Zinzani P L, Magagnoli M, Franchi R, Zompatori M, Frezza G, Galassi R, Gherlinzoni F, Bendandi M, Albertini P, Monetti N, Tura S
Istituto di Ematologia e Oncologia Medica "Seràgnoli", Policlinico S.Orsola, Via Massarenti 9, 40138 Bologna, Italy.
Haematologica. 1999 Jul;84(7):604-7.
Therapy of both Hodgkin's disease (HD) and aggressive non-Hodgkin's lymphoma (NHL) with mediastinal presentation at the time of diagnosis is frequently followed by radiological detection of residual masses. Computed tomography (CT) scanning is generally unable to detect the differences between tumor tissue and fibrosis. Gallium-67-citrate single photon emission ((67)GaSPECT) can potentially differentiate residual active tumor tissue from fibrosis.
Seventy-five patients with HD or aggressive NHL presenting mediastinal involvement (64% with a bulky mass) were studied with CT and (67)GaSPECT at the end of combined modality therapy (chemo- and radiation therapy).
After treatment, 3/3 (100%) patients with positive (67)GaSPECT and negative CT scan relapsed while only 1/18 (6%) patients with both negative (67)GaSPECT and CT scan did so. At the same time, 54 patients had a positive restaging CT scan (abnormal mass < 10% of size of initial mass). Of these patients, 13 had a positive (67)GaSPECT, 10 of whom (77%) relapsed; 41 had a negative (67)GaSPECT of whom 5 (12%) relapsed. The 4-year actuarial relapse-free survival rate was 90% for those with negative scans compared with 23% for gallium-positive patients (p < 0.000000).
In lymphoma patients with mediastinal involvement, (67)GaSPECT should be considered, at least in patients who are CT positive, the imaging technique of choice for monitoring and differentiating the nature of any residual masses.
霍奇金淋巴瘤（HD）和侵袭性非霍奇金淋巴瘤（NHL）在诊断时若有纵隔表现，其治疗后常通过影像学检查发现残留肿块。计算机断层扫描（CT）通常无法区分肿瘤组织和纤维化。枸橼酸镓-67单光子发射断层扫描（（67）GaSPECT）有可能区分残留的活性肿瘤组织与纤维化。
对75例HD或侵袭性NHL且有纵隔受累（64%有巨大肿块）的患者在综合治疗（化疗和放疗）结束时进行CT和（67）GaSPECT检查。
治疗后，（67）GaSPECT阳性而CT扫描阴性的3/3（100%）患者复发，而（67）GaSPECT和CT扫描均阴性的仅1/18（6%）患者复发。同时，54例患者复查CT扫描阳性（异常肿块＜初始肿块大小的10%）。在这些患者中，13例（67）GaSPECT阳性，其中10例（77%）复发；41例（67）GaSPECT阴性，其中5例（12%）复发。扫描阴性患者的4年无病生存率为90%，而镓阳性患者为23%（p＜0.000000）。
在有纵隔受累的淋巴瘤患者中，应考虑进行（67）GaSPECT检查，至少对于CT阳性的患者，它是监测和鉴别任何残留肿块性质的首选成像技术。
