Bangerter M, Kotzerke J, Griesshammer M, Elsner K, Reske S N, Bergmann L
Department of Medicine III, University of Ulm, Germany.
Acta Oncol. 1999;38(6):799-804. doi: 10.1080/028418699432969.
The purpose of this retrospective study was to evaluate the accuracy of positron emission tomography (PET) using 18-F-fluorodeoxyglucose (FDG) in predicting lymphomatous involvement in the hilar and mediastinal regions in the staging and follow-up of patients with malignant lymphoma. One hundred forty-seven thoracic PET studies in 89 consecutive lymphoma patients were reviewed. Static FDG-PET imaging was performed following application of 270 MBq FDG (mean). Results of FDG-PET were compared with the findings of computed tomography (CT) in all patients and clinical follow-up examination. Eighty-nine of 147 (60%) PET studies showed no FDG uptake in the hilar or mediastinal regions, while 58 (40%) studies did detect FDG uptake in these regions. In 52 of 58 abnormal studies (90%), lymphomatous involvement of the hilar and/or mediastinal regions seen by CT was present. In the remaining six abnormal PET studies (10%), FDG uptake was considered as false-positive because of missing lesions on corresponding CT scans. In four patients false-positive FDG uptake was observed before treatment, in two patients after completion of therapy. In these two patients FDG uptake after therapy was caused by thymus hyperplasia. The remaining four cases before treatment remained unresolved. Sensitivity of FDG-PET was 96%, specificity 94%, positive predictive value 90%, and negative predictive value 98%, respectively. The present study suggests that FDG-PET has potential value in predicting lymphomatous involvement in the hilar and mediastinal regions. FDG-PET may obviate invasive diagnostic procedures in patients with lymphoma.
本回顾性研究的目的是评估使用18-F-氟脱氧葡萄糖（FDG）的正电子发射断层扫描（PET）在恶性淋巴瘤患者分期和随访中预测肺门和纵隔区域淋巴瘤累及情况的准确性。回顾了89例连续淋巴瘤患者的147例胸部PET研究。平均应用270 MBq FDG后进行静态FDG-PET成像。将所有患者的FDG-PET结果与计算机断层扫描（CT）结果及临床随访检查结果进行比较。147例PET研究中有89例（60%）在肺门或纵隔区域未显示FDG摄取，而58例（40%）研究在这些区域检测到FDG摄取。在58例异常研究中的52例（90%）中，CT显示存在肺门和/或纵隔区域的淋巴瘤累及。在其余6例异常PET研究（10%）中，由于相应CT扫描上未发现病变，FDG摄取被认为是假阳性。4例患者在治疗前观察到假阳性FDG摄取，2例患者在治疗完成后观察到。在这2例患者中，治疗后的FDG摄取是由胸腺增生引起的。其余4例治疗前的病例仍未明确。FDG-PET的敏感性分别为96%、特异性为94%、阳性预测值为90%、阴性预测值为98%。本研究表明，FDG-PET在预测肺门和纵隔区域淋巴瘤累及方面具有潜在价值。FDG-PET可能避免淋巴瘤患者进行侵入性诊断程序。
