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影像学检查(如CT、MRI、SPECT、PET、数字减影血管造影技术、超声等)为临床诊断提供了多种模态的医学图像。单一的医学图像只能提供相关脏器的单一信息。在临床应用中,各种模态的信息量相对单一及片面,且存在其自身局限性,而多种不同模态图像的信息融合能使彼此的优势互补及交叉验证成为可能,有利于对复杂疾病的全面准确评估,为治疗方式的合理选择和治疗方案的制定提供了客观可靠的依据。
近年来,以18F-FDG PET/CT为代表的多模态成像技术发展迅速,其在肿瘤的诊治过程中的优势已得到临床的广泛认可,但其局限性也逐渐显露,如软组织分辨率较差,CT与PET采集的不同步导致的配准误差,患者不可避免接受高剂量电离辐射(尤其是对于需要多次复查的患者)等,这些局限性在很大程度上来源于同机CT。随着一体化PET/MR成像系统的研发成功并应用于临床,多模态成像技术向前迈进了一大步,克服了PET/CT的固有缺陷,实现了解剖和功能、代谢、生化影像的实时融合,做到了真正意义上的数据同步采集,并明显降低了电离辐射,集代谢和功能成像于一体的数据可由PET/MR系统一站式采集完成。目前,有关18F-FDG PET/CT和PET/MR在临床上的对比研究结果初步表明,PET/MR在临床上对于一些疾病的评估是可行的、准确的,二者有其各自的优势[1]。
本文综述了多模态成像(PET/CT和PET/MR)在黑色素瘤中的研究现状及进展,此外,还讨论了已经转化于临床应用阶段的新型分子影像探针的应用进展。
PET/CT和PET/MR在黑色素瘤中的临床应用及新进展
Clinical application and new progress of PET/CT and PET/MR imaging in malignant melanoma
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摘要: 黑色素瘤易转移、复发率高,已经成为严重危及人民健康的恶性肿瘤之一,早期诊断和准确分期对预后及远期生存十分关键。18F-FDG PET/CT作为一项集PET与CT于一体的成像模式,被广泛地应用于包括黑色素瘤等在内的恶性肿瘤的诊断、分期及疗效的评估。随着一体化PET/MR成像系统研发的成功,多模态成像技术向前迈进了一大步,实现了真正意义上的数据同步采集。笔者就18F-FDG PET/CT及PET/MR在黑色素瘤分期、复发和疗效评价中的研究现状进行综述,介绍了多模态成像技术在黑色素瘤中的新进展。
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关键词:
- 黑色素瘤 /
- 多模态成像 /
- 正电子发射断层显像计算机体层摄影术 /
- 磁共振成像 /
- 氟脱氧葡萄糖F18
Abstract: Malignant melanoma is prone to metastasis and recurrence. It has become one of the seriously health-threatening malignant tumors. Early diagnosis and accurate staging are very important for prognosis and long-term survival. 18F-FDG PET/CT is a novel imaging technique that combines the functional data of PET with the morphological information of CT. It has been widely used in the diagnosis and staging, local recurrence, and therapeutic response evaluation of malignant tumour including melanonma. With the successful clinical application of integrated-PET/MR imaging system, It has taken a great step forward in multi-modal imaging technology field, thereby realizing synchronous data acquisition. To understand new progress of multimodal imaging technology in malignant melanoma, this article provides a review of the value of 18F-FDG PET/CT and PET/MR in the staging, local recurrence, chemotherapy response evaluation of melanoma. -
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