摘要目的:探讨 68Ga－1，4，7，10－四氮杂环十二烷－1，4，7，10－四乙酸－ D－苯丙氨酸1－酪氨酸3－苏氨酸8－奥曲肽(DOTATATE)联合 18F－FDG全身PET/CT显像在神经内分泌肿瘤(NEN)原发灶诊断及肿瘤异质性评价中的价值。 方法:回顾性分析2020年8月至2023年3月在复旦大学附属中山医院行1/10活度 18F－FDG和1/2活度 68Ga－DOTATATE全身PET/CT显像的39例具有病理诊断患者的临床、影像及病理资料[NEN 30例，非NEN 9例；男18例，女21例；年龄(54.0±11.4)岁]。将NEN原发灶分为神经内分泌瘤(NET)G1、G2、G3及神经内分泌癌(NEC)。分析双显像剂全身PET/CT显像互补结合对NEN原发灶的诊断效能及对肿瘤异质性评价的价值。 结果:68Ga－DOTATATE单独及联合 18F－FDG全身PET/CT诊断NEN原发灶的灵敏度、特异性、准确性分别为81.2%(26/32)、7/9、80.5%(33/41)和90.6%(29/32)、7/9、87.8%(36/41)。有10个NET G1和7个NET G2病灶有 68Ga－DOTATATE摄取，无 18F－FDG摄取；有2个NET G2病灶没有 68Ga－DOTATATE摄取，但有 18F－FDG摄取；2个NET G1及6个NET G2病灶同时具有 68Ga－DOTATATE和 18F－FDG摄取。患者接受的 68Ga－DOTATATE、 18F－FDG和1次检查CT的辐射剂量分别为(1.59±0.50)、0.49(0.44，0.58)和11.46(10.53，12.85) mSv。 结论:双显像剂全身PET/CT显像互补结合对NEN原发灶具有较高的诊断效能，可充分评估肿瘤间的异质性。

abstractsObjective:To investigate the value of 68Ga-1, 4, 7, 10-tetraazacyclododecane-1, 4, 7, 10-tetraacetic acid- D-Phe1-Tyr3-Thr8-octreotide (DOTATATE) combined with 18F-FDG total-body PET/CT imaging in the diagnosis and heterogeneity assessment of primary foci of neuroendocrine neoplasms (NEN). Methods:Clinical, imaging and pathological data of 39 patients with pathological diagnosis (30 NEN and 9 non-NEN, 18 males and 21 females, age (54.0±11.4) years) who underwent 1/10 activity 18F-FDG and 1/2 activity 68Ga-DOTATATE total-body PET/CT combined imaging in Zhongshan Hospital, Fudan University from August 2020 to March 2023 were retrospectively analyzed. The NEN primary foci were classified as neuroendocrine tumor (NET) G1, G2, G3, and neuroendocrine carcinoma (NEC). Diagnostic efficacy of combined dual-low activity dual-tracer imaging for NEN primary foci and its value for evaluating tumor heterogeneity were analyzed. Results:The sensitivities, specificities, and accuracies of 68Ga-DOTATATE alone and in combination with 18F-FDG total-body PET/CT for the diagnosis of NEN primary foci were 81.2%(26/32), 7/9, 80.5%(33/41) and 90.6%(29/32), 7/9, 87.8%(36/41), respectively. Ten NET G1 and seven NET G2 lesions showed 68Ga-DOTATATE uptake and no 18F-FDG uptake; two NET G2 lesions showed no 68Ga-DOTATATE uptake but 18F-FDG uptake; and two NET G1 and six NET G2 lesions showed both 68Ga-DOTATATE and 18F-FDG uptake. The radiation doses of 68Ga-DOTATATE, 18F-FDG and a single examination of CT were (1.59±0.50), 0.49(0.44, 0.58) and 11.46(10.53, 12.85) mSv, respectively. Conclusion:Combining total-body PET/CT imaging with dual tracers can effectively diagnose NEN primary foci and assess inter-tumor heterogeneity.