基于摄像头的FDG PET和67Ga SPECT在淋巴瘤评估中的比较研究

Camera-based FDG PET and 67Ga SPECT in evaluation of lymphoma: comparative study.

作者信息

Bar-Shalom Rachel, Yefremov Nikolai, Haim Nissim, Dann Eldad J, Epelbaum Ron, Keidar Zohar, Gaitini Diana, Frenkel Alex, Israel Ora

机构信息

Department of Nuclear Medicine, Rambam Medical Center and the Technion, Israel Institute of Technology, Bat Galim, Haifa 35254, Israel.

出版信息

Radiology. 2003 May;227(2):353-60. doi: 10.1148/radiol.2272020195. Epub 2003 Mar 13.

DOI:10.1148/radiol.2272020195

PMID:12637679

Abstract

PURPOSE

To compare gallium 67 (67Ga) scintigraphy and camera-based fluorodeoxyglucose (FDG) positron emission tomography (PET) in the evaluation of patients with lymphoma.

MATERIALS AND METHODS

The performance of 67Ga scintigraphy and camera-based FDG PET in the detection of lymphoma was retrospectively evaluated and compared in 84 patients with lymphoma, with 219 suspected sites of disease. Eighty-nine percent of patients were examined during or after treatment. Camera-based FDG PET was initiated by equivocal characterization of the status of disease based on clinical, radiologic, and 67Ga scintigraphic assessment. Findings of 67Ga scintigraphy and camera-based FDG PET were compared on a per-patient and per-site basis for the whole group, for histologic subtypes, and for anatomic locations. Comparison of sensitivity, specificity, and accuracy between the two modalities for detection of lymphoma was performed with the McNemar test.

RESULTS

There was a statistically significant difference in sensitivity, specificity, and accuracy of 67Ga scintigraphy and camera-based FDG PET at both patient- and site-based analysis. 67Ga scintigraphy helped to accurately define disease state in 63% of patients and in 33% of sites, compared with 83% and 87%, respectively, for camera-based FDG PET. For discordant findings between the two modalities, camera-based FDG PET findings were confirmed as true-positive in 71% and as true-negative in 92% of patients. Camera-based FDG PET had a significantly higher detection rate for both nodal and extranodal lymphoma sites. It provided accurate assessment of lymphoma involvement of the skeleton in 93% of sites compared with 29% for 67Ga scintigraphy and excluded active lymphoma in 10 67Ga-positive benign parahilar sites.

CONCLUSION

In this selected group of patients with lymphoma, camera-based FDG PET allowed a significantly more accurate definition of active disease compared with that allowed with 67Ga scintigraphy.

摘要

目的

比较镓67（67Ga）闪烁扫描术和基于相机的氟脱氧葡萄糖（FDG）正电子发射断层扫描（PET）在淋巴瘤患者评估中的应用。

材料与方法

回顾性评估并比较84例淋巴瘤患者（共219个疑似病灶部位）中67Ga闪烁扫描术和基于相机的FDG PET检测淋巴瘤的性能。89%的患者在治疗期间或治疗后接受检查。基于相机的FDG PET是在根据临床、放射学和67Ga闪烁扫描评估对疾病状态进行模糊定性后启动的。对整个组、组织学亚型和解剖部位，逐患者和逐部位比较67Ga闪烁扫描术和基于相机的FDG PET的结果。采用McNemar检验比较两种检查方法检测淋巴瘤的敏感性、特异性和准确性。

结果

在基于患者和基于部位的分析中，67Ga闪烁扫描术和基于相机的FDG PET在敏感性、特异性和准确性方面均存在统计学显著差异。67Ga闪烁扫描术有助于准确界定63%的患者和33%的病灶部位的疾病状态，而基于相机的FDG PET分别为83%和87%。对于两种检查方法不一致的结果，基于相机的FDG PET结果在71%的患者中被确认为真阳性，在92%的患者中被确认为真阴性。基于相机的FDG PET对淋巴结和结外淋巴瘤部位的检出率显著更高。它对93%的骨骼部位的淋巴瘤累及情况提供了准确评估，而67Ga闪烁扫描术为29%，并且在10个67Ga阳性的良性肺门旁部位排除了活动性淋巴瘤。