Positron Emission Tomography
Radioisotopes in PET 各種常用正子放射核種的特性： C-11 20.4 0.96 0.28 Isotope T1/2 (min) Emax (MeV) FWHM (mm) F-18 109.7 0.635 0.22 C-11 20.4 0.96 0.28 N-13 9.96 1.19 0.60 O-15 2.07 1.72 1.1 Ga-68 68.3 1.90 1.35 Rb-82 1.25 3.35 2.6
Positron emitted Radiopharmaceuticals
PET scanner
FDG PET in Normal
PET in Oncology 顯影藥物：FDG, C-11 methionine, N-13 glutamate, F-18 FU, F-18 misonidazole, etc. 良性、惡性腫瘤鑑別 癌症病灶偵測定位 偵測癌症淋巴腺及轉移病灶 精確的癌症分期 癌症復發、壞死鑑別 藥物、受體分析 癌症篩檢
FDG accumulation in cancer cells Action of glucose transporter proteins Highly active hexokinase bound to tumor mitochondria helps to trap FDG into cell Relative hypoxia in tumor masses which activate the anaerobic glycolytic pathway
FDG uptake in cancer cells The increased glucose uptake is due to the need for nucleic acid synthesis and, therefore, is directly related to the tumor’s tendency to grow. Minn et al. FDG uptake is strongly related to the number of viable tumor cells, although not directly regulated by the need for DNA synthesis. Higashi & Haberkorn Cancer 1988:1776, JNM 1991:1548, JNM 1993:414
Health Care Finance Administration 臨床症狀 肺癌（非微小可疑點） 黑色素瘤 結腸癌 淋巴瘤 食道癌 頭頸癌 腦疾發作（如癲癇） 心肌存活 乳癌 阿茲海默症 給付類別 診斷、分期、再分期 診斷、分期、再分期（局部結點除外） 手術前評估 SPECT 未有結論時之追蹤 MCAC 研究中 www.hefa.gov 12/2000
PET/CT in Esophageal cancer
PET in Neurology 顯影藥物：FDG, C-11 NMSP, F-18 L-dopa, C-11 benzodiazepine, C-11 carfentanil, etc. 老年癡呆症早期診斷 癲癇病灶偵測定位 腦瘤良性、惡性、壞死 腦血管疾病早期診斷 癌症復發、壞死鑑別 椎體外神經系統疾病 精神疾病
FDG PET in Alzheimer’s disease
PET in Cardiology 顯影藥物：FDG, C-11 palmitate, C-11 acetate, N-13 NH3, F-18 misonidazole, etc. 存活心肌 PTCA, CABG 術前評估、術後追蹤 心肌梗塞範圍、預後 冠心症診斷、嚴重度 、側支循環 Dilated or Ischemic 心肌病變鑑別診斷
PET/CT or PET/MR : Clinical Benefits Improved oncological diagnosis improved localization of disease assistance with biopsy guidance monitoring chemo- & radiation therapy radiation therapy planning faster PET scanning time JNM 2000 (8):