Shen Yeh-You, Kao Albert, Yen Ruoh-Fang
Department of Nuclear Medicine and PET Center, Shin Kong Wu Ho-Su Memorial Hospital, Taiwan.
Oncol Rep. 2002 Mar-Apr;9(2):321-5.
This study evaluates and compares the accuracy of positron emission tomography with 18F-fluoro-2-deoxyglucose (FDG-PET) and gallium-67 citrate (Ga-67) scintigraphy in identifying disease sites in patients with malignant lymphoma at initial diagnosis or relapse. Histology subgroups included low (n=5), intermediate (n=6), high-grade (n=5) non-Hodgkin's lymphoma (NHL) and Hodgkin's disease (HD) (n=14). Ann-Arbor staging included 7 patients in stage I, 8 in stage II, 9 in stage II, 6 in stage IV and 11 extra-nodal. In this study, before any therapy, 25 contemporaneous FDG-PET and Ga-67 scintigraphies were performed on patients with either NHL (16) or HD (14). One hundred and eleven sites of disease were correlated on a site-by-site basis in corresponding areas of FDG-PET and Ga-67 scintigraphy. Discordant FDG-PET and Ga-67 scintigraphic findings were correlated with CT/MRI and clinical evaluation. FDG-PET detected malignant lymphoma in 24/25 patients (sensitivity: 96.0%). There was a false-negative FDG-PET result in only 1 patient with low-grade gastric malignant lymphoma. Ga-67 scintigraphy detected malignant lymphoma in 18/25 patients (sensitivity: 72.0%). There were false-negative Ga-67 scintigraphic results in 4 cases with low-grade non-Hodgkin's lymphoma, 2 cases with bone or bone marrow involvement, and 3 smaller disease sites. FDG-PET upstaged 6 patients in whom Ga-67 scintigraphy detected disease sites partially. In imaging lymphoma prior to therapy, FDG-PET had a higher sensitivity and detected significantly more disease sites when compared with Ga-67 scintigraphy in the initial evaluation of this group of patients. Upstaging of patients with FDG-PET may result in a change in treatment strategy. However, evaluation of the final sensitivity, specificity and accuracy of these imaging modalities will need a further study with a larger patient number.
本研究评估并比较了18F-氟-2-脱氧葡萄糖正电子发射断层扫描（FDG-PET）和枸橼酸镓（Ga-67）闪烁扫描在初诊或复发的恶性淋巴瘤患者中识别疾病部位的准确性。组织学亚组包括低级别（n=5）、中级（n=6）、高级别（n=5）非霍奇金淋巴瘤（NHL）和霍奇金病（HD）（n=14）。Ann-Arbor分期包括I期7例、II期8例、II期9例、IV期6例以及11例结外病变患者。在本研究中，在任何治疗之前，对16例NHL患者和14例HD患者进行了25次同期FDG-PET和Ga-67闪烁扫描。在FDG-PET和Ga-67闪烁扫描的相应区域，对111个疾病部位进行了逐个部位的相关性分析。FDG-PET和Ga-67闪烁扫描结果不一致的情况与CT/MRI及临床评估进行了相关性分析。FDG-PET在24/25例患者中检测到恶性淋巴瘤（敏感性：96.0%）。仅1例低级别胃恶性淋巴瘤患者出现FDG-PET假阴性结果。Ga-67闪烁扫描在18/25例患者中检测到恶性淋巴瘤（敏感性：72.0%）。4例低级别非霍奇金淋巴瘤、2例有骨骼或骨髓受累以及3个较小疾病部位出现Ga-67闪烁扫描假阴性结果。FDG-PET使6例Ga-67闪烁扫描仅部分检测到疾病部位的患者分期上调。在治疗前对淋巴瘤进行成像时，在对这组患者的初始评估中，与Ga-67闪烁扫描相比，FDG-PET具有更高的敏感性，检测到的疾病部位显著更多。FDG-PET对患者分期上调可能会导致治疗策略的改变。然而，对这些成像模式的最终敏感性、特异性和准确性的评估将需要在更多患者中进行进一步研究。
