[PET/CT 在中枢神经系统肿瘤中的作用]。

Magyar onkologia Pub Date : 2023-12-18 Epub Date: 2023-10-06
Péter Szabó
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引用次数: 0

摘要

包括 PET/CT 在内的混合成像技术的出现,不仅是核医学发展的一个巨大里程碑,也是整个医学成像技术发展的一个巨大里程碑。目前,最常用的放射性药物 18F-FDG 检查已成为肿瘤患者治疗中最重要的诊断工具之一,适用于多种适应症。然而,由于脑背景活动较高,FDG PET 对中枢神经系统恶性肿瘤(尤其是脑部恶性肿瘤)的描述存在局限性,主要用于淋巴瘤病例。为了评估胶质瘤和脑转移瘤,氨基酸示踪剂(11C-蛋氨酸、18F-DOPA 和 18F-FET)得到了广泛应用,与 FDG 相比,它们能反映其他生物过程。随着证据的增多,其用途也越来越多样化,从脑肿瘤(良性与恶性)的初步评估,到脑肿瘤的分级和治疗后生存能力/复发的评估,直至放疗计划的制定。本文将对所有这些方面进行更详细的回顾,并简要提及未来的前景和挑战。
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[The role of PET/CT in the central nervous system tumours].

The appearance of hybrid imaging, including PET/CT has been a huge milestone not only in the development of nuclear medicine but of the whole medical imaging. The examination with 18F-FDG, the most frequently used radiopharmaceutical has become for now one of the most important diagnostic tools in oncological patient care, applied with numerous indication goals. However, the depiction of central nervous system malignancies, especially those of the brain, with FDG PET has limitations due to high cerebral background activity, it can be used primarily in lymphoma cases. To evaluate gliomas and brain metastases, amino acid tracers (11C-methionine, 18F-DOPA and 18F-FET) gained ground, which reflect other biological processes compared to that of FDG. Upon multiplying of evidences their usage is becoming more and more diverse, from the primary assessment of brain tumours (benign vs. malignant), through their grading and evaluation of posttherapeutical viability/recurrence, up to the radiotherapy planning. This paper reviews all of these in more details, mentioning shortly the prospects and challenges of the future.

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