PDF(Pubmed)
Abstract：
BACKGROUND: This PET/MRI study compared contrast-enhanced MRI, 18F-FACBC-, and 18F-FDG-PET in the detection of primary central nervous system lymphomas (PCNSL) in patients before and after high-dose methotrexate chemotherapy. Three immunocompetent PCNSL patients with diffuse large B-cell lymphoma received dynamic 18F-FACBC- and 18F-FDG-PET/MRI at baseline and response assessment. Lesion detection was defined by clinical evaluation of contrast enhanced T1 MRI (ce-MRI) and visual PET tracer uptake. SUVs and tumor-to-background ratios (TBRs) (for 18F-FACBC and 18F-FDG) and time-activity curves (for 18F-FACBC) were assessed.
RESULTS: At baseline, seven ce-MRI detected lesions were also detected with 18F-FACBC with high SUVs and TBRs (SUVmax:mean, 4.73, TBRmax: mean, 9.32, SUVpeak: mean, 3.21, TBRpeak:mean: 6.30). High TBR values of 18F-FACBC detected lesions were attributed to low SUVbackground. Baseline 18F-FDG detected six lesions with high SUVs (SUVmax: mean, 13.88). In response scans, two lesions were detected with ce-MRI, while only one was detected with 18F-FACBC. The lesion not detected with 18F-FACBC was a small atypical MRI detected lesion, which may indicate no residual disease, as this patient was still in complete remission 12 months after initial diagnosis. No lesions were detected with 18F-FDG in the response scans.
CONCLUSIONS: 18F-FACBC provided high tumor contrast, outperforming 18F-FDG in lesion detection at both baseline and in response assessment. 18F-FACBC may be a useful supplement to ce-MRI in PCNSL detection and response assessment, but further studies are required to validate these findings. Trial registration ClinicalTrials.gov. Registered 15th of June 2017 (Identifier: NCT03188354, https://clinicaltrials.gov/study/NCT03188354 ).
RESULTS: At baseline, seven ce-MRI detected lesions were also detected with 18F-FACBC with high SUVs and TBRs (SUVmax:mean, 4.73, TBRmax: mean, 9.32, SUVpeak: mean, 3.21, TBRpeak:mean: 6.30). High TBR values of 18F-FACBC detected lesions were attributed to low SUVbackground. Baseline 18F-FDG detected six lesions with high SUVs (SUVmax: mean, 13.88). In response scans, two lesions were detected with ce-MRI, while only one was detected with 18F-FACBC. The lesion not detected with 18F-FACBC was a small atypical MRI detected lesion, which may indicate no residual disease, as this patient was still in complete remission 12 months after initial diagnosis. No lesions were detected with 18F-FDG in the response scans.
CONCLUSIONS: 18F-FACBC provided high tumor contrast, outperforming 18F-FDG in lesion detection at both baseline and in response assessment. 18F-FACBC may be a useful supplement to ce-MRI in PCNSL detection and response assessment, but further studies are required to validate these findings. Trial registration ClinicalTrials.gov. Registered 15th of June 2017 (Identifier: NCT03188354, https://clinicaltrials.gov/study/NCT03188354 ).
摘要：
背景：这项PET/MRI研究比较了对比增强MRI，18F-FACBC-,和18F-FDG-PET在高剂量甲氨蝶呤化疗前后患者原发性中枢神经系统淋巴瘤（PCNSL）的检测中。3名具有免疫能力的弥漫性大B细胞淋巴瘤的PCNSL患者在基线和反应评估时接受了动态18F-FACBC-和18F-FDG-PET/MRI。通过对比增强T1MRI（ce-MRI）和视觉PET示踪剂摄取的临床评估来定义病变检测。评估SUV和肿瘤背景比(TBR)(对于18F-FACBC和18F-FDG)和时间-活性曲线(对于18F-FACBC)。
结果：在基线时，用18F-FACBC在高SUV和TBR的情况下也检测到7个ce-MRI检测到的病变(SUVmax：平均值，4.73，TBRmax：平均值，9.32，SUVpeak：平均，3.21，TBRpeak：平均值：6.30）。18F-FACBC检测到的病变的高TBR值归因于低SUVbackground。基线18F-FDG检测到6个高SUV病变（SUVmax：平均值，13.88)。在响应扫描中，CE-MRI检测到两个病变，而18F-FACBC仅检测到一种。18F-FACBC未检测到的病变是一个小的不典型MRI检测到的病变，这可能表明没有残留疾病，因为该患者在初次诊断后12个月仍处于完全缓解状态。在响应扫描中使用18F-FDG未检测到病变。
结论：18F-FACBC提供了较高的肿瘤对比度，在基线和反应评估中，病变检测优于18F-FDG。18F-FACBC在PCNSL检测和反应评估中可能是CE-MRI的有用补充，但需要进一步的研究来验证这些发现。审判登记ClinicalTrials.gov.2017年6月15日注册（标识符：NCT03188354，https://clinicaltrials.gov/study/NCT03188354）。
结果：在基线时，用18F-FACBC在高SUV和TBR的情况下也检测到7个ce-MRI检测到的病变(SUVmax：平均值，4.73，TBRmax：平均值，9.32，SUVpeak：平均，3.21，TBRpeak：平均值：6.30）。18F-FACBC检测到的病变的高TBR值归因于低SUVbackground。基线18F-FDG检测到6个高SUV病变（SUVmax：平均值，13.88)。在响应扫描中，CE-MRI检测到两个病变，而18F-FACBC仅检测到一种。18F-FACBC未检测到的病变是一个小的不典型MRI检测到的病变，这可能表明没有残留疾病，因为该患者在初次诊断后12个月仍处于完全缓解状态。在响应扫描中使用18F-FDG未检测到病变。
结论：18F-FACBC提供了较高的肿瘤对比度，在基线和反应评估中，病变检测优于18F-FDG。18F-FACBC在PCNSL检测和反应评估中可能是CE-MRI的有用补充，但需要进一步的研究来验证这些发现。审判登记ClinicalTrials.gov.2017年6月15日注册（标识符：NCT03188354，https://clinicaltrials.gov/study/NCT03188354）。
