关键词: ¹⁸F-氟代脱氧葡萄糖, PET/CT, 葡萄糖负荷, 糖尿病, 恶性肿瘤, 预后

Abstract:

Objective To find out whether there is relationship between hyperglycemia and activities of multi-drug resistance protein (MRP) or P-glycoprotein (P-gp) which are the key enzymes of ¹⁸F-FDG extraction out of cells through the method of glucose loading at delayed phase of PET/CT scaning, and to clarify its possible mechanism. Methods 12 patients with malignant tumor were randomly selected to the experimental group, as a control, 30 cases of conventional dual phase scan were randomly selected into control group.The patients in groups received routine fasting early phase PET/CT scan, and the delayed scan in experimental group was performed after orally taken glucose, whereas in control group, there was not any glucose or sugar taken.The standardized uptake values (SUV) of early and delayed imaging of tumor and healthy tissues in two groups were recorded and analyzed. Results The SUV changes of each ROI between two phases at control group: the SUV_max of tumors was increased obviously at delayed phase (P<0.01);the SUV_mean of musclus erector spinae wasn't increased obviously at delayed phase(P<0.05), the SUV_mean of live (P<0.01) and aorta (P<0.01) were decreased obviously at delayed phase.However, in experimental group, the SUV_mean of musculus erector spinae was increased obviously at delayed phase(P<0.05);the SUV_max of tumors wasn't increased obviously at delayed phase (P<0.05), which were different with control group; whereas the SUV_mean of live (P<0.01) and aorta (P<0.01) were also decreased obviously at delayed phase. Conclusion The SUV in tumor tissue isn't increased significantly after glucose loading, which indicates that a balance of ¹⁸F-FDG discharging and entering the tumor cells is obtained and illustrates that hyperglycemia might induce the up-regulation or activation of MRP or P-gp.

Key words: ¹⁸F-fluorodeoxyglucose, PET/CT, glucose loading, diabetes mellitus, malignant tumor, prognosis