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PET/CT作为分子水平的显像技术,是利用放射性核素标记显像剂进行解剖、功能显像的。18F-FDG是目前临床上最常用的显像剂,其在全身许多肿瘤中的应用价值已获得广泛认可,但还存在以下不足 [1-2] :①脑皮质对18F-FDG的摄取较高,甚至高于多数脑肿瘤的摄取,影响了对颅内病变的观察;②分化程度较好的肝细胞肝癌(hepatocellular carcinoma,HCC)对18F-FDG的摄取与周围正常组织基本一致,可导致假阴性诊断;③18F-FDG经由泌尿系统进行排泄,因此18F-FDG显像时盆腔内放射性分布较高,影响盆腔内肿瘤的观察,且前列腺肿瘤组织对18F-FDG的摄取较少,故其对前列腺癌的诊断受限;④18F-FDG在炎症病灶尤其是肉芽肿炎症病灶中的摄取较高,易产生假阳性;⑤生长缓慢的肿瘤对18F-FDG的摄取低,导致假阴性诊断;⑥糖尿病及高血糖患者的18F-FDG显像效果差。随着正电子标记药物的不断研发,放射性核素标记的胆碱逐渐应用于临床研究,如脑肿瘤、肺癌、肝癌、膀胱肿瘤、前列腺癌、妇科肿瘤等。笔者将对放射性核素标记的胆碱在肿瘤显像中的应用作一综述。
放射性核素标记的胆碱在PET/CT肿瘤显像中的应用
Application of radionuclide-labeled choline in PET/CT tumor imaging
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摘要: 18F-FDG PET/CT可明显提高恶性肿瘤诊断的准确性,指导恶性肿瘤的分期与再分期,对患者治疗方案的选择产生了重要影响。其在全身许多肿瘤中的应用价值已获得认可,但还存在一些不足。随着正电子标记药物的不断研发,放射性核素标记的胆碱逐渐应用于临床。胆碱是细胞膜的重要组成成分,恶性肿瘤的胆碱代谢增高。近年来的研究表明,胆碱PET/CT在胶质瘤、头颈部肿瘤、肺癌、肝细胞肝癌、前列腺癌、膀胱肿瘤等的诊断、分期及复发检测等方面具有很好的应用价值,特别是对颅内病变的观察、高分化肝细胞肝癌的诊断、生物靶区勾画、复发病灶的定位等,在一定程度上弥补了18F-FDG PET/CT的不足。笔者回顾了放射性核素标记的胆碱(11C-胆碱和18F-胆碱)在肿瘤显像中的应用。
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关键词:
- 胆碱 /
- 放射性同位素 /
- 正电子发射断层显像计算机体层摄影术 /
- 肿瘤
Abstract: 18F-FDG PET/CT has significantly enhanced the accuracy of diagnosing malignant tumors, guided the staging and restaging of malignant tumors, and considerably impacted the treatment of patients. The importance of the clinical application of this technology in many tumors has been recognized, but several deficiencies remain. With the development of positron imaging agent, radionuclide-labeled choline has been increasingly applied in clinical research. Choline is an important component of the cell membrane, and its metabolism increases malignant tumors. Recent studies have shown that choline PET/CT has good value in the diagnosis, staging, and recurrence detection of glioma, head and neck cancer, lung cancer, hepatocellular carcinoma, prostate cancer, and bladder cancer. This technology is especially beneficial for observing intracranial lesions, diagnosing well-differentiated hepatocellular carcinoma, and mapping the biological target area and location of recurrent lesions. Therefore, choline PET/CT complements the deficiency of FDG PET/CT to some extent. This paper reviews the application of radionuclide-labeled choline (11C-choline/18F-choline) in tumor imaging.-
Key words:
- Choline /
- Radioisotopes /
- Positron emission tomography computed tomography /
- Neoplasms
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