Turkiye Klinikleri Medical Oncology - Special Topics

Santral Sinir Sistemi Tümörleri Özel Sayısı
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Primer Beyin Tümörlerinin Değerlendirilmesinde Nükleer Tıp'ın Yeri
The Role of Nuclear Medicine Methods in the Evaluation of Primary Brain Tumors
Nilüfer YILDIRIM POYRAZa
aNükleer Tıp Kliniği, Ankara Atatürk Eğitim ve Araştırma Hastanesi, Ankara
Turkiye Klinikleri J Med Oncol-Special Topics. 2013;6(1):14-8
Article Language: TR
ÖZET
Beyin tümörlerinin tanı ve takibinde morfolojik ve fonksiyonel görüntüleme yöntemleri önemli role sahiptir. Pozitron emisyon tomografi (PET) ve sintigrafi (SPECT) tümörün malignite derecesi, komşu dokulara invazyonu, tedaviye bağlı değişiklikler ve rekürrens hakkında ek bilgiler sağlar. En sık kullanılan PET ajanı olan 18F- fluorodeoxyglucose (FDG)'nin yanında beyin tümörlerinin görüntülenmesi için radyoaktif işaretli aminoasitler, nükleozid ajanları, nöroreseptör ligandları ve biyolojik aktif moleküllerin öncüleri de geliştirilmiştir. Ayrıca perfüzyon ajanları, radyoaktif işaretli aminoasit ve nöropeptidler ile sintigrafik görüntüleme yöntemleri de kolay ulaşılabilir ve düşük maliyetli olması nedeniyle beyin tümörlerinin değerlendirilmesinde önemini korumaktadır. Fonksiyonel görüntülemede en önemli kısıtlayıcı faktör anatomik detayların eksikliği ve fizyolojik aktivite varlığıdır. Entegre sistemler sayesinde aynı seansta fonksiyonel ve anatomik görüntüleme yapılarak patolojik aktivite lokalizasyonu ve bilinen lezyonun aktivitesi daha doğru olarak belirlenebilmektedir. Bu derlemede fonksiyonel görüntülemenin beyin tümörlerinin değerlendirilmesine katkısı, kullanılan radyofarmasötikler ve yeni gelişmeler ışığında potansiyel radyofarmasötikler özetlenmiştir.

Anahtar Kelimeler: Beyin neoplazileri; pozitron emisyon tomografi; radyonuklit görüntüleme
ABSTRACT
Neuroimaging with morpological and functional imaging modalities plays a significant role in the primary diagnosis and management of brain tumors. PET and SPECT can provide additional information about tumor grade, peripheral invasion, and treatment-induced changes, as well as recurrences. In addition to the most widely available PET agent FDG, radiolabeled aminoacid analogues, nucleosides, neuroreceptor ligands and biologically active molecules precursors have also been developed for imaging of brain tumors. Scintigraphic methods with perfusion agents, radiolabeled aminoacids and neuropeptides maintain their importance in evaluation of brain tumors because of their availability and cost-effectiveness. The main limitation of functional imaging methods is the lack of precise anatomic details. This drawback is overcome by dual-modality integrated imaging systems which are helpful in providing the precise localization of tracer uptake. In this review, the contribution of functional imaging to evaluation of brain tumors, radiopharmaceuticals in use and recently developed potential radiopharmaceuticals have been summarized.

Keywords: Brain neoplasms; positron-emission tomography; radionuclide imaging

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30.03.2014

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