Malignant tumours always threaten human health.For tumour diagnosis,positron emission tomography(PET)is the most sensitive and advanced imaging technique by radiotracers,such as radioactive^(18)F,^(11)C,^(64)Cu,^(68)G...Malignant tumours always threaten human health.For tumour diagnosis,positron emission tomography(PET)is the most sensitive and advanced imaging technique by radiotracers,such as radioactive^(18)F,^(11)C,^(64)Cu,^(68)Ga,and^(89)Zr.Among the radiotracers,the radioactive^(18)F-labelled chemical agent as PET probes plays a predominant role in monitoring,detecting,treating,and predicting tumours due to its perfect half-life.In this paper,the^(18)F-labelled chemical materials as PET probes are systematically summarized.First,we introduce various radionuclides of PET and elaborate on the mechanism of PET imaging.It highlights the^(18)F-labelled chemical agents used as PET probes,including[^(18)F]-2-deoxy-2-[^(18)F]fluoro-D-glucose([^(18)F]-FDG),^(18)F-labelled amino acids,^(18)F-labelled nucleic acids,^(18)F-labelled receptors,^(18)F-labelled reporter genes,and^(18)F-labelled hypoxia agents.In addition,some PET probes with metal as a supplementary element are introduced briefly.Meanwhile,the^(18)F-labelled nanoparticles for the PET probe and the multi-modality imaging probe are summarized in detail.The approach and strategies for the fabrication of^(18)F-labelled PET probes are also described briefly.The future development of the PET probe is also prospected.The development and application of^(18)F-labelled PET probes will expand our knowledge and shed light on the diagnosis and theranostics of tumours.展开更多
背景与目的:弥漫性大B细胞淋巴瘤(diffuse large B cell lymphoma,DLBCL)分子遗传学特征和患者治疗前^(18)F-FDG PET/CT检查评估的SUV_(max)值均与患者预后密切相关,但两者的关系及其与R-CHOP治疗方案治疗反应的相关性尚不清楚。本研究...背景与目的:弥漫性大B细胞淋巴瘤(diffuse large B cell lymphoma,DLBCL)分子遗传学特征和患者治疗前^(18)F-FDG PET/CT检查评估的SUV_(max)值均与患者预后密切相关,但两者的关系及其与R-CHOP治疗方案治疗反应的相关性尚不清楚。本研究旨在分析DLBCL分子遗传学特征与治疗前经^(18)F-FDG PET/CT检测的SUV_(max)值的关系及其与临床病理学特征、R-CHOP治疗反应的相关性。方法:回顾性收集复旦大学附属肿瘤医院2022-2023年同时经淋巴瘤481基因DNA panel二代测序(next-generation sequencing,NGS)和治疗前经PET/CT检查的DLBCL患者225例,本研究通过复旦大学附属肿瘤医院医学伦理委员会的审查(伦理批号:050432-4-2307E)并获得患者知情同意;除基因突变特征外,同时收集荧光原位杂交法检测的BCL2、BCL6和MYC基因易位情况;另收集该组病例的临床病理学参数以及经R-CHOP治疗后的PET/CT检查结果。结果:总计191例DLBCL患者纳入最终分析,重要基因MYD88突变、TP53突变、CDKN2A/2B拷贝数异常、CD79B突变发生率分别为24.6%、27.2%、32.5%和16.8%。治疗前SUV_(max)值范围是5.10~63.10(24.44±10.70,中位22.80)。MYD88L265P突变型DLBCL的治疗前SUV_(max)值显著高于MYD88野生型DLBCL(P=0.039),SUV_(max)值与DLBCL其他基因变异类型包括TP53突变、CDKN2A/B拷贝数减少、CD79B突变、KMT2D突变、TNFAIP3突变、B2M突变、EZH2突变、BTG1/2突变、CREBBP突变、MYC、BCL2、BCL6基因重排之间无显著的相关性。治疗前高SUV_(max)值与高血清乳酸脱氢酶(lactate dehydrogenase,LDH)水平(P=0.012)及非生发中心(non-germinal center B-cell-like,non-GCB)亚型显著相关(P=0.040),但与R-CHOP治疗反应无显著的相关性(P=0.714)。DLBCL中TP53基因突变与R-CHOP治疗反应差显著相关(P=0.001),是R-CHOP治疗后非完全代谢缓解的独立预测因子。联合TP53基因突变、Ann Arbor分期、国际预后指数(International Prognostic Index,IPI)及血清LDH水平能够更好地预测患者对R-CHOP治疗的反应。结论:在DLBCL中,MYD88L265P突变型患者具有较高的治疗前SUV_(max)值。DLBCL治疗前SUV_(max)值与R-CHOP治疗反应无关,而TP53基因突变与R-CHOP治疗反应差显著相关,并且是独立预测因子。TP53基因突变联合临床病理学参数可更好地预测R-CHOP治疗反应。关于各基因变异特征及SUV_(max)值与患者预后的关系尚需作进一步随访研究。展开更多
文摘Malignant tumours always threaten human health.For tumour diagnosis,positron emission tomography(PET)is the most sensitive and advanced imaging technique by radiotracers,such as radioactive^(18)F,^(11)C,^(64)Cu,^(68)Ga,and^(89)Zr.Among the radiotracers,the radioactive^(18)F-labelled chemical agent as PET probes plays a predominant role in monitoring,detecting,treating,and predicting tumours due to its perfect half-life.In this paper,the^(18)F-labelled chemical materials as PET probes are systematically summarized.First,we introduce various radionuclides of PET and elaborate on the mechanism of PET imaging.It highlights the^(18)F-labelled chemical agents used as PET probes,including[^(18)F]-2-deoxy-2-[^(18)F]fluoro-D-glucose([^(18)F]-FDG),^(18)F-labelled amino acids,^(18)F-labelled nucleic acids,^(18)F-labelled receptors,^(18)F-labelled reporter genes,and^(18)F-labelled hypoxia agents.In addition,some PET probes with metal as a supplementary element are introduced briefly.Meanwhile,the^(18)F-labelled nanoparticles for the PET probe and the multi-modality imaging probe are summarized in detail.The approach and strategies for the fabrication of^(18)F-labelled PET probes are also described briefly.The future development of the PET probe is also prospected.The development and application of^(18)F-labelled PET probes will expand our knowledge and shed light on the diagnosis and theranostics of tumours.
文摘背景与目的:弥漫性大B细胞淋巴瘤(diffuse large B cell lymphoma,DLBCL)分子遗传学特征和患者治疗前^(18)F-FDG PET/CT检查评估的SUV_(max)值均与患者预后密切相关,但两者的关系及其与R-CHOP治疗方案治疗反应的相关性尚不清楚。本研究旨在分析DLBCL分子遗传学特征与治疗前经^(18)F-FDG PET/CT检测的SUV_(max)值的关系及其与临床病理学特征、R-CHOP治疗反应的相关性。方法:回顾性收集复旦大学附属肿瘤医院2022-2023年同时经淋巴瘤481基因DNA panel二代测序(next-generation sequencing,NGS)和治疗前经PET/CT检查的DLBCL患者225例,本研究通过复旦大学附属肿瘤医院医学伦理委员会的审查(伦理批号:050432-4-2307E)并获得患者知情同意;除基因突变特征外,同时收集荧光原位杂交法检测的BCL2、BCL6和MYC基因易位情况;另收集该组病例的临床病理学参数以及经R-CHOP治疗后的PET/CT检查结果。结果:总计191例DLBCL患者纳入最终分析,重要基因MYD88突变、TP53突变、CDKN2A/2B拷贝数异常、CD79B突变发生率分别为24.6%、27.2%、32.5%和16.8%。治疗前SUV_(max)值范围是5.10~63.10(24.44±10.70,中位22.80)。MYD88L265P突变型DLBCL的治疗前SUV_(max)值显著高于MYD88野生型DLBCL(P=0.039),SUV_(max)值与DLBCL其他基因变异类型包括TP53突变、CDKN2A/B拷贝数减少、CD79B突变、KMT2D突变、TNFAIP3突变、B2M突变、EZH2突变、BTG1/2突变、CREBBP突变、MYC、BCL2、BCL6基因重排之间无显著的相关性。治疗前高SUV_(max)值与高血清乳酸脱氢酶(lactate dehydrogenase,LDH)水平(P=0.012)及非生发中心(non-germinal center B-cell-like,non-GCB)亚型显著相关(P=0.040),但与R-CHOP治疗反应无显著的相关性(P=0.714)。DLBCL中TP53基因突变与R-CHOP治疗反应差显著相关(P=0.001),是R-CHOP治疗后非完全代谢缓解的独立预测因子。联合TP53基因突变、Ann Arbor分期、国际预后指数(International Prognostic Index,IPI)及血清LDH水平能够更好地预测患者对R-CHOP治疗的反应。结论:在DLBCL中,MYD88L265P突变型患者具有较高的治疗前SUV_(max)值。DLBCL治疗前SUV_(max)值与R-CHOP治疗反应无关,而TP53基因突变与R-CHOP治疗反应差显著相关,并且是独立预测因子。TP53基因突变联合临床病理学参数可更好地预测R-CHOP治疗反应。关于各基因变异特征及SUV_(max)值与患者预后的关系尚需作进一步随访研究。
文摘目的探究胸部正电子发射断层/磁共振(positron emission tomography/magnetic resonance,PET/MR)检查中^(18)F-氟代脱氧葡萄糖(^(18)F-fluorodeoxyglucose,^(18)F-FDG)使用剂量降低对正电子发射断层(positron emission tomography,PET)图像质量及病变可检测性的影响。材料与方法回顾性分析2022年3月至2023年8月于东部战区总医院放射诊断科使用SIGNA PET/MR行^(18)F-FDG胸部PET/MR检查(注射剂量3.70 MBq/kg)的患者图像118例,所有图像中均有异常放射性核素浓聚病灶。用5个不同PET采集时间(20、10、5、2、1 min)对列表(list-mode,list)数据回顾性重建,分别模拟100%、50%、25%、10%、5%^(18)F-FDG注射剂量,记作G100、G50、G25、G10、G5。用李克特5分法对5组图像整体质量进行主观评分,采用Friedman检验比较各组间差异。客观分析指标包括病变标准化摄取值(standardized uptake value,SUV)的最大值(maximum SUV of lesion,L-SUVmax)、平均值(mean SUV of lesion,L-SUVmean)、标准差(standard deviation of lesion SUV,L-SUVsd)、背景SUV标准差(standard deviation of background SUV,B-SUVsd)、病变信噪比(signal-to-noise ratio of lesion,L-SNR)、图像噪声比(image noise ratio,IN)和L-SUVmax相对背景噪声比(lesion-to-background ratio,LBR),采用单因素重复测量方差分析比较各指标组间整体差异,组间两两比较采用Bonferroni校正。以G100为参考,评估其他组病变可检测性。结果5组^(18)F-FDG模拟剂量越高图像整体质量的主观评分也越高(P<0.05)。G25、G50、G100图像质量可满足临床诊断需求,均评分>4分。各组L-SUVmax、L-SUVmean、L-SUVsd、IN和LBR随^(18)F-FDG模拟剂量增加而降低,差异有统计学意义(均P<0.05),L-SNR随^(18)F-FDG模拟剂量增加而增加,差异亦有统计学意义(P<0.05)。组间比较结果:在L-SUVmax和L-SUVsd上G25、G50、G100任意两组相比差异均无统计学意义(均P>0.05),其余任意两组相比差异均有统计学意义(均P<0.05);L-SUVmean和L-SNR上,G5、G10两组之间或G25、G50、G100三组之间对比差异均无统计学意义(均P>0.05),其余任意两组相比差异均有统计学意义(均P<0.05);IN上,5组之间任意两组对比差异均有统计学意义(均P<0.05);LBR上,G5和G10、G25和G100、G50和G100对比差异均无统计学意义(均P>0.05),余任意两组相比差异均有统计学意义(均P<0.05)。以G100为参考,G50、G25、G10、G5漏检率分别为1.4%、2.4%、4.4%、6.8%。结论使用SIGNA PET/MR,若胸部^(18)F-FDG PET/MR检查PET时间为20 min,^(18)F-FDG剂量可由3.70 MBq/kg减少至0.93 MBq/kg,用量减少了75%,这不会改变PET图像质量及定量评估结果。
