ojrdrtОнкологический журнал: лучевая диагностика, лучевая терапияJournal of oncology: diagnostic radiology and radiotherapy2587-75932713-167XНЕКОММЕРЧЕСКОЕ ПАРТНЕРСТВО «ОБЩЕСТВО ИНТЕРВЕНЦИОННЫХ ОНКОРАДИОЛОГОВ»10.37174/2587-7593-2018-1-1-19-23ojrdrt-35Research ArticleЯДЕРНАЯ МЕДИЦИНАNUCLEAR MEDICINEВозможности ПЭТ/КТ с 18F-холином при глиальных опухолях18F-choline PET/CT in Cerebral GliomasДолгушинМ. Б.DolgushinM. B.

Москва

Moscow

mdolgushin@mail.ruПронинА. И.ProninA. I.

Москва

Moscow

ВихроваН. Б.VihrovaN. B.

Москва

Moscow

НевзоровД. И.NevzorovD. I.

Москва

Moscow

НечипайЭ. А.NechipaiE. A.

Москва

Moscow

КобяковаЕ. А.KobyakovaE. A.

Москва

Moscow

МещеряковаН. А.MeshcheryakovaN. A.

Москва

Moscow

ТулинП. Е.TulinP. E.

Москва

Moscow

ОджароваА. А.OdzharovaA. R.

Москва

Moscow

Национальный медицинский исследовательский центр онкологии им. Н.Н. Блохина Минздрава РФРоссияN.N. Blokhin National Medical Research Center of OncologyRussian Federation201830032018111923Copyright © Долгушин М.Б., Пронин А.И., Вихрова Н.Б., Невзоров Д.И., Нечипай Э.А., Кобякова Е.А., Мещерякова Н.А., Тулин П.Е., Оджарова А.А., 20182018Долгушин М.Б., Пронин А.И., Вихрова Н.Б., Невзоров Д.И., Нечипай Э.А., Кобякова Е.А., Мещерякова Н.А., Тулин П.Е., Оджарова А.А.Dolgushin M.B., Pronin A.I., Vihrova N.B., Nevzorov D.I., Nechipai E.A., Kobyakova E.A., Meshcheryakova N.A., Tulin P.E., Odzharova A.R.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/35Цель

Цель: Оценить диагностическую ценность метода позитронной эмиссионной томографии (ПЭТ) с 18F-холином у больных с глиальными опухолями головного мозга.

Материал и методы

Материал и методы: В исследование включены результаты исследований ПЭТ/КТ и МРТ 30 пациентов с внутримозговыми опухолями: глиобластомы – у 9 (30 %), анапластические астроцитомы – у 9 (30 %), глиомы GrII – у 7 (23,3 %), доброкачественные астроцитомы GrI – у 5 (16,7 %). Всем пациентам было выполнено ПЭТ/КТ-исследование с 18F-холином и минимум два исследования МРТ в динамике. ПЭТ/КТ проводили на аппарате Biograph mCT Siemens (КТ – 300 мА, 120 кВ, КТ в спиральном режиме: шаг среза при реконструкции 1,2 мм, ПЭТ – на 4-рядном кольце детекторов на основе ортосиликата лютеция (48 блоков на каждый), ширина одной зоны сканирования (slab) 21,6 см, время сканирования на первом этапе 5 мин/slab, на втором – 10 мин/slab). Первый этап проводили сразу после внутривенного введения радиофармпрепарата (РФП) с помощью автоматического инжектора для РФП Intego 2010, второй – через 45–55 мин. Вводимая активность составляла 300 МБк. Количественную оценку maxSUV проводили offline на рабочей станции SyngoVia с использованием протокола Oncology.

Результаты

Результаты: Наиболее высокие средние значения накопления РФП (maxSUV1) были получены в анапластических астроцитомах и глиобластомах – 5,07 и 4,89 соответственно, наибольший средний прирост значений maxSUV2 отмечался в глиобластомах – 15,46 %, наиболее низкие значения maxSUV1 были в глиомах GrI – 0,76.

Выводы

Выводы: ПЭТ/КТ-исследование с использованием различных РФП предоставляет уникальную информацию о функциональном состоянии опухолей по ряду биологических процессов. 18F-холин – это мембранный маркер, который позволяет оценить активность формирования мембраны клетки. В неизмененном веществе головного мозга 18F-холин практически не накапливается. Методика двухэтапного ПЭТ-сканирования с 18F-холином головного мозга у больных с внутримозговыми опухолями позволила предположить степень их злокачественности, которая зависит как от уровня накопления РФП на первом этапе, так и от степени увеличения значения на втором этапе. Таким образом, «прирост» значений maxSUV может иметь прогностическое значение в диагностике опухолевой активности новообразований головного мозга.

Purpose

Purpose: To evaluate the diagnostic value of PET with 18F-choline in patients with glial brain tumors.

Material and methods

Material and methods: The analysis was based on data generated from PET/CT and MRI examinations of 30 patients with intracerebral tumors: glioblastomas – 9 (30 %) cases, anaplastic astrocytomas – 9 (30 %) cases, gliomas GrII – 7 (23.3 %) cases, benign astrocytomas GrI – 5 (16.7 %) cases. All patients with brain neoplasms underwent a selective brain 18F-choline PET/CT and MRI follow up at minimum two time points: for at least 6 months. All PET/CT studies were performed with Biograph mCT Siemens (multidetector (64) helical CT scanner, 120 kV, 300 mA, slice thick ness 1.2 mm; PET acquisitions occurred at 4 ring positions (48 lutetium orthosilicate based units each), scan slab – 21.6 cm, at the first stage 5 min / slab, the second 10 min / slab). The first registration was performed immediately after intravenous injection of the radiopharmaceutical (RP) using an automatic RP injector Intego 2010. Then patient were scanned again with the same protocol 45–55 min after injection. Administered activity was 300 MBq. Images visually and semiquantitatively assessment, with maximum standardized uptake value registration (maxSUV1 – on the first stage and maxSUV2 – on the second), was performed offline on a SyngoVia workstation using Oncology protocol.

Results

Results: The highest average maxSUV1 were observed in anaplastic astrocytomas and glioblastomas – 5.07 and 4.89, respectively, but the highest average growth (in %) of maxSUV2 observed in glioblastomas – 15.46 %. The lowest maxSUV1 0.76 was registered in low-grade gliomas GrI.

Conclusion

Conclusion: PET using different radiopharmaceuticals, provides unique information on the functional status of tumors for a variety of biological processes. 18F-choline is a marker of cell membrane lipid metabolism, so it could allow estimating the activity of cell membranes formation. An unaffected brain substance almost does not accumulate 18F-choline. Two-stage PET technique of brain scanning with 18F-choline enabled us to assume the gradate of malignancy of intracranial tumors which depends on both the level of accumulation of tracer in the first stage (maxSUV1) and the degree of uptake increase in the second stage (maxSUV2). Thus, the increment of maxSUV2 may be useful in the evaluation of tumor activity.

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