嗅覺F-18 FDG正子斷層－電腦斷層掃描－初步報告

Olfactory F-18 FDG Positron Emission Tomography-Computed Tomography: A Preliminary Report

江榮山(Rong-San Jiang) ； 魯祐祐(Yu-Yu Lu) ； 蔡世傳(Shih-Chuan Tsai) ； 梁凱莉(Kai-Li Liang)

《核子醫學暨分子影像雜誌》 31卷2期 (2018/06) Pp. 59-66

https://doi.org/10.6332/ANMMI.201806_31(2).0001

摘要

背景：嗅覺功能檢查目前以心理物理方法為主。這些方法雖然簡單、易操作，但是卻都是主觀性的檢查。因此發展客觀性檢查工具有其臨床必要性。本研究嘗試利用酚基乙基乙醇刺激介入之嗅覺F-18 fluorodeoxyglucose (FDG)正子斷層—電腦斷層掃描(positron emission tomography-computed tomography, PET/CT)來評估嗅覺功能的可行性。方法：本研究共收集17名20 ~ 64歲鼻咽癌病人。其中9名為嗅覺正常的新診斷鼻咽癌受試者，他們主訴嗅覺功能正常而且酚基乙基乙醇氣味察覺閾值試驗的閾值小於-6；另外8名經放射線治療後嗅覺全失的鼻咽癌受試者，他們主訴嗅覺全失者而且酚基乙基乙醇氣味察覺閾值試驗的閾值為-1。所有受試者接受F-18 FDG PET/CT檢查，檢查時使用酚基乙基乙醇作為嗅覺刺激物。取得PET/CT影像後，測量嗅球及眼眶額葉皮質的最大標準攝取值(maximum standard uptake value, SUVmax)。結果：嗅覺正常受試者的嗅球SUVmax在刺激側(鼻孔放置嗅覺刺激物)及未刺激側(鼻孔未放置嗅覺刺激物)分別為9.64 ± 2.64及9.65 ± 2.50；眼眶額葉皮質SUVmax分別為12.89 ± 2.66及13.11 ± 2.96。嗅覺全失受試者的嗅球SUVmax分別為8.77 ± 2.73及8.29 ± 3.17；眼眶額葉皮質SUVmax分別為11.80 ± 3.23及11.69 ± 3.00。嗅覺正常受試者的嗅球及眼眶額葉皮質SUVmax雖稍高於嗅覺全失受試者，但兩組之間沒有顯著差異。刺激側與未刺激側之間的SUVmax也沒有顯著差異。結論：本研究並未發現酚基乙基乙醇刺激介入之嗅覺F-18 FDG PET/CT對於評估嗅球及眼眶額葉皮質的代謝活性有出現明顯改變。未來或許須再改進提供嗅覺刺激方式來發展F-18 FDG PET/CT在檢查嗅覺功能的應用。

關鍵字

F-18 FDG正子斷層—電腦斷層掃描 ； 嗅球 ； 眼眶額葉皮質 ； 酚基乙基乙醇

並列摘要

Background: The examination of olfactory function is mainly based on psychophysical methods. Although these methods are simple and easy to operate, they are subjective examinations. Therefore, the development of objective tests is necessary clinically. In this study, we attempted to evaluate the olfactory function by the olfactory F-18 fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET/CT) using phenylethyl alcohol as stimulation. Methods: A total of 17 patients aged 20 to 64 years with nasopharyngeal carcinoma were enrolled in this study. Nine of them were freshly diagnosed subjects with normal olfactory function. Their thresholds of phenyl ethyl alcohol odor detection threshold test were below -6. The other 8 were post-irradiated subjects, who complained of a complete loss of olfactory function. Their thresholds of phenyl ethyl alcohol odor detection threshold test were all -1. All subjects received a F-18 FDG PET/CT examination using phenyl ethyl alcohol as olfactory stimulus. After obtaining PET/CT images, the maximum standard uptake value (SUVmax) of the olfactory bulbs and orbitofrontal cortices were measured. Results: In the normal subjects, the SUVmax of the olfactory bulbs were 9.64 ± 2.64 and 9.65 ± 2.50 on the stimulating side (the side of the nasal cavity stuffed with the olfactory stimulus) and the unstimulated side, respectively. And the SUVmax of their orbitofrontal cortices were 12.89 ± 2.66 and 13.11 ± 2.96, respectively. In anosmic subjects, the SUVmax of olfactory bulbs were 8.77 ± 2.73 and 8.29 ± 3.17 on the stimulating side and the unstimulated side, respectively. And the SUVmax of their orbitofrontal cortices were 11.80 ± 3.23 and 11.69 ± 3.00, respectively. The SUVmax of the olfactory bulbs and orbitofrontal cortices of the normal subjects were slightly higher than those of the anosmic subjects, but there was no significant difference between the two groups. There was also no significant difference in SUVmax between the stimulated side and the unstimulated side. Conclusions: In this study, it was not found that the metabolic activity of olfactory bulb and orbital frontal cortex changed significantly in the olfactory F-18 FDG PET/CT examination using phenylethyl alcohol as stimulus. In the future, we may need to modify the method of olfactory stimulation to improve the feasibility of F-18 FDG PET/CT in the evaluation of olfactory function.

並列關鍵字

F-18 FDG PET/CT ； olfactory bulb ； orbitofrontal cortex ； phenylethyl alcohol