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ENGLISH ABSTRACT
18F-AlF-NOTA-OC PET/CT与MRI对神经内分泌肿瘤肝转移检出效能的比较
蔺旭阳
王冉
孙珂
刘小婷
张晓晗
韩星敏
作者及单位信息
·
DOI： 10.3760/cma.j.cn321828-20240515-00169
Comparing the efficacies of 18F-AlF-NOTA-octreotide PET/CT and MRI in detecting liver metastases of neuroendocrine neoplasm
Lin Xuyang
Wang Ran
Sun Ke
Liu Xiaoting
Zhang Xiaohan
Han Xingmin
Authors Info & Affiliations
Lin Xuyang
Department of Nuclear Medicine, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
Wang Ran
Department of Nuclear Medicine, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
Sun Ke
Department of Nuclear Medicine, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
Liu Xiaoting
Department of Nuclear Medicine, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
Zhang Xiaohan
Department of Nuclear Medicine, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
Han Xingmin
Department of Nuclear Medicine, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
·
DOI： 10.3760/cma.j.cn321828-20240515-00169
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摘要

目的比较 18F-AlF-1，4，7-三氮杂环壬烷-1，4，7-三乙酸(NOTA)-奥曲肽(OC)PET/CT显像与MRI对神经内分泌肿瘤肝转移(NENLM)病灶的检出效能。

方法回顾性收集2021年7月至2023年12月于郑州大学第一附属医院经病理或临床随访证实为肝转移的44例神经内分泌肿瘤患者[男26例、女18例，年龄(53.8±13.4)岁]的资料，分析其 18F-AlF-NOTA-OC PET/CT及MRI(包括MR动态增强扫描及弥散加权成像)检查结果。根据肝转移病灶大小分为长径≤1 cm、1 cm<长径≤2 cm及长径>2 cm 3组。根据2019 WHO病理分级将患者分为G1、G2、G3、神经内分泌癌4组。应用McNemar χ 2检验比较2种检查方式对肝转移患者及病灶检出情况的差异。

结果 18F-AlF-NOTA-OC PET/CT及MRI对肝转移患者的检出率均为95.45%(42/44)。44例患者中， 18F-AlF-NOTA-OC PET/CT检出病灶227个，MRI检出病灶303个。基于病灶( n＝307)分析， 18F-AlF-NOTA-OC PET/CT对NENLM病灶的检出率低于MRI [73.94%(227/307)与98.70%(303/307); χ 2＝66.96, P<0.001]。对于长径≤1 cm、1 cm<长径≤2 cm、长径>2 cm的肝转移灶，MRI检出率均高于 18F-AlF-NOTA-OC PET/CT[98.72%(77/78)、93.55%(116/124)、97.35%(110/113)与47.44%(37/78)、73.39%(91/124)、87.61%(99/113); χ 2值：5.88～36.21，均 P<0.05]。

结论与 18F-AlF-NOTA-OC PET/CT相比，MRI对不同长径NENLM病灶有更高的检出率，尤其对于长径≤1 cm的病灶。

神经内分泌瘤;肿瘤转移;肝;奥曲肽;正电子发射断层显像术;体层摄影术，X线计算机;磁共振成像
ABSTRACT

ObjectiveTo compare the efficacy of 18F-AlF-1, 4, 7-triazacyclononane-1, 4, 7-triacetic acid (NOTA)-octreotide (OC) PET/CT and MRI in detecting liver metastases (LM) of neuroendocrine neoplasm (NENLM).

Methods 18F-AlF-NOTA-OC PET/CT and MRI findings (dynamic contrast enhanced MRI and diffusion weighted imaging) of 44 patients (26 males, 18 females, age (53.8±13.4) years) with neuroendocrine neoplasm (NEN) confirmed by pathological or clinical follow-up in the First Affiliated Hospital of Zhengzhou University from July 2021 to December 2023 were retrospectively analyzed. According to the size of LM, patients were divided into 3 groups with long diameter ≤1 cm, 1 cm< long diameter ≤2 cm and long diameter >2 cm. According to the 2019 WHO pathological grade, patients were divided into G1, G2, G3 and neuroendocrine carcinoma groups. McNemar χ 2 test was used to compare the difference in detecting LM and lesions between the two methods.

ResultsThe detection rate of 18F-AlF-NOTA-OC PET/CT and MRI in patients with NENLM was 95.45%(42/44). Among 44 patients, 227 lesions were detected by PET/CT and 303 were detected by MRI. Based on lesion analysis ( n=307), the detection rate of 18F-AlF-NOTA-OC PET/CT for NENLM was lower than that of MRI (73.94%(227/307) vs 98.70%(303/307); χ 2=66.96, P<0.001). For NENLM with long diameter ≤1 cm, 1 cm < long diameter ≤2 cm, long diameter >2 cm, the detection rates of MRI were higher than those of 18F-AlF-NOTA-OC PET/CT (98.72%(77/78), 93.55%(116/124), 97.35%(110/113) vs 47.44%(37/78), 73.39%(91/124), 87.61%(99/113); χ 2 values: 5.88-36.21, all P<0.05).

ConclusionsCompared with 18F-AlF-NOTA-OC PET/CT, MRI has a higher detection rate for NENLM with different long diameters of NEN, especially for lesions with long diameter≤1 cm.

Neuroendocrine tumors;Neoplasm metastasis;Liver;Octreotide;Positron-emission tomography;Tomography, X-ray computed;Magnetic resonance imaging
Han Xingmin, Email: nc.defudabe.uzznahmx
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引用本文

蔺旭阳,王冉,孙珂,等. 18F-AlF-NOTA-OC PET/CT与MRI对神经内分泌肿瘤肝转移检出效能的比较 [J]. 中华核医学与分子影像杂志,2025,45(03)：149-153.

DOI:10.3760/cma.j.cn321828-20240515-00169

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神经内分泌肿瘤(neuroendocrine neoplasm, NEN)是一种起源于神经内分泌细胞的相对罕见的异质性肿瘤，可发生于全身各处，国内以胃肠胰NEN最为常见。胃肠胰NEN在初诊时往往已出现肝转移(NEN-liver metastasis, NENLM)，而出现转移性病灶与高发病率和死亡率有关 [ 1 ]。神经内分泌肝转移瘤常表现为多灶性和双灶性，仅20%～30%的患者可进行肝切除术以达到治疗目的。因此，评估NEN患者肝转移情况对患者预后很重要，还会影响进一步的管理和治疗策略 [ 2 , 3 ]。
生长抑素受体(somatostatin receptor, SSTR)显像被广泛应用于NEN的诊断中，其中 68Ga-1，4，7，10-四氮杂环十二烷-1，4，7，10-四乙酸(1, 4, 7, 10-tetraazacyclododecane, DOTA)-生长抑素类似物PET/CT显像被认为是诊断NEN的"金标准" [ 4 ]。据报道，MRI对肝脏、脑及胰腺等部位的病变的检出有更高价值 [ 5 , 6 ]。相关研究表明，相较于 68Ga-DOTA- D-苯丙氨酸1-酪氨酸3-苏氨酸8-奥曲肽( D-Phe1-Tyr3-Thr8-octreotide, TATE)PET/CT，MRI能检出更多NEN的肝内转移灶 [ 7 ]；而 18F-AlF-1，4，7-三氮杂环壬烷-1，4，7-三乙酸(1, 4, 7-triazacyclononane-1, 4, 7-triacetic acid, NOTA)-奥曲肽(octreotide, OC)PET/CT对肝脏病灶的检出效能更好，病灶检出率更高 [ 4 ]。另外， 18F的正电子能量低，可由回旋加速器大量生产，其标记生长抑素类似物显像的图像质量更优，且更易推广应用 [ 8 , 9 ]。目前，MRI与 18F-AlF-NOTA-OC PET/CT对NENLM检出方面的比较尚缺广泛研究。本研究对比评价了两者对NENLM的检出情况，现报道如下。
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备注信息
A
韩星敏，Email: nc.defudabe.uzznahmx
B

蔺旭阳：研究实施、论文撰写、统计学分析；王冉、张晓晗：统计学分析；孙珂、刘小婷、韩星敏：研究指导、论文修改、经费支持

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