论著 · 临床研究

不同年龄段儿童与青少年18F-FDG PET/CT显像肝脏本底与纵隔血池生理分布特征及影响因素分析

  • 王少雁 ,
  • 李超 ,
  • 黄硕 ,
  • 吴书其 ,
  • 陈素芸
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  • 上海交通大学医学院附属新华医院核医学科,上海 200092
陈素芸,副主任医师,博士;电子信箱:nuyus@outlook.com

收稿日期: 2025-07-14

  录用日期: 2025-11-10

  网络出版日期: 2026-04-10

Physiological distribution characteristics and influencing factors of hepatic background and mediastinal blood pool on 18F-FDG PET/CT in children and adolescents of different ages

  • Wang Shaoyan ,
  • Li Chao ,
  • Huang Shuo ,
  • Wu Shuqi ,
  • Chen Suyun
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  • Department of Nuclear Medicine, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
Chen Suyun, E-mail: nuyus@outlook.com.

Received date: 2025-07-14

  Accepted date: 2025-11-10

  Online published: 2026-04-10

摘要

目的·探讨儿童与青少年在氟-18标记的氟代脱氧葡萄糖(fluorine-18 fluorodeoxyglucose,18F-FDG)正电子发射断层成像/计算机断层显像(positron emission tomography/computed tomography,PET/CT)中肝脏本底及纵隔血池的生理分布特征及影响因素。方法·收集271例<18岁的经病理确诊或怀疑恶性肿瘤的患儿病例资料,按年龄分为≤2岁组、3~5岁组、6~10岁组和≥11岁组。测量PET/CT影像中肝脏与纵隔血池的最大及平均标准化摄取值(SUVmax和SUVmean),分析其与年龄、体质量、身高、体质量指数(body mass index,BMI)、性别、肝功能及化学治疗状态的关系。结果·肝脏SUVmax和SUVmean分别为1.89±0.62和1.36±0.44;纵隔血池SUVmax和SUVmean分别为1.11±0.37和0.98±0.32。Pearson相关性分析结果显示:肝脏与纵隔血池之间的SUVmax和SUVmean均呈显著正相关(r=0.78~0.86,P<0.001),且各项SUV值均与患儿年龄、体质量、身高、BMI呈正相关(r=0.47~0.73,P<0.05);而性别与肝脏、纵隔血池各项SUV参数间无明显相关性(r=0.02~0.04,P>0.05)。肝脏及纵隔血池FDG摄取随年龄增长而升高;肝脏SUVmax从≤2岁组的1.41±0.32升至≥11岁组的2.57±0.60(P<0.001),纵隔血池SUVmax由0.91±0.27升至1.42±0.41(P<0.001)。肝功能异常患儿的肝脏SUVmax低于肝功能正常者(1.71±0.61 vs 1.93±0.61,P=0.034),化学治疗前后差异不显著。多元回归分析结果显示,体质量和年龄是肝脏SUV值的独立影响因素(P<0.001),体质量对纵隔血池SUV值的影响最显著(P<0.001)。结论·儿童与青少年肝脏本底及纵隔血池18F-FDG摄取随年龄和体质量增长而升高,5岁以下儿童SUV值多低于2;以肝脏本底和纵隔血池SUV值作为疗效评估中的非靶器官参数,具有良好一致性和可重复性,有助于提高儿童PET/CT判读准确性与标准化。

本文引用格式

王少雁 , 李超 , 黄硕 , 吴书其 , 陈素芸 . 不同年龄段儿童与青少年18F-FDG PET/CT显像肝脏本底与纵隔血池生理分布特征及影响因素分析[J]. 上海交通大学学报(医学版), 2026 , 46(4) : 496 -501 . DOI: 10.3969/j.issn.1674-8115.2026.04.009

Abstract

Objective ·To investigate the physiological distribution characteristics of fluorine-18 fluorodeoxyglucose(18F-FDG) in the liver background and mediastinal blood pool on positron emission tomography/computed tomography (PET/CT) in children and adolescents, and to analyze the influencing factors. Methods ·A total of 271 pediatric patients (<18 years) with pathologically confirmed or suspected malignant tumors were retrospectively analyzed. Patients were divided into four age groups: ≤2 years, 3‒5 years, 6‒10 years, and ≥11 years. The maximum standardized uptake value and mean standardized uptake value (SUVmax and SUVmean) of the liver and mediastinal blood pool were measured. Their associations with age, weight, height, body mass index (BMI), gender, liver function, and chemotherapy status were assessed. Results ·The SUVmax and SUVmean of the liver were 1.89±0.62 and 1.36±0.44, respectively.The mediastinal blood pool SUVmax and SUVmean were 1.11±0.37 and 0.98±0.32. Pearson correlation analysis showed that SUVmax and SUVmean values of the liver and mediastinal blood pool were significantly positively correlated (r=0.78‒0.86, P<0.001). All SUV parameters were positively correlated with age, weight, height, and BMI (r=0.47‒0.73, P<0.05), but showed no significant correlation with gender (r=0.02‒0.04, P>0.05). 18F-FDG uptake in both the liver and mediastinal blood pool increased significantly with age. Hepatic SUVmax increased from 1.41±0.32 in the ≤2-year group to 2.57±0.60 in the ≥11-year group (P<0.001), while mediastinal SUVmax increased from 0.91±0.27 to 1.42±0.41 (P<0.001). Children with abnormal liver function had lower hepatic uptake compared to those with normal liver function (1.71±0.61 vs 1.93±0.61, P=0.034), while no significant difference was observed before and after chemotherapy. Multivariate regression analysis identified weight and age as independent influencing factors for hepatic SUV values (P<0.001), and body weight had the greatest impact on mediastinal blood pool SUV values (P<0.001). Conclusion ·Hepatic background and mediastinal blood pool 18F-FDG uptake increases with age and weight in children and adolescents, with SUV values typically below 2 in children under 5 years old. The SUV values of the liver and mediastinal blood pool show good consistency and reproducibility as non-target reference parameters for therapeutic response evaluation in pediatric PET/CT, which may improve the accuracy and standardization of image interpretation.

参考文献

[1] Kluge R, Kurch L, Georgi T, et al. Current role of FDG-PET in pediatric Hodgkin's lymphoma[J]. Semin Nucl Med, 2017, 47(3): 242-257.
[2] Baum S H, Frühwald M, Rahbar K, et al. Contribution of PET/CT to prediction of outcome in children and young adults with rhabdomyosarcoma[J]. J Nucl Med, 2011, 52(10): 1535-1540.
[3] Lee J W, Cho A, Yun M J, et al. Prognostic value of pretreatment FDG PET in pediatric neuroblastoma[J]. Eur J Radiol, 2015, 84(12): 2633-2639.
[4] Boktor R R, Omar W S, Mousa E, et al. A preliminary report on the impact of 18F-FDG PET/CT in the management of paediatric head and neck cancer[J]. Nucl Med Commun, 2012, 33(1): 21-28.
[5] Kubota K, Watanabe H, Murata Y, et al. Effects of blood glucose level on FDG uptake by liver: a FDG-PET/CT study[J]. Nucl Med Biol, 2011, 38(3): 347-351.
[6] Shiono S, Abiko M, Okazaki T, et al. Positron emission tomography for predicting recurrence in stage I lung adenocarcinoma: standardized uptake value corrected by mean liver standardized uptake value[J]. Eur J Cardiothorac Surg, 2011, 40(5): 1165-1169.
[7] Ozcan Kara P, Kara T, Kara Gedik G, et al. The role of fluorodeoxyglucose-positron emission tomography/computed tomography in differentiating between benign and malignant adrenal lesions[J]. Nucl Med Commun, 2011, 32(2): 106-112.
[8] Wahl R L, Jacene H, Kasamon Y, et al. From RECIST to PERCIST: evolving Considerations for PET response criteria in solid tumors[J]. J Nucl Med, 2009, 50(Suppl 1): 122S-150S.
[9] Okuyama C, Matsushima S, Nishimura M, et al. Increased 18F-FDG accumulation in the tonsils after chemotherapy for pediatric lymphoma: a common physiological phenomenon[J]. Ann Nucl Med, 2019, 33(5): 368-373.
[10] Kumbhar S S, Qi J. Normal FDG uptake in the adenoids and palatine tonsils in children on PET/MRI[J]. Pediatr Radiol, 2020, 50(7): 958-965.
[11] Vali R, Bakari A A, Marie E, et al. FDG uptake in cervical lymph nodes in children without head and neck cancer[J]. Pediatr Radiol, 2017, 47(7): 860-867.
[12] Taralli S, Leccisotti L, Mattoli M V, et al. Physiological activity of spinal cord in children: an 18F-FDG PET-CT study[J]. Spine, 2015, 40(11): E647-E652.
[13] Brink I, Reinhardt M J, Hoegerle S, et al. Increased metabolic activity in the thymus gland studied with 18F-FDG PET: age dependency and frequency after chemotherapy[J]. J Nucl Med, 2001, 42(4): 591-595.
[14] Meier J M, Alavi A, Iruvuri S, et al. Assessment of age-related changes in abdominal organ structure and function with computed tomography and positron emission tomography[J]. Semin Nucl Med, 2007, 37(3): 154-172.
[15] Sedig L K, Bailey J J, Wong K K, et al. Do Deauville scores improve the clinical utility of end-of-therapy FDG PET scans for pediatric Hodgkin lymphoma?[J]. AJR Am J Roentgenol, 2019, 212(2): 456-460.
[16] Jorgov L, Montravers F, Balogova S, et al. Paediatric and adolescent Hodgkin lymphoma: information derived from diffuse organ uptake of 18 F-fluorodeoxyglucose on pre-treatment and on interim PET/CT[J]. Eur J Nucl Med Mol Imaging, 2016, 43(7): 1220-1230.
[17] Beath S V. Hepatic function and physiology in the newborn[J]. Semin Neonatol, 2003, 8(5): 337-346.
[18] Suchy F L, Sokol R J, Balistreri W F, et al. Functional development of liver[M]//Suchy F J. Liver disease in children.4th ed. Cambridge: Cambridge University Press,2014: 10-23.
[19] Iozzo P, Geisler F, Oikonen V, et al. Insulin stimulates liver glucose uptake in humans: an 18F-FDG PET Study[J]. J Nucl Med, 2003, 44(5): 682-689.
[20] Sprinz C, Zanon M, Altmayer S, et al. Effects of blood glucose level on 18F fluorodeoxyglucose (18F-FDG) uptake for PET/CT in normal organs: an analysis on 5623 patients[J]. Sci Rep, 2018, 8(1): 2126.
[21] Webb R L, Landau E, Klein D, et al. Effects of varying serum glucose levels on 18F-FDG biodistribution[J]. Nucl Med Commun, 2015, 36(7): 717-721.
[22] Peters A M, Keramida G, Pencharz D. Assessment of alteration in liver 18F-FDG uptake due to steatosis in lymphoma patients and its impact on the Deauville score[J]. Eur J Nucl Med Mol Imaging, 2018, 45(12): 2231-2232.
[23] Viglianti B L, Wong K K, Wimer S M, et al. Effect of hyperglycemia on brain and liver 18F-FDG standardized uptake value (FDG SUV) measured by quantitative positron emission tomography (PET) imaging[J]. Biomedecine Pharmacother, 2017, 88: 1038-1045.
[24] Eskian M, Alavi A, Khorasanizadeh M, et al. Effect of blood glucose level on standardized uptake value (SUV) in 18F-FDG PET-scan: a systematic review and meta-analysis of 20, 807 individual SUV measurements[J]. Eur J Nucl Med Mol Imaging, 2019, 46(1): 224-237.
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