ojrdrtОнкологический журнал: лучевая диагностика, лучевая терапияJournal of oncology: diagnostic radiology and radiotherapy2587-75932713-167XНЕКОММЕРЧЕСКОЕ ПАРТНЕРСТВО «ОБЩЕСТВО ИНТЕРВЕНЦИОННЫХ ОНКОРАДИОЛОГОВ»10.37174/2587-7593-2020-3-2-31-42ojrdrt-118Research ArticleЯДЕРНАЯ МЕДИЦИНАNUCLEAR MEDICINEСовременный взгляд на использование в нейроонкологии позитронной эмиссионной томографии с 18-фторэтилтирозином, совмещенной с компьютерной томографиейA Modern View of the Use of Positron Emission Tomography with 18F-fluoroethyltyrosine Combined with Computed Tomography in Neurooncologyhttps://orcid.org/0000-0002-2963-4176ПарнасА. В.ParnasA. V.

Парнас Александр Вадимович — ординатор кафедры рентгенологии и радиологии, SPIN-код: 1797-3900, AuthorID: 1063530.

125993 Москва, ул. Баррикадная, 2/1, стр. 1

2/1, build.1 Barricadnaya str., Moscow, 125993

alexandrparnas@gmail.comhttps://orcid.org/0000-0002-5375-2498ИльяковВ. С.IljakovV. S.

Ильяков Вадим Сергеевич — ординатор кафедры рентгенологии и радиологии, SPIN-код: 5726-0148.

125993 Москва, ул. Баррикадная, 2/1, стр. 1

2/1, build.1 Barricadnaya str., Moscow, 125993

vadimilakov075@gmail.comhttps://orcid.org/0000-0001-7460-3267МихайловА. И.MikhaylovA. I.

Михайлов Азат Игоревич — кандидат медицинских наук, ассистент кафедры рентгенологии и радиологии ФГБОУ ДПО РМАНПО Минздрава России; врач-радиолог, врач-рентгенолог отделения радионуклидной диагностики АО Европейский МЦ; SPIN-код: 7848-2364, AuthorID: 790859.

125993 Москва, ул. Баррикадная, 2/1, стр. 1; 129090 Москва, ул. Щепкина, 35

2/1, build.1 Barricadnaya str., Moscow, 125993; 35 Shchepkina str., Moscow, 129090

azatmihailov@gmail.comhttps://orcid.org/0000-0003-3930-5998ДолгушинМ. Б.DolgushinM. B.

Долгушин Михаил Борисович — доктор медицинских наук, профессор РАН, руководитель отдела радиоизотопной диагностики и терапии, зав. отделением ПЭТ ФГБУ НМИЦО им. Н.Н. Блохина» Минздрава России; профессор ФГБОУ ДПО РМАНПО Минздрава России. SPIN-код: 6388-9644, AuthorID: 168894.

125993 Москва, ул. Баррикадная, 2/1, стр. 1; 115478 Москва, Каширское шоссе, 24

2/1, build.1 Barricadnaya str., Moscow, 125993; 24 Kashirskoye Highway, Moscow, 115478

mdolgushin@mail.ruФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава РоссииРоссияRussian Medical Academy of Continuing Professional EducationRussian FederationФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава России; Европейский Медицинский Центр, АОРоссияRussian Medical Academy of Continuing Professional Education; European Medical Center, JSCRussian FederationФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава России; ФГБУ «Национальный медицинский исследовательский центр онкологии им. Н.Н. Блохина» Минздрава РоссииРоссияRussian Medical Academy of Continuing Professional Education; N.N. Blokhin National Medical Research Center of OncologyRussian Federation202019062020323142Copyright © Парнас А.В., Ильяков В.С., Михайлов А.И., Долгушин М.Б., 20202020Парнас А.В., Ильяков В.С., Михайлов А.И., Долгушин М.Б.Parnas A.V., Iljakov V.S., Mikhaylov A.I., Dolgushin M.B.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.oncoradjournal.ru/jour/article/view/118

Метод позитронно-эмиссионной томографии, совмещенной с компьютерной томографией (ПЭТ/КТ), дает возможность оценить не только анатомические и структурные, но и метаболические изменения в опухолевом образовании. ПЭТ/КТ с 18F-фторэтилтирозином (18-ФЭТ) базируется на оценке транспорта в тканях аминокислоты тирозина, меченной F.

Точная оценка степени злокачественности опухоли по шкале GradeI—IV является важным этапом для оценки прогноза и назначения лечения пациентам с глиальными неоплазиями. ПЭТ/КТ с 18F-ФЭТ позволяет получить информацию о метаболизме в опухолевой ткани и определить зоны наибольшей пролиферативной активности. Применение 18F-ФЭТ позволяет не только провести дифференциальную диагностику и оценку степени злокачественности глиом, но и улучшить навигацию при биопсии, точнее спланировать лучевую терапию, а также оценить эффективность лечения.

Помимо глиальных новообразований, актуальной проблемой нейроонкологии являются метастатические поражения головного мозга. Большое значение для прогноза и терапевтической тактики ведения больного имеет посттерапевтическая дифференциальная диагностика рецидива метастастати-ческого поражения, постлучевых и смешанных изменений. Применение 18F-ФЭТ показало высокую специфичность получаемых диагностических данных для определения оптимального места биопсии и для планирования лучевой терапии, а также для дифференциации изменений при подозрении на рецидив опухоли.

Кроме того, ПЭТ/КТ с 18F-ФЭТ показала высокую эффективность в дифференциальной диагностике активно пролиферирующих новообразований от условно доброкачественных опухолей, а также от проявлений ятрогенного характера, прежде всего, после лучевого воздействия.

Positron emission tomography combined with computed tomography (PET/CT) allows for assessment of not only anatomical and structural, but also metabolic changes in tumor masses. 18F-fluoroethyl tyrosine (18F-FET) PET/CT is based on evaluation of transport of 18F-labeled amino acid tyrosine in tissues.

Precise evaluation of brain tumor WHO Grade (I-IV) is a crucial step in assessment of prognosis and treatment planning for patients with glial neoplasms. 18F-FET PET-tracer allows to carry out multi-stage and dynamic examinations, which significantly increases method’s sensitivity. 18F-FET PET makes it possible to acquire information about tumor tissue metabolism and to determine the most proliferatively active parts of neoplasm.

In addition to glial neoplasms, a topical matter of neuro-oncology is the metastatic lesions of the central nervous system. It is highly important for the prognosis and therapeutic tactics to differentiate between brain tumors recurrence, post-treatment changes and mixed lesions. The use of 18F-FET PET-tracer provides high specificity of the obtained diagnostic data which allows for precise determination of an optimal biopsy site and radiation-treatment planning, as well as for differential diagnosis in cases of suspected tumor recurrence.

18F-FET PET/CT demonstrated high efficiency in differentiation of actively proliferating neoplasms from conditionally benign tumors, as well as from manifestations of iatrogenic nature, primarily after radiation-treatment.

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The authors declare that there are no conflicts of interest present.