不同示踪剂PET-CT在前列腺癌诊断中应用.pptVIP

不同示踪剂PET/CT在前列腺癌诊断中的应用 2放射性核素示踪技术 是核医学的基本技术！ 前列腺癌MRI T1骨显像18F-FDG患者男性，72岁。尿频、尿急2年。近来全身酸痛，直肠指诊未触及结节，PSA 6ng/ml骨显像首先发现全身成骨转移符合线路SPECT Positron Emitting Isotopes18F T? 110 minutes11C T? 20 minutes13N T? 10 minutes15O T? 2 minutesNotice how short the half-lives are – that means that most of these tracers have to be produced close to the scanner. At the moment, only 18F compounds can be transported PET RadiotracersMetabolismGlucoseAminoacids Nucleotides Fatty acidsAcetateBlood FlowBlood VolumeHypoxiaDrug kinetics/metabolismNeuroreceptorsDopamine (pre and post synaptic)SerotonineOpiateBenzodiazepine The positron emitting isotope can be incorporated into a variety of tracers. What tracer is used, depends on the physiological process being studied. The PET scanner consists of rings of paired detectors that detect these gamma rays CholineFDGPMSAAcetateFDHTNaFPCaRadiotracers used in PCa 99mTc-MDP 、PSA 单抗、?18F-FLT、18F-FMAU、anti-18F-FACBC 、18F-FMISO FDG PET/CT The role of fluorodeoxyglucose (FDG)-PET scanning in men with suspected recurrent prostate cancer is controversial . Some early reports concluded that PET is of limited utility overall, particularly for men with a low serum PSA or PSA velocity In contrast, others suggest that PET is useful in imaging local recurrences , osseous metastases , or nodal and soft tissue lesions . 2015-6-15PSA 4.622015-11-13PSA 17 2015-02-152015-07-08PSA 0.87PSA 9.8 2015-7-21 前列腺癌根治性切除术后，内分泌治疗后，肝转移PSA 4.5 前列腺癌术后复发PSA 1.2 Choline PET/CTa Tool for Identifying Early Recurrence In a large cohort of patients, the feasibility of 11C-choline PET/CT for detecting the sites of metastatic disease in PCa patients with BCR was confirmed. The PSA level was the main predictor of a positive scan with 1.16 ng/mL as the optimal cut-off value. In the majority of positive scans oligometastatic disease, potentially treatable with salvage therapies, was observed. 18F-Choline PET/CT-response assessment Acetate PET/CT PSMA PET/CTa Techni