18F-氟赤硝基咪唑PET-CT检测非小细胞肺癌乏氧的应用价值

目的 探讨静脉注射18F-氟赤硝基咪唑(18F-FETNIM)示踪剂后,应用PET-CT扫描检测非小细胞肺癌(NSCLC)患者肿瘤组织乏氧的状况.方法 42例经病理学证实且未经治疗的NSCLC患者,其中19例于静脉注射18F-FETNIM后120 min行单次PET-CT扫描;23例分别于注药后60、120 min后两次行PET-CT扫描.计算肿瘤组织内最大标准摄取值(SUVmax-T)和对侧肺组织相应区域内最大标准摄取值(SUVmax-N);计算靶与非靶比值(T/N),即肿瘤感兴趣区放射性计数与对侧肺组织相应区域放射性计数的比值.结果 注药后120 min时,SUVmax-T显著大于SUVmax-N(P<0.001).60 min时,SUVmax-T和SUVmax-N均显著高于120 min时的SUVmax-T和SUVmax-N(均P<0.01);60 min和120 min时的T/N比值差异无统计学意义(P=0.324).结论 18F-FETNIM PET-CT显像能在人体上对NSCLC的乏氧进行定量分析和空间位置的评价,能直接反映肿瘤组织乏氧程度和分布,为制定和实施个体化放射治疗及化疗提供依据.

Value of 18F-FETNIM PET-CT for detection of tumor hypoxia in non-small-cell lung cancer

Objective To assess the feasibility of 18F ] fluoroerythronitroimidazole (18F-FETNIM ) with integrated positron emission tomography and computed tomography (PET-CT) imaging in detection of hypoxia in non-small-cell lung cancer ( NSCLC) patients. Methods Forty-two patients with newly diagnosed NSCLC underwent 18F-FETNIM PET-CT before treatment. Nineteen patients rested for approximately 120 minutes before undergoing PET-CT,23 patients underwent 2 sequential PET-CT scans at 60 minutes and 120 minutes after intravenous injection 18F-FETNIM. 18F-FETNIM uptake was quantified by calculating the maximum standardized uptake value in the tumor (SUVmax-T) and contralateral normal lung tissue (SUVmax-N). Regions of interest (ROIs) were drawn in the tumor and contralateral position and the radioactivity ratio of tumor to normal (T/N) was calculated.Results SUVmax-T ( 2. 43 ± 1. 34) was significantly higher than SUVmax-N (0.87 ±0.46, P<0.001) at 120 min. SUVmax-T (2. 80 ± 1.09) and SUVmax-N (1. 16 ± 0. 56) at 60 min were significantly higher than SUVmax-T (2. 61 ± 1. 10) and SUVmax-N (P<0.01) at 120 min. T/N (2.56 ± 0.71) at 60 min was higher than that at 120 min (2.48 ± 0.60),but the difference between them was not significant (P =0.324). Conclusion Our results indicate that 18F-FETNIM PET-CT may be a useful tool for evaluating hypoxia and may be a means to target specifically tumor cells resistant to conventional treatment before and during ongoing therapy in NSCLC.