利用F-18 FDG符合探测正电子发射断层扫描对恶性淋巴瘤进行成像。

Imaging of malignant lymphomas with F-18 FDG coincidence detection positron emission tomography.

作者信息

Hwang K, Park C H, Kim H C, Kim H, Yoon S, Pai M, Kim S

机构信息

Department of Nuclear Medicine, School of Medicine, Ajou University, Suwon, Korea.

出版信息

Clin Nucl Med. 2000 Oct;25(10):789-95. doi: 10.1097/00003072-200010000-00008.

DOI:10.1097/00003072-200010000-00008

PMID:11043718

Abstract

PURPOSE

The authors evaluated the utility of F-18 fluorodeoxyglucose (FDG) coincidence detection (CoDe) positron emission tomography (PET) for staging, post-treatment evaluation, and follow-up assessment of patients with malignant lymphomas.

MATERIALS AND METHODS

Fifty-eight patients with histologically proved malignant lymphomas (4 Hodgkin's disease, 54 non-Hodgkin's lymphoma) underwent CoDe PET using F-18 FDG. CoDe PET was performed using a dual-head gamma camera equipped with coincidence detection circuitry. Of the 87 CoDe PET studies, 26 were performed for staging, 38 for post-treatment evaluation, and 23 for follow-up evaluation of recurrence. The entire trunk, from the cervical to the inguinal regions, or selected regions were scanned with the patient in the supine position. No attenuation correction was made and reconstruction was performed using filtered back-projection rather than iterative reconstruction. CoDe PET findings were compared with corresponding results of computed tomographic (CT) and magnetic resonance imaging (MRI), tissue biopsy, or clinical follow-up.

RESULTS

For staging, 52 sites were positive on CoDe PET or CT-MRI. CoDe PET detected 49 sites (94%), and CT-MRI showed 47 sites (90%). CoDe PET detected five more lymphomatous lesions and missed three lesions. For post-treatment evaluation, CoDe PET showed a positive predictive value of 100% and a negative predictive value of 83%, but the validated cases numbered only 11. For follow-up for recurrence, CoDe PET had a negative predictive value of 90%, but frequent false-positive findings were noted in the head and neck region as a result of underlying inflammatory changes.

CONCLUSIONS

For staging, FDG CoDe PET alone without attenuation correction is not sensitive enough to be used as an independent imaging method, especially for small abdominal lesions. However, it appears to be an accurate method for assessing residual disease and for patient follow-up.

摘要

目的

作者评估了F-18氟脱氧葡萄糖（FDG）符合探测（CoDe）正电子发射断层扫描（PET）在恶性淋巴瘤患者分期、治疗后评估及随访中的应用价值。

材料与方法

58例经组织学证实的恶性淋巴瘤患者（4例霍奇金病，54例非霍奇金淋巴瘤）接受了使用F-18 FDG的CoDe PET检查。CoDe PET使用配备符合探测电路的双头γ相机进行。在87例CoDe PET检查中，26例用于分期，38例用于治疗后评估，23例用于复发的随访评估。患者仰卧位扫描整个躯干，从颈部到腹股沟区域，或扫描选定区域。未进行衰减校正，采用滤波反投影而非迭代重建进行图像重建。将CoDe PET检查结果与计算机断层扫描（CT）、磁共振成像（MRI）、组织活检或临床随访的相应结果进行比较。

结果

在分期方面，CoDe PET或CT-MRI上有52个部位呈阳性。CoDe PET检测到49个部位（94%），CT-MRI显示47个部位（90%）。CoDe PET多检测到5个淋巴瘤病灶，漏检3个病灶。在治疗后评估中，CoDe PET的阳性预测值为100%，阴性预测值为83%，但经证实的病例仅11例。在复发随访中，CoDe PET的阴性预测值为90%，但由于潜在的炎症改变，头颈部区域出现频繁的假阳性结果。