Jpn. J. Med. Phys. Vol. 35 No. 1: 2 9 (2015) PET 検査のこれまでとこれから * 1. PET 検査の歴史 PET positron emission tomography (positron emitter) in vivo 1928 Dirac PAM 1932 Anderson CD Bethe HA Joliot F Joliot-Curie F Joliot- Curie I 1975 Ter-Pogossian MM PET 1) 2. PET 検査の原理 1 511 kev 180 21 (positron range) 2 180 3 2 0.001% 3. PET 検査で用いられる放射性薬剤 PET 11 C20 13 N 10 15 O 2 18 F 110 PET 89 Zr 78 124 I 100 図 1 陽電子放出核種の崩壊と消滅放射線 * 277 85776 5 1 Division of Functional Imaging, Exploratory Oncology Research and Clinical Trial Center (EPOC), National Cancer Center, 6 5 1 Kashiwanoha, Kashiwa, Chiba 277 8577, Japan E-mail: hifujii@east.nnc.go.jp 2
Jpn. J. Med. Phys. Vol. 35 No. 1 (2015) 図 2 PET 装置の原理 37 MBq(1 mci) fluorodeoxyglucose (FDG) 0.1 ng (1 ng 10 9 g) FDG 100 mg/kg 2 2) FDG PET FDG ng PET FDG PET 4. PET 検査の特徴 PET PET PET 2 2 filtered back projection ordered-subset expectation maximization PET 2 図 3 PET/CT 複合撮像装置 CTPET PET single photon emission computed tomography (SPECT) 511 kev 5. 複合撮像装置 (PET/CT 装置 PET/MRI 装置 ) PET PET CT MRI PET 2000Townsend PET/CT 3) PET PET/CT 3 MRI CT PET/MRI 3
35 1 MRI PET MR PET/MR 図 4 18 F 標識 fluorodeoxyglucose (FDG) 2 18 F 6. PET 検査の臨床応用 18 F FDG FDG PET FDG PET FDG PET PET FDG PET PET PET PET 6.1 腫瘍 PET 検査 PET 18 F-FDG 2 18 F 4 metabolic trapping 18 F 5 図 5 18 F-FDGの腫瘍細胞への集積機序 FDG PET FDG PET/CT 2 4) 6 RE- CIST FDG-PET FDG PERCIST 5) FDG PET 4
Jpn. J. Med. Phys. Vol. 35 No. 1 (2015) 図 7 認知症 ( アルツハイマー病 ) 症例の 18 F-FDG 脳 PET 画像 図 6 18 F-FDG 検査による乳がんの肝転移病巣の検出 CT PET FDG PET PET 6) 18 F fluoromisonidazole (FMISO) 18 F fluoroazomycin arabinoside (FAZA) 62/64 Cu diacetyl-bis(n4-methylthiosemicarbazone) (ATSM) PET PET fluorothymidine (FLT) 18 F 11 C 図 8 18 F 標識 florbetapir 画像 10 11 C 6.2 脳神経 PET 検査 CT PET PET ( 15 O) (H 15 2 O) 5
35 1 図 9 13 N- アンモニア心筋血流 PET 検査 7) dopa 18 F 18 F-fluorodopa PET 8) PET 15 O PET 18 F-FDG PET PET 18 F-FDG PET FDG 18 F-FDG PET 9) 7 β β PET PET PET β PET 18 F florbetapir 18 F florbetapir 10) 8 6.3 循環器 PET 検査 PET 18 F-FDG PET 13 N- PET 9 11 C- 201 TlCl 99m Tc 99m Tc-estamibi 99m Tc-tetrofosmin SPECT PET 6
Jpn. J. Med. Phys. Vol. 35 No. 1 (2015) PET 13 N 10 1 18 F-FDG PET 18 F-FDG PET 18 F-FDG SPECT 18 F-FDG 7. PET 検査のこれから PET PET PET PET PET PET 18 F FDG PET PET PET 18 F florbetapir 18 F-FDG PET 18 F-FDG PET 8. まとめ PET PET PET PET 7
35 1 参考文献 1) Ter-Pogossian MM, Phelps ME, Hoffman EJ, et al.: A positron-emission transaxial tomograph for nuclear imaging (PETT). Radiology 114: 89 98, 1975 2) Bessell EM, Courtenay VD, Foster AB: Some in vivo and in vitro antitumour effects of the deoxyfluoro-dgluco-pyranose. Eur. J. Cancer 9: 463 470, 1973 3) Beyer T, Townsend DW: A combined PET/CT scanner for clinical oncology. J. Nucl. Med. 41: 1369 1379, 2000 4) PET PET 11 Isotope News 722: 52 56, 2014 5) Wahl RL, Jacene H, Kasamon Y, et al.: From RECIST to PERCIST: evolving considerations for PET response criteria in solid tumors. J. Nucl. Med. 50 (Suppl 1): 122S 150S, 2009 6) Padhani AR, Krohn KA, Lewis JS, et al.: Imaging of oxygenation of human tumours. Eur. Radiol. 17: 861 872, 2007 7) Broick K, Alavi A, Kushner M: Positron emission tomography in cerebrovascular disorders. Semin. Nucl. Med. 22: 224 232, 1992 8) Patel NH, Vyas NS, Puri BK, et al.: Positron emission tomography in schizophrenia: a new perspective. J. Nucl. Med. 51: 511 520, 2010 9) Minoshima S, Frey KA, Koeppe RA, et al.: A diagnostic approach in Alzheimer s disease using three-dimensional stereotactic surface projection of fluorine-18 FDG PET. J. Nucl. Med. 36: 1238 1248, 1995 10) Doraiswamy PM, Sperling RA, K Johnson K: Florbetapir F 18 amyloid PET and 36-month cognitive decline: a prospective multicenter study. Mol. Psychiat. 19: 1044 1051, 2014 11) Shiga T, Morimoto Y, Kubo N, et al.: A new PET scanner with semiconductor detectors enables better identification of intratumoral inhomogeneity. J. Nucl. Med. 50: 148 155, 2009 著者紹介藤井博史 MRI 8
Jpn. J. Med. Phys. Vol. 35 No. 1 (2015) The PET, Past and Future Hirofumi FUJII* Division of Functional Imaging, Exploratory Oncology Research and Clinical Trial Center (EPOC), National Cancer Center Keywords: positron emission tomography (PET), positron emitter, combined scanner, metabolic trapping, dementia Abstract Positron emission tomography (PET) is a unique nuclear medicine test using positron emitters such as 18 F and 11 C. In PET tests, various kinds of functional aspects of human bodies can be evaluated by using compounds labeled by these positron emitters. Recently, combined scanners of PET and anatomical imaging modalities such as CT and MRI have been developed and functional information with anatomical location can be easily obtained, increasing the usefulness of PET tests. PET tests are now essential imaging tools to diagnose various kinds of disease with functional abnormalities. In the field of oncology, 18 F-fluorodeoxy glucose PET tests are routinely used in clinical practice under health insurance. In the field of neurology, PET tests are actively used to investigate cerebral function by labeled neurotransmitters and so on. Currently, brain PET tests to detect beta-amyloid are applied to the diagnosis of dementia. In the field of cardiology, cardiac perfusion and myocardial metabolism are quantitatively measured by using PET and obtained results have successfully revealed the pathogenesis of intractable cardiac diseases. Future technical advances will enhance the usefulness of PET tests more and more. 9