定量18F-FDG PET/CT研究健康受试者肝脏糖代谢的方法学考虑
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崔嘉德，莫勒，索伦森
定量18F-FDG PET/CT研究健康受试者肝脏糖代谢的方法学考虑
核医学杂志2015 Sep;56(9):1366-71。doi: 10.2967 / jnumed.115.154211。Epub 2015年7月9日。
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26159590 (PubMed视图］
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未标记:PET与葡萄糖类似物(18)F-FDG用于测量区域组织葡萄糖代谢。然而，(18)F-FDG对质膜转运蛋白和细胞内酶的亲和性可能不同于葡萄糖;集总常数(LC)可以用来对这些差异进行动力学校正。本研究的目的是探讨用动态(18)F-FDG PET/CT测量人肝脏葡萄糖代谢的可行性，并通过与(3)h -葡萄糖测量结果进行比较，确定(18)F-FDG的操作LC。方法:纳入8名健康受试者。在所有的研究中，(18)F-FDG和(3)h -葡萄糖混合在生理盐水中并共同给药。对肝脏进行60分钟动态PET记录180分钟，并从肝静脉和桡动脉导管中采血(血液中(18)F-FDG和(3)h -葡萄糖浓度)。以吲哚青绿输注法测定肝脏血流量。首先，对3名受试者进行了研究，比较在高胰岛素-正糖夹持期间，丸剂给药和持续输注示踪剂给药。接下来，5名受试者接受研究，比较空腹和高胰岛素-正糖夹持与示踪剂输注。 Splanchnic extraction fractions of (18)F-FDG (E*) and (3)H-glucose (E) were calculated from concentrations in blood, and the LC was calculated as ln(1 - E*)/ln(1 - E). Volumes of interest were drawn in the liver tissue, and hepatic metabolic clearance of (18)F-FDG (mL of blood/100 mL of liver tissue/min) was estimated. RESULTS: For bolus versus infusion, E* values were always negative when (18)F-FDG was administered as a bolus and were always positive when it was administered as an infusion. For fasting versus clamping, E* values were positive in 4 of 5 studies during fasting and were always positive during clamping. Negative extraction fractions were ascribed to the tracer distribution in the large volume of distribution in the prehepatic splanchnic bed. The LC ranged from 0.43 to 2.53, with no significant difference between fasting and clamping. CONCLUSION: The large volume of distribution of (18)F-FDG in the prehepatic splanchnic bed may complicate the analysis of dynamic PET data because it represents the mixed tracer input to the liver via the portal vein. Therefore, dynamic (18)F-FDG data for human hepatic glucose metabolism should be interpreted with caution, but constant tracer infusion seems to yield more robust results than bolus injection.
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