クリニカルPET 臨床応用のためのガイドブック

出版社： 先端医療技術研究所
著者：
発行日： 1997-03-25
分野： 臨床医学：一般  >  放射線/核医学
ISBN： 9784925089005
電子書籍版： 1997-03-25 （初版第2刷）
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クリニカルPETが成熟段階に突入し、多くの医師が本分野に関心を持ち新しく参加を希望している今日、テキストブックとなる本書が、鳥塚先生を中心とした本分野のトップレベルの分担執筆者を網羅して、企画・編集され、ここにわが国で初めての出版の運びとなったことは、誠に時宜を得たものであり、社会的寄与は極めて大きい。（刊行に寄せてより）

目次

  • 表紙
  • カラーグラビア
  • 著者一覧
  • 「クリニカルPET」の刊行に寄せて
  • 目次
  • 序論
  • 第I編 基礎と測定
  • 第1章 基礎
  • 1. 標識薬剤の合成と品質管理
  • 1.1 はじめに
  • 1.2 放射性核種の選択
  • 1.3 ポジトロン放射性薬剤に用いられている放射性核種の特性
  • 1.3.1 放射能の特性
  • 1.3.2 元素としての特性
  • 1.3.3 82Cu, 68Ga, 82Rb
  • 1.4 核種の製造と放射性薬剤の合成
  • 1.4.1 11C, 13N, 15O, 18F
  • 1.4.2 62Cu, 68Ga, 82Rb
  • 1.5 品質管理
  • 1.5.1 品質管理基準
  • 1.5.2 確認試験
  • 1.5.3 純度試験
  • 1.5.4 定量法
  • 1.5.5 そのほかの規格試験
  • 1.5.6 製剤学的安定性
  • 1.5.7 成熟薬剤の実例
  • 2. PET装置
  • 2.1 PETの特徴
  • 2.2 PET装置の原理
  • 2.2.1 ポジトロンと消滅光子の発生
  • 2.2.2 消滅光子の同時計数
  • 2.2.3 PET装置の原理的な限界
  • 2.3 検出器
  • 2.4 検出器配列と走査方式
  • 2.4.1 駆動型PET
  • 2.4.2 静止型PET
  • 2.4.3 3次元PET
  • 2.4.4 飛行時間 (time of flight ; TOF) PET
  • 2.4.5 Nal使用PET
  • 2.5 基本的性能
  • 2.5.1 感度
  • 2.5.2 画像分解能
  • 2.5.3 軸方向分解能 (スライス厚)
  • 2.5.4 計数率特性
  • 2.6 データサンプリングの条件
  • 2.7 画像再構成
  • 2.8 定量性向上のためのデータ補正
  • 2.8.1 検出器感度 (ブランク補正)
  • 2.8.2 γ線の減弱補正
  • 2.8.3 ランダム (偶発、散乱) 同時計数
  • 2.8.4 計数の数え落とし
  • 2.8.5 絶対値測定のための感度相互校正
  • 2.8.6 部分容積効果 (PVE)
  • 2.8.7 雑音 (S/N, NEC) 評価
  • 2.9 おわりに
  • 第2章 測定法
  • 1. 臨床PET計測の手順
  • 1.1 被検者への説明
  • 1.2 固定と位置合わせ
  • 1.3 入力関数の測定
  • 1.4 生理学的データの測定
  • 1.5 患者の状態のコントロール
  • 2. PETデータの処理
  • 2.1 生理学的定量化
  • 2.2 画像の位置変換
  • 2.3 ROIの設定
  • 2.4 三次元表示
  • 2.5 ソフトウエア
  • 3. おもな放射性薬剤のPET測定法
  • 3.1 15Oガスによる脳血流、酸素代謝、血液量の測定
  • 3.2 15O-水による脳血流の測定
  • 3.3 18FDGによる糖代謝の測定
  • 3.4 11C-酢酸による心筋好気性代謝の測定
  • 3.5 18F-DOPAによるドパミン系節前機能の測定
  • 3.6 11C-NMSPによるドパミン受容体の測定
  • 4. データの管理と保管
  • 4.1 システム構成
  • 4.1.1 ネットワーク
  • 4.1.2 データフォーマット
  • 4.2 データベースの構造
  • 4.3 データベースへの登録
  • 4.4 データベースの検索と管理
  • 4.5 今後の課題
  • 第II編 臨床
  • 第3章脳疾患
  • 1. 脳血管障害
  • 1.1 Clinical PET - 脳血管障害 - のための基礎
  • 1.1.1 脳循環とエネルギー代謝
  • 1.1.2 脳循環の保護機構
  • 1.1.3 虚血と脳組織
  • 1.2 臨床
  • 1.2.1 脳梗塞
  • 2. 痴呆
  • 2.1 はじめに
  • 2.1.1 痴呆の定義
  • 2.1.2 痴呆の頻度と分類
  • 2.1.3 痴呆における臨床PET検査の意義
  • 2.2 痴呆を対象とした臨床PET検査法
  • 2.2.1 18F - フルオロデオキシグルコース
  • 2.2.2 15O標識水および15Oガス
  • 2.2.3 痴呆における臨床PET画像収集
  • 2.2.4 臨床PET画像解析法
  • 2.3 痴呆性疾患の脳代謝異常とPET所見
  • 2.3.1 アルツハイマー病
  • 2.3.2 脳血管性痴呆
  • 2.3.3 痴呆を伴うパーキンソン病とびまん性レビー小体病
  • 2.3.4 その他の神経変性性痴呆
  • 2.3.5 感染による痴呆
  • 2.3.6 正常圧水頭症
  • 2.4 おわりに
  • 3. 運動障害
  • 3.1 はじめに
  • 3.2 パーキンソン病
  • 3.3 多系統萎縮症
  • 3.4 進行性核上麻痺
  • 3.5 舞踏病
  • 3.6 ジストーニア
  • 3.7 骨髄小脳変性症
  • 3.8 運動ニューロン疾患
  • 3.9 PETによる運動障害患者の鑑別診断
  • 4. てんかん
  • 4.1 はじめに
  • 4.2 PET検査の必要性
  • 4.3 局所性てんかんの分類
  • 4.4 PET所見を読むにあたっての注意
  • 4.5 発作間欠期のPET所見
  • 4.6 側頭葉てんかん発作間欠期のPET所見
  • 4.7 PET所見とMRI所見との比較
  • 4.8 PET検査とSPECT検査
  • 4.9 PET検査の将来
  • 5. 精神疾患
  • 5.1 はじめに
  • 5.2 血流・代謝
  • 5.3 受容体
  • 5.4 おわりに
  • 第4章 心疾患
  • 1. 虚血性心疾患
  • 1.1 はじめに
  • 1.2 心臓のPET診断
  • 1.2.1 PET装置
  • 1.2.2 PETトレーサ
  • 1.2.3 PET撮像と画像評価
  • 1.3 心筋血流のPET診断
  • 1.3.1 心筋血流イメージング
  • 1.3.2 心筋血流トレーサ
  • 1.3.3 13N-ammonia PETの臨床プロトコール
  • 1.3.4 13N-ammonia PET像の視覚評価
  • 1.3.5 13N-ammonia PETによる局所心筋血流量の計測
  • 1.3.6 13N-ammonia PETの診断的意義
  • 1.4 心筋代謝のPET診断
  • 1.4.1 心筋のエネルギー代謝
  • 1.4.2 心筋糖代謝とトレーサ : 18F-FDG
  • 1.4.3 18F-FDG PETの臨床プロトコール
  • 1.4.4 18F-FDG PET像の視覚評価
  • 1.4.5 18F-FDG PET像の定量評価
  • 1.4.6 18F-FDG PETの診断的意義
  • 1.5 おわりに
  • 2. 心筋症
  • 2.1 心筋のエネルギー代謝
  • 2.2 肥大型心筋症の検討
  • 2.3 拡張型心筋症の検討
  • 2.4 新しい病態解析
  • 2.5 まとめ
  • 3. 動脈硬化
  • 3.1 はじめに
  • 3.2 PETを用いた冠血流予備能定量化による冠動脈硬化早期診断
  • 3.2.1 高コレステロール血症
  • 3.2.2 高トリグリセリド血症
  • 3.2.3 糖尿病
  • 3.2.4 高血圧症
  • 3.3 18FDG-PETによる心筋、骨格筋ブドウ糖代謝の定量 ― インスリン抵抗性症候群の病態解析
  • 3.3.1 糖尿病
  • 3.3.2 高血圧、高脂血症
  • 3.4 今後の展望
  • 第5章 腫瘍
  • 1. 脳
  • 1.1 はじめに
  • 1.2 グリオーマの局所循環代謝
  • 1.2.1 循環量
  • 1.2.2 酸素代謝
  • 1.2.3 糖消費量
  • 1.2.4 腫瘍局所の循環代謝様態
  • 1.2.5 脳組織における循環代謝
  • 1.3 グリオーマにおける循環代謝と予後
  • 1.4 他の脳腫瘍における循環代謝
  • 1.4.1 髄膜腫
  • 1.4.2 中枢性神経細胞腫
  • 1.5 グリオーマの局在および伸展度
  • 1.6 グリオーマの早期診断
  • 1.7 治療効果の評価
  • 1.8 放射線照射の影響および放射線壊死の評価
  • 1.9 まとめ
  • 2. 肺・縦隔腫瘍
  • 2.1 はじめに
  • 2.2 肺癌の診断
  • 2.2.1 肺腫瘤影の鑑別診断
  • 2.2.2 ステージ診断、転移診断
  • 2.2.3 肺癌PET画像の評価法
  • 2.2.4 PET画像の意味と誤診の原因
  • 2.3 肺癌の治療評価
  • 2.3.1 PETによる治療評価のメリット
  • 2.3.2 治療モニタリング
  • 2.3.3 FDGによ治療評価
  • 2.4 縦隔腫瘍の診断
  • 3. 腹部、骨盤部
  • 3.1 はじめに
  • 3.2 膵癌と腫瘤形性膵炎の鑑別
  • 3.2.1 はじめに
  • 3.2.2 検査の実際
  • 3.2.3 診断成績
  • 3.2.4 考案
  • 3.3 直腸癌術後局所再発の診断
  • 3.3.1 はじめに
  • 3.3.2 検査の実際
  • 3.3.3 診断成績
  • 3.3.4 考案
  • 3.4 FDG-PETによる腫瘍診断の問題点
  • 3.5 その他の応用
  • 3.6 今後の展望
  • 4. 乳腺
  • 4.1 はじめに
  • 4.2 検査方法
  • 4.3 評価方法
  • 4.4 良、悪性の鑑別
  • 4.5 乳腺症
  • 4.6 Dynamic MRIとの診断能の比較
  • 4.7 腋窩リンパ節浸潤の評価
  • 4.8 臨床病理学的および既知の予後因子とFDG集積の関係
  • 4.9 放射線治療効果の判定
  • 4.10 おわりに
  • 5. 頭頸部
  • 5.1 はじめに
  • 5.2 使用放射性薬剤
  • 5.3 検査方法
  • 5.3.1 FDG-PET
  • 5.3.2 Mcthionine - PET
  • 5.3.3 データの解析方法
  • 5.4 正常像
  • 5.4.1 FDG - PET
  • 5.4.2 Methionine - PET
  • 5.5 臨床的意義
  • 5.6 臨床応用
  • 5.6.1 病巣の検出
  • 5.6.2 良悪性の鑑別
  • 5.6.3 所属リンパ節転移巣の検出
  • 5.6.4 治療効果判定
  • 5.6.5 腫瘍の残存、再発の診断
  • 5.6.6 予後の予測
  • 6. 全身PETによるがん転移の診断
  • 6.1 はじめに
  • 6.2 検査方法
  • 6.3 全身PET検査の臨床的意義
  • 6.4 吸収補正
  • 6.5 三次元PETデータ収集 (3D-PET)
  • 6.6 2検出器対向型ガンマカメラによる全身イメージング
  • 7. PETによるがんスクリーニング
  • 7.1 はじめに
  • 7.2 FDG
  • 7.3 PETと一般核医学検査のちがい
  • 7.4 吸収補正
  • 7.5 がんにおける糖代謝亢進
  • 7.6 PET検査の手順
  • 7.7 全身PET正常像
  • 7.8 PET画像の読影
  • 7.9 全身PETによるがんスクリーニングの成績
  • 7.10 PETで検出困難ながんと検出可能ながん
  • 7.11 がん検診によるがん発見率
  • 7.12 PET検査の被曝線量
  • 7.13 おわりに
  • 第6章 PET関連新技術の展望
  • 1. FDG・SPECT
  • 1.1 撮像機器および検査方法
  • 1.1.1 511keVコリメータ
  • 1.1.2 検査方法
  • 1.2 腫瘍診断
  • 1.2.1 原発巣の評価
  • 1.2.2 局所再発
  • 1.2.3 転移
  • 1.2.4 治療効果判定
  • 1.2.5 18F - FDG - SPECTの検出限界
  • 1.3 今後の動向
  • 2. がんの中性子捕捉療法におけるポジトロンCTの役割
  • 2.1 はじめに
  • 2.2 ポジトロンCTと中性子捕捉療法
  • 2.3 悪性脳腫瘍のFBPA画像
  • 2.4 18F - 10B - FBPA - PET検査の特性
  • 2.5 中性子捕捉療法の実際
  • 2.6 まとめ
  • 第7章 将来展望
  • 1. バイオメディカルイメージングの展望
  • 1.1 はじめに
  • 1.2 18F-FDG糖代謝イメージング
  • 1.3 ニューロレセプター・イメージング
  • 1.3.1 ニューロレセプター・イメージングにおける問題点
  • 1.3.2 シナプス間隙の神経伝達物質濃度の推定
  • 1.3.3 サブタイプ特異的レセプター・イメージング
  • 1.3.4 マルチ・トレーサー法による神経伝達機構の解明
  • 1.4 遺伝子工学を用いたトレーサー・リガンドの開発
  • 1.4.1 リガンド特異性
  • 1.4.2 アンチセンス・イメージング
  • 1.5 おわりに
  • 2. 臨床PETの将来展望
  • 2.1 核医学検査としてのPETの特徴
  • 2.2 標識薬剤からみたPETの位置づけ
  • 2.2.1 15OによるPET
  • 2.2.2 11Cと13NによるPET
  • 2.3.3 18FによるPET
  • 2.2.4 ジェネレータ核種によるPET
  • 2.3 新しいアプローチ
  • 2.3.1 測定システムの将来
  • 2.3.2 標識薬剤の将来
  • 第III編 技術資料編
  • 各社製品に関する技術資料
  • 第1章 サイクロトロン & CBB
  • 1. NKK-OXFORD超伝導小型サイクロトロン&CBB
  • 1.1 NKK-OXFORD超伝導小型サイクロトロン
  • 1.2 ターゲットボックス
  • 1.3 標識化合物合成装置 (CBB)
  • 2. JSWサイクロトロンと標識化合物合成装置
  • 2.1 はじめに
  • 2.2 BC2010N型ベビーサイクロトロン
  • 2.2.1 BC2010Nの性能と仕様
  • 2.2.2 BC2010Nの特長
  • 2.2.3 BC2010Nの運転方法
  • 2.3 RDS111型サイクロトロン
  • 2.3.1 RDS111の性能と仕様
  • 2.3.2 RDS111の特長
  • 2.4 ガス状標識化合物合成装置システム
  • 2.4.1 無機RIガス精製装置 (ARIS-G1)
  • 2.4.2 無機RIガス分析装置 (ARIS-GA)
  • 2.4.3 ガス吸入装置 (ARIS-GK-1)
  • 2.5 液状標識化合物合成装置
  • 2.5.1 [O-15] 水合成注入装置
  • 2.5.2 [F-18] FDG合成装置
  • 2.5.3 その他の合成装置
  • 3. 住友のPET診断用標識化合物合成システム
  • 3.1 はじめに
  • 3.2 サイクロトロン
  • 3.3 周辺装置および標識薬剤合成装置
  • 3.3.1 15O標識ガス合成装置
  • 3.3.2 15O標識水注射液合成装置
  • 3.3.3 18FDG合成装置
  • 3.3.4 13NH3合成装置
  • 3.3.5 11C標識薬剤合成装置
  • 3.3.6 18FDOPA合成装置
  • 3.3.7 ホットセル
  • 3.4 まとめ
  • 4. IBA社サイクロトロンおよびCBB
  • 4.1 IBA社について
  • 4.2 サイクロン18/9およびサイクロン10/5の特徴
  • 4.2.1 サイクロトロン本体
  • 4.2.2 化学処理モジュール (CBB)
  • 4.2.3 ターゲット装置
  • 4.2.4 コントロールシステム
  • 4.3 サイクロン3
  • 4.3.1 サイクロン3の特徴
  • 4.3.2 サイクロン3の標準的な設置面積
  • 第2章 PETスキャナ
  • 1. GE社製ADVANCE PETスキャナおよびPET性能評価
  • 1.1 はじめに (ADVANCE PETスキャナの概要)
  • 1.2 システム仕様
  • 1.3 GE社製ADVANCE PETスキャナの2Dおよび3Dスキャンにおける性能評価
  • 1.3.1 空間分解能
  • 1.3.2 感度
  • 1.3.3 散乱フラクションおよびその補正
  • 1.3.4 同時計数率特性
  • 1.4 おわりに
  • 2. 3次元PETスキャナ
  • 2.1 2次元PETと3次元PETの違い
  • 2.1.1 2次元収集
  • 2.1.2 3次元収集
  • 2.2 3次元データ収集
  • 2.2.1 3次元データ収集の基礎
  • 2.2.2 シーメンス社製ECAT HR+の場合
  • 2.2.3 2次元収集
  • 2.2.4 3次元収集
  • 2.3 3次元画像再構成
  • 2.3.1 2次元画像再構成
  • 2.3.2 3次元画像再構成
  • 2.4 3次元PETでの各補正法
  • 2.4.1 吸収補正
  • 2.4.2 散乱補正
  • 第3章 画像処理ソフト
  • 1. Dr.Viewについて
  • 1.1 はじめに
  • 1.2 Dr. Viewの基本機能
  • 1.3 Dr. ViewのPET解析機能 (画像合成)
  • 1.4 Dr. Viewの3次元表示機能
  • 第4章 PET関連機器・設備計画
  • 1. PET関連機器・設備
  • 1.1 はじめに
  • 1.2 基本レイアウト
  • 1.3 PET関連備品
  • 1.3.1 ホットセル
  • 1.3.2 標識化合物合成装置
  • 1.3.3 自動分注装置
  • 1.3.4 カス吸入システム
  • 1.4 その他開発製品
  • 2. 放射線防護・安全対策
  • 2.1 はじめに
  • 2.2 部屋別の対策
  • 2.2.1 超小型サイクロトロン室
  • 2.2.2 ホットラボ
  • 2.2.3 品質検査室
  • 2.2.4 PET室
  • 2.2.5 処置室
  • 2.2.6 貯蔵室
  • 2.2.7 廃棄物保管室
  • 2.3 その他の安全のための設備等
  • 索引
  • 奥付

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本参考文献は電子書籍掲載内容を元にしております。

第I編 基礎と測定

P.21 掲載の参考文献
1) PET用放射性薬剤佐治英郎,横山陽;月間薬事 34, 33-41, 1992.
 
2) 11Cの薬理学的研究への応用佐治英郎,横山陽; 病態生理 12, 778-785, 1993.
 
3) A new Zinc-62/Copper-62 Generator as a Copper-62 Source for PET Radiopharmaceuticals. Y. Fujibayashi, K. Matsumoto, Y. Yonekura, J. Konishi and A. Yokoyama;J Nucl Med 30, 1838-1842, 1989.
 
4) サイクロトロン核医学利用専門委員会が成熟技術として認定した放射性薬剤の基準と臨床使用の指針 (1994年改定) 日本アイソトープ協会医学薬学部会サイクロトロン核医学利用専門委員会; Radioisotopes 44, i-xxiii, 1995.
 
P.33 掲載の参考文献
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2) Nohara N, Tanaka E, Tomitani T, et al:Positologica:A positron ECT device with a continuously rotating detector ring. IEEE Trans Nucl Sci NS-27 3:1128-1136, 1980.
 
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4) 山下貴司:PET:最近の装置と検出器. Radioisotopes 42:237-243, 1993.
 
5) Townsend DW, Geissbuhler A, Defrise M, et al:Fully three-dimensional reconstruction for a PET camera with retractable septa. IEEE Trans Med Imaging MI-10:505-512, 1991.
 
6) Ter-Pogossian MM, Ficke DC, Yamamoto M, et al:Super PETT-I:A positron emission tomograph utilizing photon time-of-flight information. IEEE Trans Med Imaging MI-1:179-192, 1982.
 
7) Muehllehner G, Karp JS:A positron camera using positron-sensitive detector:PENN-PET. J Nucl Med 27:90-98, 1986.
 
8) 田中栄一:三次元アイソトープ像の計測と画像再構成. Radioisotopes 39:510-520, 1990.
 
9) 村山秀雄:PET:画像の再構成とデータ補正. Radioisotopes 42:244-254, 1993.
 
10) 千田道雄, 米倉義晴, 向井孝夫, 他:ポジトロンCTにおける数え落としの補正-単一光子計数法を用いる方法-. 核医学 24:837-841, 1987.
 
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P.38 掲載の参考文献
1) Iida H, Kanno I, Miura S, et al:Error analysis of a quantitative cerebral blood fiow measurement using H215O autoradiography and positron emission tomography, with respect to the dispersion of the input function. J Cereb Blood Flow Metabol 6:536-545, 1986.
 
P.41 掲載の参考文献
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2) Logan J, Fowler JS, Volkow ND, et al:Graphical analysis of reversible radioligand binding from time-activity measurements applied to[N-11C-methyl]-(-)-cocaine PET studies in human subjects. J Cereb Blood Flow Metabol 10:740-747, 1990.
 
3) Pelizzari CA, Chen GTY, Spelbring DR, et al:Accurate three-dimensional registration of CT, PET, and/or MR images of the brain. J Comput Assist Tomogr 13:20-26, 1989.
 
4) Woods RP, Mazziotta JC, Cherry SR:MRI-PET registration with automated algorithm. J Comput Assist Tomogr 17:536-546, 1993.
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6) Fox PT, Perlmetter JS, Raichle ME:A stereotactic method of anatomical localization for positron emitting tomography. J Comput Assist Tomogr 9:141-153, 1985.
 
7) Friston KJ, Frith CD, Liddle PF, et al:Plastic transformation of PET images. J Comput Assist Tomogr 15:634-639, 1991.
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8) Minoshima S, Koeppe RA, Frey KA, et al:Anatomic standardization, linear scaling and nonlinear warping of functional brain images. J Nucl Med 35:1528-1537, 1994.
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P.45 掲載の参考文献
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2) Sadato N, Yonekura Y, Senda M, et al:PET and the autoradiographic method with continuous inhalation of oxygen-15-gas, theoretical analysis and comparison with conventional steady-state methods. J Nucl Med 34:1672-1680, 1993.
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3) Herscovitch P, Markham J, Raichle ME:Brain blood flow measured with intravenous H2150;I. Theory and error analysis. J Nucl Med 24:782-789, 1983.
 
4) Kim CK, Gupta NC, Chandramouli GB et al:Standardized uptake values of FDG, body surface area correction is preferable to body weght correction. J Nucl Med 35:164-167, 1994.
 
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8) Martin WPW, Palmer MR, Patlak CS, et al:Nigrostiatal function in humans studied with positron emission tomography. Ann Neurol 26:535-542, 1989.
 
9) Brooks DJ, Ibanez V, Sawle GV, et al:Differing patterns of striatal 18F-dopa uptake in Parkinson's disease, multiple system atrophy, and progressive supranuclear palsy. Ann Neurol 28:547-555, 1990.
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10) Leenders KL, Palmer AJ, Quinn N, et al:Brain dopamine metabolism in patiens with Parkinson's disease measured with positron emission tomography. J Neurol Neurosurg Psychiatry 49:853--860, 1986.
 
11) Eckernas SA, Aquilonius SM, Hartvig P, et al:Positron emission tomography (PET) in the study of dopamine receptors in the primate brain, evaluation of a kinetic model using 11C-N-methyl-spiperone. Acta Neurol Scand 75:168-78, 1987.
 

第II編 臨床

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第III編 技術資料編

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