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氟离子与骨组织中的羟基磷灰石晶体羟基交换形成氟磷灰石。18F-NaF在成骨性和溶骨性病变中的摄取反映局部血流以及骨转换的加快[5]。18F-NaF的摄取机制与99Tcm-MDP相似, 但是18F-NaF比99Tcm-MDP具有更好的药代动力学特性, 包括更快的血液清除速度以及在骨组织中2倍的摄取量[3, 6]。
虽然18F-NaF和99Tcm-MDP在剂量学上相似, 然而18F-NaF PET/CT检查花费时间更短(18F-NaF PET/CT和99Tcm-MDP骨扫描检查花费时间分别为1~2.5 h和2~3 h), 且能够更快得到诊断[5]。18F-NaF PET/CT在检测骨病变方面比常规骨扫描更灵敏。99Tcm-MDP骨扫描对成骨性病变和溶骨性病变的检出率相近, 而18F-NaF PET/CT拥有更高的检出率并且能更准确地区分良恶性病变[7-8]。除了药代动力学上的优越性, 18F-NaF能够在生产18F-FDG的加速器上轻易获得。因此, 考虑到18F-NaF PET/CT比99Tcm-MDP骨扫描具备更优越的特性及改变治疗方式的潜力和应用的简便性, 18F-NaF PET/CT有潜力在诊断骨转移方面替代99Tcm-MDP骨扫描[9]。18F-NaF PET/CT和99Tcm-MDP骨扫描的比较见表 1。
表 1 18F-NaF PET/CT和99Tcm-MDP骨扫描比较
Table 1. Compare with 18F-NaF PET/CT and 99Tcm-MDP bone scan
18F-氟化钠PET/CT诊断肿瘤骨转移应用进展
Application progress of 18F-NaF PET/CT in the diagnosis of neoplasm metastases
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摘要: 18F-氟化钠(18F-NaF)作为骨扫描示踪剂已有50多年的历史,期间由于正电子探测器的缺乏等因素被99Tcm-MDP替代。随着PET/CT的发展,将18F-NaF作为PET/CT示踪剂的研究逐渐增多。18F-NaF本身的药物特性以及PET/CT相对于SPECT/CT的优势,使得18F-NaFPET/CT诊断恶性肿瘤骨转移的灵敏度、特异度优于99Tcm-MDP骨扫描。与99Tcm-MDP骨显像、18F-FDGPET/ CT和MRI相比,18F-NaFPET/CT在诊断恶性肿瘤骨转移时具有更高的灵敏度,并且对于不同肿瘤的骨转移有不同的诊断价值。18F-NaF联合18F-FDGPET/CT扫描被证明具有一定的应用价值。18F-NaFPET/CT是诊断恶性肿瘤骨转移的安全、有效、简便、无创的方法。Abstract: 18F-NaF has been used for the tracer of bone scans more than 50 years. After a period of decline for the shortage of positron detector, scholars using 18F-NaF as radioactive tracer is increasing with the development of PET/CT. The natural medicinal property of 18F-NaF and the advantage of PET make the 18F-NaF PET/CT a better way to assess malignant osseous metastases than 99Tcm-MDP bone scan in sensitivity and specificity. When compared with 99Tcm-MDP bone scan, 18F-FDG PET/CT and magnetic resonance imaging, 18F-NaF PET/CT has higher sensitivity in detecting osseous metastases of malignancies. 18F-NaF PET/CT also has different diagnostic values in management of patients with malignancies. Combine 18F-NaF and 18F-FDG in one PET/CT examination is proven to have potential in clinical management. 18F-NaF PET/CT is a safe, effective, simple and noninvasive method in diagnosis of bone metastases in malignant tumor.
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Key words:
- Sodium /
- Bone /
- Neoplasm metastases /
- Positron-emission tomography /
- Tomography /
- X-ray /
- Fluorine radioisotopes
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表 1 18F-NaF PET/CT和99Tcm-MDP骨扫描比较
Table 1. Compare with 18F-NaF PET/CT and 99Tcm-MDP bone scan
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