful for detecting resistance to radiotherapy and chemotherapy. Therefore, PET imaging techniques are useful for detecting biopsy-targeting points, deciding on tumor resection, radiotherapy planning, monitoring therapy, and distinguishing glioma recurrence or progression from post-radiotherapy effects. However, it is not possible to use only one PET tracer to make all clinical decisions because each tracer has both advantages and disadvantages. This study focuses on the different kinds of PET tracers and summarizes their recent applications in patients with gliomas. Combinational uses of PET tracers are expected tocontribute to differential diagnosis, prognosis, targeted treatment, and monitoring therapy.

关 键 词：胶质瘤 正电子发射断层成像 18F-脱氧葡萄糖 11C-蛋氨酸 18F-胸腺嘧啶核苷 18F-硝基咪唑 11C-胆碱 

分 类 号：R739.41[医药卫生—肿瘤] R730.44[医药卫生—临床医学]