Najjar F, Hustinx R, Jerusalem G, Fillet G, Rigo P
Divisions of Nuclear Medicine and Onco-Hematology, University Hospital, Liege, Belgium.
Cancer Biother Radiopharm. 2001 Aug;16(4):297-304. doi: 10.1089/108497801753131372.
Although positron emission tomography (PET) imaging is now recognized as a useful tool for staging intermediate and high-grade non-Hodgkin's lymphoma (NHL), few data are available regarding its accuracy in low grade NHL. We therefore studied 36 patients with histologically proven low-grade NHL. Whole-body 2-(fluorine-18) fluoro-2-deoxy-D-glucose (FDG) PET was performed at the time of initial diagnosis (n = 21) or for disease recurrence (n = 15) prior to any treatment. PET results were compared to those of physical examination and computed tomography (CT). PET studies were read without knowledge of any clinical data. Any focus of increased activity was described and given a probability of malignancy using a 5 point-scale (0: normal to 4: definitively malignant). An individual biopsy was available for a total of 31 lesions. The sensitivity and specificity were 87% and 100% for FDG-PET, 100% and 100% for physical examination and 90% and 100% for CT respectively. In addition, 42 of 97 peripheral lymph node lesions observed by FDG-PET were clinically undetected, whereas the physical examination detected 23 additional nodal lesions. PET and CT both indicated 12 extranodal lymphomatous localizations. FDG-PET showed 7 additional extranodal lesions while 5 additional unconfirmed lesions were observed on CT. Regarding bone marrow infiltration, PET and biopsy were concordant in 24 patients with 11 true positive (TP) and 13 true negative (TN). However PET was FN in 11 patients and no biopsy was performed in one patient. The combination PET/CT/physical examination seems to be more sensitive than the conventional approach for staging low grade NHL. Its sensitivity however is unacceptably low for diagnosing bone marrow infiltration.
尽管正电子发射断层扫描（PET）成像目前被认为是用于中、高度非霍奇金淋巴瘤（NHL）分期的有用工具，但关于其在低度NHL中的准确性的数据却很少。因此，我们研究了36例经组织学证实为低度NHL的患者。在初始诊断时（n = 21）或疾病复发时（n = 15）且在任何治疗之前进行了全身2-（氟-18）氟-2-脱氧-D-葡萄糖（FDG）PET检查。将PET结果与体格检查和计算机断层扫描（CT）的结果进行比较。PET研究在不了解任何临床数据的情况下进行判读。描述任何活性增加的病灶，并使用5分制（0：正常至4：明确为恶性）给出恶性概率。共有31个病灶进行了个体活检。FDG-PET的敏感性和特异性分别为87%和100%，体格检查为100%和100%，CT为90%和100%。此外，FDG-PET观察到的97个外周淋巴结病灶中有42个在临床上未被发现，而体格检查发现了另外23个淋巴结病灶。PET和CT均显示12个结外淋巴瘤定位。FDG-PET显示了另外7个结外病灶，而CT上观察到另外5个未经证实的病灶。关于骨髓浸润，PET和活检在24例患者中结果一致，其中11例真阳性（TP）和13例真阴性（TN）。然而，PET在11例患者中为假阴性（FN），1例患者未进行活检。PET/CT/体格检查相结合对于低度NHL分期似乎比传统方法更敏感。然而，其对于诊断骨髓浸润的敏感性低得令人无法接受。
