PDF(Pubmed)
Abstract：
BACKGROUND: This study aims to evaluate the effect of various background reference regions on spinal 18F-FET PET imaging, with a focus on distinguishing between spinal tumors and myelitis. To enhance diagnostic accuracy, we investigated the pons and several other spinal cord area as potential references, given the challenges in interpreting spinal PET results.
RESULTS: A retrospective analysis was conducted on 30 patients, 15 with cervical myelitis and 15 with cervical tumors, who underwent O-(2-[18F]-fluoroethyl)-L-tyrosine (FET) PET/MR imaging. The stability of uptake across four regions, including the pons, C2, C2-C7, and T1-T3, was compared. The standardized uptake value ratio (SUVR) was then evaluated using various background regions, and their effectiveness in differentiating between spinal tumors and myelitis was compared. Additionally, we correlated the SUVR values derived from these regions with the Ki-67 proliferation index in tumor patients. The study found no significant difference in SUVmax (U = 110, p = 0.93) and SUVmean (U = 89, p = 0.35) values at lesion sites between myelitis and tumor patients. The pons had the highest average uptake (p < 0.001) compared to the other three regions. However, its coefficient of variation (CV) was significantly lower than that of the C2-C7 (p < 0.0001) and T1-T3 segments (p < 0.05). The SUVRmax values, calculated using the regions of pons, C2-C7 and T1-T3, were found to significantly differentiate between tumors and myelitis (p < 0.05). However, only the pons-based SUVRmean was able to significantly distinguish between the two groups (p < 0.05). Additionally, the pons-based SUVRmax (r = 0.63, p = 0.013) and SUVRmean (r = 0.67, p = 0.007) demonstrated a significant positive correlation with the Ki-67 index.
CONCLUSIONS: This study suggests that the pons may be considered a suitable reference region for spinal 18F-FET PET imaging, which can improve the differentiation between spinal tumors and myelitis. The significant correlation between pons-based SUVR values and the Ki-67 index further highlights the potential of this approach in assessing tumor cell proliferation.
RESULTS: A retrospective analysis was conducted on 30 patients, 15 with cervical myelitis and 15 with cervical tumors, who underwent O-(2-[18F]-fluoroethyl)-L-tyrosine (FET) PET/MR imaging. The stability of uptake across four regions, including the pons, C2, C2-C7, and T1-T3, was compared. The standardized uptake value ratio (SUVR) was then evaluated using various background regions, and their effectiveness in differentiating between spinal tumors and myelitis was compared. Additionally, we correlated the SUVR values derived from these regions with the Ki-67 proliferation index in tumor patients. The study found no significant difference in SUVmax (U = 110, p = 0.93) and SUVmean (U = 89, p = 0.35) values at lesion sites between myelitis and tumor patients. The pons had the highest average uptake (p < 0.001) compared to the other three regions. However, its coefficient of variation (CV) was significantly lower than that of the C2-C7 (p < 0.0001) and T1-T3 segments (p < 0.05). The SUVRmax values, calculated using the regions of pons, C2-C7 and T1-T3, were found to significantly differentiate between tumors and myelitis (p < 0.05). However, only the pons-based SUVRmean was able to significantly distinguish between the two groups (p < 0.05). Additionally, the pons-based SUVRmax (r = 0.63, p = 0.013) and SUVRmean (r = 0.67, p = 0.007) demonstrated a significant positive correlation with the Ki-67 index.
CONCLUSIONS: This study suggests that the pons may be considered a suitable reference region for spinal 18F-FET PET imaging, which can improve the differentiation between spinal tumors and myelitis. The significant correlation between pons-based SUVR values and the Ki-67 index further highlights the potential of this approach in assessing tumor cell proliferation.
摘要：
背景：这项研究旨在评估各种背景参考区域对脊柱18F-FETPET成像的影响，重点是区分脊柱肿瘤和脊髓炎。为了提高诊断的准确性，我们调查了脑桥和其他几个脊髓区域作为潜在的参考，考虑到解释脊柱PET结果的挑战。
结果：对30例患者进行了回顾性分析，15例宫颈脊髓炎和15例宫颈肿瘤，谁接受了O-（2-[18F]-氟乙基）-L-酪氨酸（FET）PET/MR成像。四个地区的摄取稳定性，包括脑桥,比较C2、C2-C7和T1-T3。然后使用各种背景区域评估标准化摄取值比率(SUVR)，并比较了它们区分脊柱肿瘤和脊髓炎的有效性。此外,我们将来自这些区域的SUVR值与肿瘤患者的Ki-67增殖指数相关联.研究发现，脊髓炎和肿瘤患者的病变部位的SUVmax（U=110，p=0.93）和SUVmean（U=89，p=0.35）值没有显着差异。与其他三个区域相比,脑桥具有最高的平均摄取(p<0.001)。然而,其变异系数(CV)显著低于C2-C7段(p<0.0001)和T1-T3段(p<0.05)。SUVRmax值，使用桥的区域计算，发现C2-C7和T1-T3显著区分肿瘤和脊髓炎(p<0.05)。然而,只有基于桥的SUVRmean能够显著区分两组(p<0.05).此外,基于pons的SUVRmax(r=0.63,p=0.013)和SUVRmean(r=0.67,p=0.007)与Ki-67指数呈显著正相关.
结论：这项研究表明，脑桥可能被认为是脊柱18F-FETPET成像的合适参考区域，这可以改善脊柱肿瘤和脊髓炎之间的区别。基于pons的SUVR值与Ki-67指数之间的显着相关性进一步突出了该方法在评估肿瘤细胞增殖中的潜力。
结果：对30例患者进行了回顾性分析，15例宫颈脊髓炎和15例宫颈肿瘤，谁接受了O-（2-[18F]-氟乙基）-L-酪氨酸（FET）PET/MR成像。四个地区的摄取稳定性，包括脑桥,比较C2、C2-C7和T1-T3。然后使用各种背景区域评估标准化摄取值比率(SUVR)，并比较了它们区分脊柱肿瘤和脊髓炎的有效性。此外,我们将来自这些区域的SUVR值与肿瘤患者的Ki-67增殖指数相关联.研究发现，脊髓炎和肿瘤患者的病变部位的SUVmax（U=110，p=0.93）和SUVmean（U=89，p=0.35）值没有显着差异。与其他三个区域相比,脑桥具有最高的平均摄取(p<0.001)。然而,其变异系数(CV)显著低于C2-C7段(p<0.0001)和T1-T3段(p<0.05)。SUVRmax值，使用桥的区域计算，发现C2-C7和T1-T3显著区分肿瘤和脊髓炎(p<0.05)。然而,只有基于桥的SUVRmean能够显著区分两组(p<0.05).此外,基于pons的SUVRmax(r=0.63,p=0.013)和SUVRmean(r=0.67,p=0.007)与Ki-67指数呈显著正相关.
结论：这项研究表明，脑桥可能被认为是脊柱18F-FETPET成像的合适参考区域，这可以改善脊柱肿瘤和脊髓炎之间的区别。基于pons的SUVR值与Ki-67指数之间的显着相关性进一步突出了该方法在评估肿瘤细胞增殖中的潜力。
