摘要
目的分析^(99m)Tc-HYNIC-TOC单光子发射计算机断层显像(SPECT)结果阴性的瘤源性骨软化症(TIO)致病肿瘤的^(68)Ga-DOTA-TATE正电子发射断层显像/计算机断层显像(PET/CT)的图像特征,探讨其对致病肿瘤准确定位的指导价值。方法纳入37例经临床及病理确诊的^(99m)Tc-HYNIC-TOC SPECT显像结果阴性的TIO患者,回顾性分析致病肿瘤的^(68)Ga-DOTA-TATE PET/CT图像特点。结果 37例TIO患者致病肿瘤均为单发,术后病理包括35例磷酸盐尿性间叶组织肿瘤和2例梭形细胞瘤。所有TIO致病肿瘤^(68)Ga-DOTA-TATE PET/CT上均表现为放射性浓聚灶,标准化摄取最大值和标准化摄取平均值分别为7. 2±4. 3和4. 3±2. 4,平均最大径为(1. 9±0. 7) cm。37例TIO致病肿瘤,最常见发病部位为下肢(19/37),其次为躯干(11/37)、上/下颌骨(5/37)及上肢(2/37)。24例位于骨组织病灶,最常位于下肢长骨(13/24),多呈偏心性生长(8/13),3例累及骨皮质,同机CT以局限性溶骨性骨质破坏多见(14/24),部分呈骨质硬化型改变(9/24),较少累及周围软组织。13例位于软组织病灶,多呈边界清楚等或低密度结节(10/13),1例位于胸膜病灶伴钙化。结论 ^(68)Ga-DOTA-TATE PET/CT能够检出^(99m)Tc-HYNIC-TOC SPECT漏诊的TIO病例。若生长抑素受体高度表达病灶局部见溶骨性或硬化型骨质改变、软组织内等或低密度结节,更倾向于TIO的诊断。
Objective To analyze 68 Ga-DOTA-TATE positron emission tomography/computed tomography(PET/CT)imaging features of tumor-indud osteomalacia(TIO)patients with negative 99m Tc-HYNIC-TOC single photo emission computed tomography(SPECT)findings and to investigate the value of 68 Ga-DOTA-TATE PET/CT in accurate localization of culprit tumors.Methods We retrospectively analyzed 68 Ga-DOTA-TATE PET/CT imaging features including location,size,density,the maximum and mean standardized uptake value in 37 TIO patients with negative 99m Tc-HYNIC-TOC SPECT findings.Results Totally 37 solitary TIO tumors,including 35 phosphaturic mesenchymal tumors and 2 spindle cell tumors confirmed by pathological examinations,were detected via 68 Ga-DOTA-TATE PET/CT scans in the included 37 cases.These 37 TIO tumors showed obviously increased activities,with an maximum standardized uptake value of 7.2±4.3 and mean standardized uptake value of 4.3±2.4.The average maximum diameter was(1.9±0.7)cm.The majority of the tumors occurred in the lower extremities(19/37),followed by the trunk(11/37),maxillary/mandibular bone(5/37),and upper extremities(2/37).In addition,24 bone lesions were located in long bones of lower extremities(13/24),most of which demonstrated eccentric growth(8/13).Osteolytic changes(14/24)were observed mainly in the lesions via the corresponding CT imaging;meanwhile,sclerotic changes presented in nine cases.Of the 13 soft-tissue lesions,the majority(10/13)showed well-circumscribed isodense or hypodense nodules on the CT images,with spot calcification in one lesion located in the pleura.Conclusions 68 Ga-DOTA-TATE PET/CT scans can detect the TIO culprit tumors miss-diagnosed by 99m Tc-HYNIC-TOC SPECT.Somatostatin-receptors highly expressed lesions with focal osteolytic or osteosclerotic change in bone and isodense or hypodense nodules in soft tissue will favor the diagnosis of TIO tumors.
作者
张姝
王玲
王瞳
邢海群
霍力
李方
ZHANG Shu;WANG Ling;WANG Tong;XING Haiqun;HUO Li;LI Fang(Department of Nuclear Medicine,Beijing 100730,China;Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine,PUMC Hospital,CAMS and PUMC,Beijing 100730,China)
出处
《中国医学科学院学报》
CAS
CSCD
北大核心
2018年第6期757-764,共8页
Acta Academiae Medicinae Sinicae
基金
国家自然科学基金(81671722)~~
