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Objective clinical case analysis, assessment of 11C-ACE PET / CT value in the diagnosis and classification of primary brain tumors and tumor 11C-ACE uptake degree of Ki67 LI with 18F-FDG, 11C-MET comparison. Through animal experiments to explore the value of 11C-ACE PET / CT in malignancy and inflammation and granulomatous lesions differential diagnosis, and comparison with 18F-FDG. Materials and Methods clinical part: select newly diagnosed primary brain tumors and in our hospital PET / CT center head 11C-ACE, 18F-FDG PET / CT examination 12 patients, three of which were successively line 11C-ACE, 18F -FDG and 11C-MET three imaging agent checks. 12 patients with 14 lesions were pathologically confirmed. Primary brain tumors in 28 patients newly diagnosed as other selected 11C-MET PET / CT check after astrocytic tumors confirmed by pathology. PET results visually and semi-quantitative analysis. The calculated imaging agent diagnostic sensitivity. Measurement of lesion maximum standardized uptake value (SUVmax), calculate the tumor / normal white matter ratio (T / W), and pathological grading and Ki67 LI statistical comparison. Animal experiments: the choice of 30 male SD rats were randomly divided into three groups, each group 10, the C6 glioma turpentine-induced acute inflammation (group I), C6 glioma and turpentine-induced chronic inflammation ( group Ⅱ) and C6 glioma Guerin (BCG)-induced granulomas (group III) model. 14 days in each group were inoculated in C6 glioma line 11C-ACE, 18F-FDG PET / CT imaging, visual and semi-quantitative analysis. Measurement SUVmax, calculated lesions / normal muscle ratio (L / M) and tumor selection index SI. Statistical analysis was performed for each imaging agent uptake differences between tumor and inflammatory / granulomatous lesions. The results of the clinical part: visual analysis, 11C-ACE, 11C-MET PET / CT diagnostic sensitivity of brain tumors were 100%, 61.5% in the 18F-FDG. The semi-quantitative analysis of the The tumor ACE SUV, T / W value of the high-level group were significantly higher than the low-level group (SUVACE 3.15 ± 0.87 vs. 1.93 ± 0.57, P lt; 0.05; the T / WACE 4.03 ± 1.28 vs. 2.10 ± 0.55, P lt; 0.05); tumor FDG SUV and T / W value of the high-level group always make significantly higher than low level (SUVFDG, 15.50 ± 8.76 vs. 6.43 ± 2.09, P lt; 0.05; the T / WFDG, 3.75 ± 2.17 vs.1.41 ± 0.38, P lt; 0.05); astrocytoma MET T / W value of high-level group was significantly higher than that of the low-level group (T / WMET 5.07 ± 1.98 vs. 3.20 ± 1.73, P lt; 0.05) MET SUV high, compared to the low-level group difference was not statistically significant. The tumor ACE FDG uptake were significantly correlated (SUV, r = 0.741, P lt; 0.05; T / W, r = 0.832, P lt; 0.05). Various imaging agents SUV and T / W value Ki67 LI showed a significant positive correlation, the best correlation for the T / WACE value of Ki67 LI (r = 0.797, P lt; 0.05). Animal experiments: visual analysis of ACE PET C6 glioma, acute and chronic inflammation are visible ACE abnormal concentration and the degree of concentration, no granulomas ACE abnormal concentration; FDG PET C6 glioma, acute, chronic inflammation and granulomatous visible FDG abnormal concentration in which the tumor and acute inflammation, granuloma degree of concentration, chronic inflammation FDG degree of concentration lower than the tumor. The semiquantitative analysis ACESUV L / M value difference between the tumor and acute and chronic inflammation were not statistically significant, granuloma ACE concentration was significantly lower in the tumor (SUV vs.3.50 ± 0.54, 2.31 ± 0.23, P lt ; 0.001; L / M, 1.21 ± 0.15 vs. 1.83 ± 0.30, P lt; 0.001); the FDG SUV L / M values ??tumors were significantly higher than the acute and chronic inflammation and granuloma significant difference. C6 glioma and acute inflammation group (Group I), compared to SIACE I SIFDG Ⅰ was no significant difference; C6 glioma chronic inflammation group (group Ⅱ) the SIFDG II was significantly higher than SIACE II (SI, 5.24 ± 4.36 vs. 1.90 ± 1.83, P lt; 0.05); C6 glioma and granuloma group (group Ⅲ) the SIACE III was significantly higher than SIFDG III (SI vs.2.52 ± 0.79, 5.96 ± 3.64, P lt; 0.05). Variance analysis, the SIACE Ⅲ significantly higher than SIACE Ⅰ and SIACE Ⅱ (P lt; 0.05), while differences in SIACE Ⅰ and SIACE Ⅱ no statistically significant the SIFDG Ⅰ SIFDG II SIFDG Ⅲ three differences were not statistically significance; granuloma ACE intake was significantly lower than the acute chronic inflammation (P lt; 0.05), while the acute and chronic inflammation ACE no significant difference in intake, acute and chronic inflammation, granuloma three lesions FDG uptake were not statistically different. 11C-ACE conclusion, 11C-MET diagnostic sensitivity of brain tumors were significantly higher than 18F-FDG PET / CT, is more conducive to the low-level and smaller brain tumor detection and boundary drawing. ACE, FDG SUV, T / W value can effectively distinguish between high and low levels of brain tumor, is superior to MET PET in brain tumor grading. T / W is a good parameter values ??in the classification of brain tumors. The extent of the uptake of the imaging agent of the brain tumor three may reflect the proliferative activity of tumor cells, especially ACEs. PET / CT imaging agent 11C-ACE in the diagnosis and classification of brain tumors is a lot of potential and hope with greater combined value of 18F-FDG. FDG in C6 glioma and chronic inflammation identification of tumor selectivity better than ACE, selective tumor FDG in C6 glioma and acute inflammation identification similar to the ACE in C6 glioma granuloma identify ACE is superior to FDG. Showed significant uptake of FDG in C6 glioma inflammation and granulomatous lesions, unable to avoid false positives. ACE in the granulomatous lesions showed no uptake ACEPET can effectively identify tumor granulomatous lesions, to make up for FDG lack, but ACE does not distinguish between tumor and acute and chronic inflammatory lesions. The combination of imaging may provide greater help in the differential diagnosis of benign and malignant lesions.
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