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肿瘤 18F-FDG PET/MRI全身显像专家共识(德国)
王洋洋
杨光杰 [翻译]
王振光 [综述]
作者及单位信息
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DOI： 10.3760/cma.j.cn321828-20200308-00092
Whole-body [ 18F]-FDG-PET/MRI for oncology: a consensus recommendation
Umutlu Lale
Beyer Thomas
Grueneisen Johannes Stefan
Rischpler Christoph
Quick Harald H
Veit-Haibach Patrick
Eiber Matthias
Purz Sandra
Antoch Gerald
Gatidis Sergios
Nikolaou Konstantin
Schaefer Jürgen F
Rausch Ivo
Herrmann Ken
Herrmann K.
Krause B. J.
Schoenberg S. O.
Umutlu L.
Anton F.
Antoch G.
Hacker M.
Krause B. J.
Luster M.
Neumann S.
Schoenberg S. O.
Vorwerk D.
Vorstand der Interdisziplinären AG für Hybride Bildgebung in alphabetischer Reihenfolge:
Vorstand der Deutschen Röntgengesellschaft (DRG) und der Deutschen Gesellschaft für Nuklearmedizin (DGN) in alphabetischer Reihenfolge:
Authors Info & Affiliations
Umutlu Lale
Department of Diagnostic and Interventional Radiology and Neuroradiology, University-Hospital Essen, Germany
Beyer Thomas
QIMP Group, Centre for Medical Imaging and Biomedical Engineering, Medical University of Vienna, Austria
Grueneisen Johannes Stefan
Department of Diagnostic and Interventional Radiology and Neuroradiology, University-Hospital Essen, Germany
Rischpler Christoph
Department of Nuclear Medicine, University-Hospital Essen, Germany
Quick Harald H
High-Field- and Hybrid-MR-Imaging, University-Hospital Essen, Germany
Veit-Haibach Patrick
Joint Department of Medical Imaging, University of Toronto, Canada
Eiber Matthias
Department of Nuclear Medicine, Klinikum rechts der Isar, Technical University of Munich, Germany
Purz Sandra
Department of Nuclear Medicine, University of Leipzig, Germany
Antoch Gerald
Department of Diagnostic and Interventional Radiology, University Düsseldorf, Medical Faculty, Düsseldorf, Germany
Gatidis Sergios
Department of Diagnostic and Interventional Radiology, University-Hospital Tübingen, Germany
Nikolaou Konstantin
Department of Diagnostic and Interventional Radiology, University-Hospital Tübingen, Germany
Schaefer Jürgen F
Department of Diagnostic and Interventional Radiology, University-Hospital Tübingen, Germany
Rausch Ivo
QIMP Group, Centre for Medical Imaging and Biomedical Engineering, Medical University of Vienna, Austria
Herrmann Ken
Department of Nuclear Medicine, University-Hospital Essen, Germany
Herrmann K.
Department of Nuclear Medicine, University-Hospital Essen, Germany
Krause B. J.
Department of Nuclear Medicine, University Medical Center Rostock, Germany
Schoenberg S. O.
Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Germany
Umutlu L.
Department of Diagnostic and Interventional Radiology and Neuroradiology, University-Hospital Essen, Germany
Anton F.
Deutsche Röntgengesellschaft, Berlin, Germany
Antoch G.
Department of Diagnostic and Interventional Radiology, University Düsseldorf, Medical Faculty, Düsseldorf, Germany
Hacker M.
Division of Nuclear Medicine, Department of Biomedical Imaging and Image-guided Therapy, Medical University Vienna, Austria
Krause B. J.
Department of Nuclear Medicine, University Medical Center Rostock, Germany
Luster M.
Department of Nuclear Medicine, University Hospital Marburg, Germany
Neumann S.
Deutsche Röntgengesellschaft, Berlin, Germany
Schoenberg S. O.
Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Germany
Vorwerk D.
Department of Radiology, Klinikum Ingolstadt, Germany
Vorstand der Interdisziplinären AG für Hybride Bildgebung in alphabetischer Reihenfolge:
Vorstand der Deutschen Röntgengesellschaft (DRG) und der Deutschen Gesellschaft für Nuklearmedizin (DGN) in alphabetischer Reihenfolge:
·
DOI： 10.3760/cma.j.cn321828-20200308-00092
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摘要

PET/MRI一体机在2006年被首次提出可应用于临床；2010年，首台临床型PET/MRI一体机诞生。在20世纪早期，PET/CT和SPECT/CT一体机的广泛应用体现了融合显像的优势，为PET/MRI一体机的产生奠定了基础。目前，全球大约有150台全身PET/MRI一体机投入了临床应用，其中肿瘤显像是PET/MRI的主要应用领域之一。迄今为止，尽管PET/MRI临床应用在增加，但标准化的PET/MRI扫描方案还很少。因此，有必要制定患者检查和多中心研究都可遵循的标准化且一致性好的显像方案。该文总结了 18F-脱氧葡萄糖(FDG)PET/MRI全身显像的患者就诊、检查准备、工作流程、显像方案以及报告书写等主要方面的专家共识，由长期使用PET、MRI和较早使用PET/MRI的相关资深专家制定。

PET/MRI;肿瘤;全身显像;专家共识
引用本文

王洋洋,杨光杰,王振光. 肿瘤 18F-FDG PET/MRI全身显像专家共识(德国) [J]. 中华核医学与分子影像杂志,2020,40(09)：549-555.

DOI:10.3760/cma.j.cn321828-20200308-00092

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制定该共识的目的是为医疗保健专家和临床医师提供PET/MRI在肿瘤全身显像中的适应证、具体操作和影像判读等方面的指导 [ 1 ]。
PET是一种无创的显像技术，可提供放射性核素标记的生物分子(显像剂)在组织中三维分布的定量信息。 18F-脱氧葡萄糖(fluorodeoxyglucose, FDG)是一种放射性核素标记的葡萄糖，是肿瘤显像最常用的显像剂 [ 2 ]。对于大多数肿瘤，恶性肿瘤细胞糖酵解功能增强，葡萄糖转运蛋白表达和己糖激酶活性增强，导致葡萄糖利用率增加 [ 3 , 4 ]，代谢活跃的肿瘤细胞比周围正常组织摄取更多的 18F-FDG。目前， 18F-FDG PET是公认的灵敏且成熟的显像模式，可用于实体肿瘤的诊断、分期和再分期及疗效评价 [ 5 , 6 ]。
MRI也是一种无创性成像技术，在外部磁场激发下，提供基于自旋共振频率的相对差异而产生的高空间分辨率的组织解剖结构三维影像 [ 7 ]。此外，MRI采用多序列成像并结合良好的软组织对比，可在功能方面和细胞水平评价组织和器官 [ 8 ]。与基于电离辐射组织衰减而进行投射扫描的CT相比，MRI则是以外加磁场激发和磁共振信号检测为成像基础，因而MRI无电离辐射，PET/MRI所产生的辐射仅来自于PET部分，较PET/CT显像明显降低 [ 9 ]。
衰减校正是PET/CT显像的优势，而PET/MRI的衰减校正仍然是其技术难点(请参阅"衰减校正"部分)。PET探测器能被MR所兼容，为PET和MRI整合成一体机打下基础 [ 10 , 11 ]。小动物成像仪的研发 [ 12 ]让人们认识到半导体二极管代替光电倍增管能不受磁场影响而放大闪烁晶体中的闪烁信号 [ 13 ]。目前，临床应用的PET/MRI一体机配置场强3.0 T的MR [ 14 ]，研发的MRI序列能够可靠地校正PET衰减伪影，可与PET/CT影像投射扫描图衰减校正质量相媲美(也请参阅"衰减校正"部分)。
目前，有关PET/MRI临床研究不断增加。最近的研究比较了全身PET/MRI与PET/CT的诊断准确性，证实二者在同一显像剂的诊断准确性相同 [ 15 , 16 ]。但是MRI的软组织对比度高，能够提高肿瘤性病变的显示，因而PET/MRI的潜在优势已经突显出来 [ 17 , 18 , 19 , 20 ]。这些研究有利于克服PET/MRI应用过程中面对不同的诊断问题而产生的差异 [ 21 ]，因此该共识必须执行，进而通过一致性和标准化的方法来减少这些差异的产生。
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备注信息
A
王振光，Email: mocdef.nabuyilagnaugnehzgnaw
B

本文首次发表在 Nuklearmedizin, 2019, 58(2): 68-76

C

原文DOI：10.1055/a-0830-4453

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