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Неинвазивное измерение метаболизма кислорода. Часть 1: исторический обзор и современное состояние

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Метаболизм кислорода является ключевым фактором жизни живого организма. Статья является первой частью обзора методов измерения метаболизма кислорода.Цель исследования: дать представление об истории развития методов измерения метаболизма кислорода, перехода от глобального измерения перфузии головного мозга к локальному, описать роль изотопа 15O как основы “золотого стандарта” измерения метаболизма кислорода с помощью позитронно-эмиссионной томографии (ПЭТ), а также привести примеры использования методики.Материал и методы. Проанализировано более 200 работ из базы научных публикаций Pubmed по ключевым словам “positron emission tomography + O-15”, также изучались релевантные ссылки в данных публикациях, не содержащих указанных ключевых слов либо содержащих их в иной формулировке. Приведен пример измерения перфузии опухоли головного мозга методом КТ-перфузии, МР-ASL и ПЭТ с H215O из собственной практики.Результаты. Для иллюстрации эволюции методов измерения перфузии и метаболизма кислорода процитированы 57 работ, описывающих ключевые достижения в технологиях измерения. Приведены примеры использования ПЭТ с H215O в фундаментальных исследованиях и клинической практике.Заключение. Очевидная ценность данных, полученных ПЭТ с изотопом кислорода, сочетается с инвазивностью (в некоторых случаях), технической сложностью и высокой стоимостью процедуры. Вторая часть обзора будет посвящена альтернативным методам измерения метаболизма кислорода, которые развиваются в XXI веке и которые предназначены для широкого клинического применения.

Ключевые слова:
метаболизм кислорода, ПЭТ с 15-O, перфузия, oxygen metabolism, 15-O PET, perfusion

Литература:
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Non-invasive measurement of oxygen metabolism. Part 1: Historical review and state of the art

Oxygen metabolism is a key factor in the life of a living organism. The article is the first part of a review of methods for measuring oxygen metabolism.Purpose. The aim of this review is to present an insight into the evolution of methods for measuring oxygen metabolism in a way from global to local measurement of brain perfusion. The role of the 15O isotope as the “gold standard” for measuring oxygen metabolism using positron emission tomography (PET) is described. We also provide a case report of brain tumor perfusion measurements from our clinic.Materials and methods. More than 200 Pubmed publications were studied with the keywords “positron emission tomography + O-15”. Relevant publications that do not contain these keywords or contain them in a different wording were also analyzed. A clinical case of a brain tumor perfusion using CT perfusion, MR-ASL and PET with H215O is provided.Results. The evolution of methods for measuring perfusion, oxygen extraction, and oxygen metabolism, is described. More than 50 papers are cited depicting key advances in measurement technologies. Examples of the use of PET with H215O in fundamental research and clinical practice are given.Conclusion. The obvious value of oxygen-isotope PET data is combined with the invasiveness (in some cases), technical complexity and high cost of the procedure. The second part of the review will be devoted to alternative methods for measuring oxygen metabolism, which are developing in the 21st century and which are intended for wide clinical use.

Keywords:
метаболизм кислорода, ПЭТ с 15-O, перфузия, oxygen metabolism, 15-O PET, perfusion