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1.
郭佳  陈跃 《现代预防医学》2011,38(1):186-187,189
[目的]探讨18F-脱氧葡萄糖(Fluorine-18 fluorodeoxyglucose,FDG)正电子发射计算机断层显像(Positron Emission Computer Tomography,PET/CT)在乳腺癌术后肿瘤标志物(CA153,CA125,CEA)升高患者中的应用价值。[方法]对22例乳腺癌术后伴肿瘤标志物升高的患者临床资料进行回顾性分析,18F-FDGPET/CT全身显像探测有无复发或/和转移灶。[结果]18F-FDG PET/CT诊断阳性11例,其中1例经针吸病理证实为假阳性;18F-FDG PET/CT诊断阴性11例,经随访证实为真阴性。18F-FDG PET/CT诊断乳腺癌转移的灵敏度100%(10/10),特异性91.67%(11/12),阳性预测值90.91%(10/11),阴性预测值100%(11/11)。[结论]18F-FDG PET/CT显像能可靠地鉴别肿瘤标志物升高的乳腺癌术后患者有无转移或复发,准确探测复发和转移灶,改变治疗方案,是其他影像学方法和肿瘤标志物监测的重要补充。  相似文献   

2.
目的探讨^h18F—FDG PET/CT显像时,NSCLC原发灶SUVmax与肿瘤大小的关系,方法对147例NSCLC的病人行18F—FDG PET/CT检查,分析SUVmax与NSCLC原发灶大小的关系。结果总体上SUVmax与肿瘤的大小呈正相关:但当肿瘤≥3.0cm时,SLWmax与肿瘤的大小无相关性。结论SUVmax与NSCLC肿瘤的大小呈正相关,但不能作为肿瘤T分期的依据。  相似文献   

3.
目的探讨18F-氟代氧葡萄糖正电子发射计算机断层扫描显像(18F-FDG PET/CT)对患儿神经母细胞瘤骨转移的诊断价值。方法回顾性选取2018年6月—2021年6月该院收治的65例患儿神经母细胞瘤患儿,所有患儿均行18F-FDG PET/CT、99锝代亚甲基二膦酸盐(99mTc-MDP)全身骨显像检查,观察比较两种检查方法的骨转移诊断准确性,并分析18F-FDG PET/CT检查最大标准摄取值(SUVmax)、代谢体积(MTV)及糖酵解总量(TLG)参数对骨转移的诊断价值。结果65例患儿临床诊断为骨转移的患儿39例,18F-FDG PET/CT检出38例(58.46%),准确度为89.23%,灵敏度为89.74%,特异度为88.46%,阳性预测值为92.11%,99mTc-MDP全身骨显像检出41例(63.08%),准确度为87.69%,灵敏度为92.31%,特异度为80.77%,阳性预测值为87.80%;39例患儿骨转移部位分别为四肢长骨干骺端15例、骨盆8例、脊柱8例、颅骨4例、肋骨2例、肩胛骨1例及胸骨1例,溶骨性骨转移61.54%明显高于成骨性、混合型、无变化,溶骨性及混合型骨转移SUVmax值明显高于成骨性、无变化骨转移(P<0.05);骨转移组患儿的SUVmax、TLG及MTV明显高于未骨转移组(P<0.05);ROC曲线分析显示,SUVmax、TLG及MTV诊断骨转移的AUC分别为0.846、0.893及0.927,灵敏度和特异度分别为(61.5%,100%)、(82.1%,88.5%)及(87.2%,92.3%)。结论18F-FDG PET/CT诊断神经母细胞瘤患者发生骨转移具有较高的诊断价值,可通过SUVmax、TLG及MTV参数对患儿骨转移进行诊断。  相似文献   

4.
目的临床中使用正电子发射计算机断层显像仪(PET/CT)进行鉴别,能够有效的提升鉴别的准确性、敏感度,探讨18-氟(18-F)PET/CT对肺部不同大小结节良恶性鉴别诊断的价值。方法回顾性分析2014年1月—2016年12月河南科技大学第一附属医院行PET/CT检查的90例肺部结节患者,并有明确的病理随访结果,其中肺癌患者有51例(腺癌32例、鳞癌8例、腺鳞癌2例、大细胞癌3例、小细胞癌1例、临床诊断肺癌5例);良性病变39例,包括腺瘤、错构瘤、肉芽肿等。根据结节大小分为3组,计算PET/CT对不同大小肺结节的敏感性、特异性、准确性、阳性预测值、阴性预测值。结果 90例患者中PET/CT正确诊断为83例,总的诊断灵敏度、特异度、准确性、阳性预测值、阴性预测值分别为94.51%、88.62%、92.21%、92.92%、91.21%。PET/CT的假阴性病例3例,假阳性病例4例。结论 PET/CT对肺部不同结节良恶性鉴别具有较高的诊断价值。  相似文献   

5.
目的探讨18F-FDG PET/CT显像在诊断食管癌淋巴结转移与病理对照研究价值。方法回顾分析我院食管癌淋巴结转移患者,术前行18F-FDG PET/CT显像,对转移淋巴结的最大标准摄取值(SUVmax)分析,并与病理结果对照。结果 PET/CT显像SUVmax界值为2.5、5诊断食管癌淋巴结转移的灵敏度、特异性、准确性分别为:69.48%、92.71%、83.33%和87.66%、94.51%、93.26%。结论 PET/CT显像诊断食管癌转移淋巴结有较高准确性,选择SUVmax界值为5对诊断准确性更高。  相似文献   

6.
目的探讨实时超声造影与18F-脱氧葡萄糖PET显像(18F-FDG PET显像)两种诊断技术对肝脏良恶性肿瘤的诊断价值。方法选取2011年9月~2013年9月在内蒙古医科大学附属医院门诊就诊的142例怀疑肝脏占位性病变患者,其中男83例,女59例,对肝占位性病变进行实时超声造影及18F-FDG PET显像检查,对所有患者的检查结果与病理活检对照分析。结果超声造影检查对恶性病灶诊断灵敏度、特异性、阳性预测值及阴性预测值分别为61.1%、42.3%、64.7%和38.6%,对良性病灶诊断灵敏度、特异性、阳性预测值及阴性预测值分别为57.7%、38.9%、35.3%和61.4%,诊断准确率为59.9%。PET检查对恶性肿瘤诊断的灵敏度、特异性、阳性预测值及阴性预测值分别为67.8%、67.3%、78.2%和54.7%,对良性肿瘤诊断的灵敏度、特异性、阳性预测值及阴性预测值分别为32.7%、32.2%、21.8%和45.3%,诊断准确率为54.9%。结论超声造影与18F-FDG PET显像在恶性肿瘤的诊断优势无差别,而对良性肿瘤的诊断更具优势。应用超声造影和PET/CT检查对肝脏占位性病变定性诊断有一定价值,可以提高肿瘤的检出率,并为临床医生提供更为丰富的影像学信息。  相似文献   

7.
目的评估无症状体检人群中18F-FDG PET/CT筛查恶性肿瘤的应用价值。方法选取2011年1月~2014年12月在解放军总医院健康管理研究院应用18F-FDG PET/CT筛查恶性肿瘤的无症状体检人群4 899例,平均年龄(51.8±9.5)岁,男性3 390例(69.2%),女性1 509例(30.8%)。结果 PET/CT检查发现可疑高代谢或占位病灶,经穿刺或手术病理证实的恶性肿瘤72例,包括肺癌、甲状腺癌以及结肠癌等13种肿瘤,筛查阳性率为1.5%。PET/CT筛查假阴性8例,假阳性65例,筛查的敏感度为90.0%,特异性为99.8%,阳性预测值52.6%,阴性预测值98.4%。结论体检人群中PET/CT筛查可发现全身多部位的早期恶性肿瘤。为减少假阴性和假阳性,PET/CT筛查恶性肿瘤应与甲状腺、肝脏超声及胃肠镜检查相结合。低阳性预测值及射线暴露诱发肿瘤的风险是在无症状体检人群中应用PET/CT筛查恶性肿瘤时应重视的问题,应注意选择适应症,防止滥用检查和过度医疗。  相似文献   

8.
目的 探讨健康者脾脏18F-脱氧葡萄糖(FDG) PET/CT显像特征,为在18F-FDG PET/CT显像中判断脾脏是否有异常病灶提供正常参考值依据.方法 选择行18F-FDG PET/CT体格检查的健康者100例.在PET图像横断面上对脾脏和肝脏分别手动勾画感兴趣区(ROI),测定标准摄取值(SUV),包括SUV最大值(SUVmax)和SUV平均值(SUVavg),同时测定肝脏和脾脏的CT值,再计算脾脏与肝脏的SUV比值及CT值比值.结果 (1)正常脾脏SUVmax和SUVavg分别为2.27、1.73,CT值为53.90 HU.(2)脾脏/肝脏SUVmax比值为0.80,脾脏/肝脏SUVavg比值为0.86,所有受检者脾脏SUV均低于肝脏.(3)脾脏/肝脏CT值比值为0.86,所有受检者脾脏CT值均低于肝脏.(4)男性组脾脏SUVmax高于女性组(P<0.05),男女组间脾脏SUVavg比较差异无统计学意义(P>0.05).(5)<60岁和≥60岁组间脾脏SUV比较差异无统计学意义(P>0.05).结论 18F-FDGPET/CT显像示正常脾脏放射性分布及密度分布均匀,18F-FDG生理性摄取程度及CT值均低于肝脏.  相似文献   

9.
CT对于星形细胞瘤的诊断正确率为70~90%。但国内文献中尚未提及星形细胞瘤之CT诊断中出现的“假阴性”问题,所谓“假阴性”就是星形细胞瘤病人早期,已具有神经系统疾患之表现,如癫痫或一时性脑缺血(TIA),但CT颅脑检查未见病征者。兹将我院自1982~1986年,经CT检查幕上星形细胞瘤的假阴性4例,报告如下:  相似文献   

10.
目的探讨18F-脱氧葡萄糖(FDG)hPET/CT显像与99Tcm-亚甲基二膦酸盐(MDP)骨显像诊断骨转移瘤的价值。方法56例确诊的恶性肿瘤患者均于2周内分别行FDG和MDP骨显像,其中35例经手术、活组织病理检查、其他影像检查及随访证实存在骨转移病灶。对2种显像结果进行对比分析。结果35例骨转移患者18F-FDG hPET/CT显像阳性32例,骨显像阳性31例,灵敏度分别为91.4%和88.6%,差异无统计学意义(P>0.05)。21例非骨转移患者中18F-FDG hPET/CT显像阴性19例,骨显像阴性12例,特异性分别为90.5%和57.1%,差异有统计学意义(P<0.05)。2种方法诊断骨转移瘤的准确性分别为91.1%和76.8%,差异有统计学意义(P<0.05)。结论18F-FDG hPET/CT显像与99Tcm-MDP骨显像对骨转移瘤的诊断均有价值,两者灵敏度相当,前者有更高的特异性和准确性。  相似文献   

11.
目的:探讨单光子发射计算机断层(SPECT)骨显像和PET/CT骨显像结果的差异及可能的原因。方法:对2例病例均先后行SPECT骨显像和PET/CT骨显像,并对图像进行对比分析。结果:骨骼对18F-fluoride(PET/CT骨显像剂)和99mTc-MDP(SPECT骨显像剂)的摄取机理类似,均可以反映局部血流量及骨代谢更新的活跃程度,由于18F-fluoride与骨的亲和力强于99mTc-MDP,因此PET/CT图像具有比SPECT更高的系统分辨率和系统灵敏度。结论:PET/CT骨显像灵敏度和分辨率均高于SPECT,但由于其检查费用较高及自身受18F的短半衰期限制,因而其在临床应用受到一定的限制。  相似文献   

12.
INTRICATE is a prospective double-blind placebo-controlled feasibility study, assessing the influence of combined vitamin K2 and vitamin D3 supplementation on micro-calcification in carotid artery disease as imaged by hybrid Sodium [18F]Fluoride (Na[18F]F) positron emission tomography (PET)/ magnetic resonance imaging (MRI). Arterial calcification is an actively regulated process and results from the imbalance between calcification promoting and inhibiting factors. Considering the recent advancements in medical imaging, ultrasound (US), PET/MRI, and computed tomography (CT) can be used for the selection and stratification of patients with atherosclerosis. Fifty-two subjects with asymptomatic carotid artery disease on at least one side of the neck will be included in the study. At baseline, an Na[18F]F PET/MRI and CT examination will be performed. Afterwards, subjects will be randomized (1:1) to a vitamin K (400 µg MK-7/day) and vitamin D3 (80 µg/day) or to placebo. At the 3-month follow-up, subjects will undergo a second Na[18F]F PET/MRI and CT scan. The primary endpoint is the change in Na[18F]F PET/MRI (baseline vs. after 3 months) in the treatment group as compared to the placebo arm. Secondary endpoints are changes in plaque composition and in blood-biomarkers. The INTRICATE trial bears the potential to open novel avenues for future large scale randomized controlled trials to intervene in the plaque development and micro-calcification progression.  相似文献   

13.
Peripheral benzodiazepine receptor (PBR) is associated with neuroinflammation and tumor progression. [(11)C]DAA1106 and [(18)F]FEDAA1106 are two promising radioligands for positron emission tomography (PET) imaging of PBR. This study was designed to develop a new radiolabeled analog of [(11)C]DAA1106 and [(18)F]FEDAA1106, [(11)C]FEDAA1106, for PET imaging of PBR expression in brain and cancer. Precursor N-(5-fluoro-2-phenoxyphenyl)-N-(2-(2-fluoroethoxy)-5-hydroxybenzyl)acetamide (9) was synthesized in multiple steps with moderate to high chemical yields. Precursor 9 was labeled by [(11)C]CH(3)OTf and isolated by high pressure liquid chromatography (HPLC) purification to provide target radioligand N-(5-fluoro-2-phenoxyphenyl)-N-(2-(2-fluoroethoxy)-5-[(11)C]methoxybenzyl)acetamide ([(11)C]FEDAA1106, [(11)C]10) in 60-70% radiochemical yields, decay corrected to end of bombardment (EOB), based on [(11)C]CO(2). The specific activity of the target radiotracer [(11)C]10 was in a range of 111-185GBq/micromol at the end of synthesis (EOS).  相似文献   

14.
Objectives: Establish new approaches for early diagnosis of dementia, based on imaging amyloid and tau pathology, cell losses and neuronal function, in subjects with mild cognitive impairment (MCI),. The overall aim is to develop effective tools for monitoring disease progression in the living patient to facilitate discovery of early therapeutic interventions to modify the course of the disease.Design: Use 2-(l-(6-[(2-[F-18]fluoroethyl)(methyl)amino]-2-naphthyl)ethylidene)malononitrile ([F-18]FDDNP) in combination with positron emission tomography (PET) to produce dynamic images for quantification of regional cortical brain deposition in MCI patients and compare them with controls subjects and patients with Alzheimer’s disease (AD). Comparison with other molecular imaging probes for neuronal losses and function were also made.Setting: Patients are positioned supine in the tomograph bed with his/her head in the detector ring field. Upon injection of the molecular imaging probe (e.g., [F-18]FDDNP) images are obtained at very short time intervals for up to two hours. This results in dynamic sequences of brain distribution of the probe.Participants: Patients with clinical diagnosis of AD, MCI and control subjects.Measurements: Subjects in the categories established above were scanned with [F-18]FDDNP-PET and quantification performed using Logan parametric graphical analysis to measure relative quantitative amyloid loads throughout the brain within patient groups. These results were compared in the same patients with cell losses in hippocampus using 4-[F-18]fluoro-N-(2-[4-(2-methoxyphenyl)-l-piperazinyl]ethyl)-N-(2-pyridinyl)benzamide,([F-18]MPPF) and regional cerebral glucose metabolic rates using 2-deoxy-2-[F-18]fluoro-2-deoxy-D-glucose (2-[F-18]FDG).Results: [F-18]FDDNP reliably follows neuropathological progression (amyloid plaques [SP]; neurofibrillary tangles [NFT]) in the living brain of AD patients and those with MCI. The distribution of [F-18]FDDNP brain cortical accumulation correlates well with behavioral measures (e.g., MMSE scores) and follows known patterns of pathological distribution observed at autopsy. We have also established conversion of controls to MCI and MCI to AD with precision and sensitivity in patients and control subjects in follow-up studies. Moreover, we have established that hemispheric cortical surface mapping of [F-18]FDDNP binding is a powerful tool for assessment and visualization of the rate of brain pathology deposition. A strong correlation of [F-18]FDDNP binding, cell losses in hippocampus and decreased glucose utilization ([F-18]FDG PET) in several neocortical regions was found in the same AD and MCI subjects. Conclusions: The combined evaluation of [F-18]FDDNP PET (targeting NFT and_SP) with neuronal losses in the hippocampus and with [F-18]FDG PET (targeting neuronal function) offers the opportunity for reliable, noninvasive detection of MCI patients at risk for AD. The approach offers a glimpse to the molecular and cellular mechanisms associated with dementia and provides a means for their assessment in the living patient. Monitoring disease progression in MCI patients demonstrates the usefulness of this imaging approach for early diagnosis and provides a means for evaluation of neuroprotective agents and drugs aimed at prevention and modification of disease progression.  相似文献   

15.
In this study, novel specific PET radioligands containing the 4-(4-fluorobenzyl)piperidine moiety and selectively antagonistic for the NR2B subunit containing NMDA receptors were developed. Two antagonists, RGH-896 (1a) and 4-(4-fluorobenzyl)piperidinyl-1-methyl-2-benzimidazol-5-ol (2a), belonging to two different structural families, were radiolabeled by an aromatic nucleophilic radiofluorination followed by a reduction of the para-position carbonyl function. Radiotracers [18F]1a, [18F]2a or the pattern 4-(4-[18F]-fluorobenzyl)piperidine ([18F]6) demonstrated an identical in vivo behavior with high accumulation of radioactivity in bone and cartilage which would suggest a radiodefluorination of the radiotracers. The identification of metabolites from 6 by LC-MS-MS confirmed the significant degree of defluorination as a result of the in vivo hydroxylation in the benzyl ring. In conclusion, [18F]1a or [18F]2a are not suitable for imaging the NR2B NMDA receptors due to their poor brain penetration. We also argue for a cautious use of the radiolabeled pattern, 4-(4-[18F]-fluorobenzyl)piperidine, to develop PET radiotracers.  相似文献   

16.
目的:探讨不同重建矩阵对18F-FDG PET图像质量和标准摄取值(standard uptake value,SUV)的影响,以持续获得高质量的PET图像。方法:选择符合美国国家电气制造商协会标准的模体进行体模实验,选择2018年5月至2019年6月于南京市第一医院核医学科行18F-FDG PET/CT全身扫描的40例患者(共96处病灶)图像进行临床实验。对重建矩阵分别为128×128、150×150、192×192、256×256、512×512和600×600时的PET图像质量采用变异系数(coefficient of variation,CV)、对比度、信噪比及肝脏SUVmax、SUVmean、SUVSD、CVliver值和病灶SUVmax进行评估。结果:(1)不同重建矩阵所得模体PET图像微球均清晰可见,重建矩阵为192×192时,模体PET图像信噪比取得最大值,CV值取得最小值。(2)重建矩阵为192×912和256×256时,临床实例PET图像病灶清晰度和肝脏均匀度较高。不同重建矩阵所得病灶SUVmax和肝脏SUVmean差异无统计学意义(F=0.757,P=0.581;F=0.002,P>0.999),肝脏SUVmax、SUVSD和CVliver差异具有统计学意义(F=7.879、19.51、37.34,P均<0.0001)。重建矩阵为256×256时,病灶SUVmax取得最大值,且肝脏SUVmean趋于稳定。结论:18F-FDG PET图像质量和SUV值受重建矩阵影响较大,重建矩阵为256×256时可满足临床诊断需要,重建矩阵为192×192时图像质量最佳。  相似文献   

17.
目的:探讨18F-脱氧葡萄糖(FDG)PET延迟显像在原发性肺癌诊断中的价值。方法:对36例原发性肺癌患者分别进行18F-FDG PET早期头部——盆腔显像和注射后3h胸部延迟显像,测定2次显像病灶的标准摄取值(SUV),并计算18F-FDG的储留指数(RI)。结果:原发性肺癌的延迟显像SUV明显高于早期显像SUV(P<0.01);以早期显像SUV>2.5作为标准,原发性肺癌诊断的灵敏度、特异性、准确性分别为80.3%、72.7%、78.6%;以RI>20%作为标准,原发性肺癌诊断的灵敏度、特异性、准确性分别为82.8%、77.9%、80.3%;结合以上2项标准,原发性肺癌诊断灵敏度、特异性、准确性分别为90.0%、80.0%和86.7%。结论:18F-FDG PET延迟显像有助于原发性肺癌的诊断,结合应用SUV及RI2项指标可提高诊断准确率。  相似文献   

18.
Borbély K 《Orvosi hetilap》2004,145(8):411-423
Over the last two decades, the routine imaging methods available for the diagnosis and monitoring of intracranial tumors are computer tomography and magnetic resonance imaging. Both procedures provide precise anatomical delineation of the lesions, determine changes in tumor volume in response to therapy. However, they are not effective in differentiating low-grade from high-grade lesions and residual or recurrent tumor from radiation/chemo necrosis. Radionuclide procedures (positron emission tomography and single photon emission computer tomography), especially positron emission tomography is an example of a technique with high sensitivity and accuracy that has the potential to yield the information necessary not only to provide a means for diagnosis of tumors based on altered tissue metabolism but also to serve as a tool for monitoring the effects of the therapy. Measurements of the rate of glucose metabolism by 18F-FDG uptake in brain lesions are the most frequent applications in order to discriminate low-grade from high-grade lesions and tumor recurrence from radiation necrosis. 11C-methionine positron emission tomography is used to delineate the boundaries of tumors, providing information of value in directing stereotactic biopsy, planning the approach and extent of brain surgery, and permitting differentiation of the metabolizing neoplasm from simple disruption of the blood-brain barrier. Another substrate, 11C-thymidine has been used to measure nucleotide metabolism and utilization in DNA synthesis. Activation studies are useful in patients suffering from lesions near to or in the eloquent areas. It is likely that multiple positron emission tomography radioligands and multimodality imaging are the standards for diagnosis and monitoring of the effects of therapeutic intervention.  相似文献   

19.
The importance of the brain A2A adenosine receptor (A(2A)AR) in movement disorders urges the development of radiolabeled ligands for imaging those receptors by positron emission tomography (PET). This study evaluated one class of A(2A)AR antagonists, derivatives of 4-amino-6-benzylamino-1,2-dihydro-2-phenyl-1,2,4-triazolo[4,3-a]quinoxalin-2H-1-one, 10a, as agents for imaging brain A(2A)ARs by PET.. Modifications of a literature synthesis of 10a efficiently generated analogs 10b-s for pharmacological evaluation. Radioligand binding experiments showed affinities for the rat brain A(2A)AR in the low nanomolar range but similar affinities for the A1AR and substantial unspecific binding. Autoradiography employing [3H]10a, showing that high unspecific binding obscured specific binding to both the A1AR and A(2A)AR. Thus, compounds 10b-s are unsuitable as ligands for imaging brain A(2A)ARs by PET.  相似文献   

20.
INTRODUCTION: Vinpocetine is a compound widely used in the prevention and treatment of cerebrovascular diseases. The exact mechanism of action of the drug is still not known. The objective of the present investigation was to determine the global uptake and regional distribution of radiolabelled vinpocetine in the human brain. Three healthy persons were examined with positron emission tomography (PET) and [11C]-vinpocetine. RESULTS: The uptake of [11C]-vinpocetine in brain was rapid and on average as a maximum 3.7% of the total radioactivity injected was in the brain 2 minutes after radioligand administration. The uptake was heterogeneously distributed among brain regions. When compared with the cerebellum, an a priori reference region, the highest regional uptake was in the thalamus, the upper brain stem, the striatum and the cortex. CONCLUSIONS: The brain regions showing increased uptake in the human brain correspond to those in which vinpocetine has previously been shown to induce elevated metabolism and blood flow by PET clinical studies in patients with chronic ischaemic post-stroke condition.  相似文献   

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