Rahmouni Alain, Luciani Alain, Itti Emmanuel
Department of Radiology, Centre Hospitalo-Universitaire Henri Mondor, 51 Avenue du Marechal de Lattre de Tassigny, 94010 Créteil, France.
Cancer Imaging. 2005 Nov 23;5 Spec No A(Spec No A):S102-6. doi: 10.1102/1470-7330.2005.0037.
Standardized CT-based criteria used for lymphoma staging and follow-up and the current role of FDG-PET are reviewed. The current CT-based International Workshop Criteria (IWC) still have the main advantage of representing standardized criteria allowing comparability of clinical trials in patients with lymphoma. However, functional imaging with integrated IWC and FDG-PET provide more accurate response assessment, and challenge the current paradigm. Although integration of FDG-PET in IWC requires validation in a prospective trial with a large number of patients, new long-term clinical and therapeutic trials probably need to be designed using these new and hopefully standardized functional criteria. This potentially could allow a more risk-adapted approach to the treatment of aggressive lymphoma: intensive (reinforced) therapies for non-responders vs. less intensive therapies for good responders with the main goal of improved clinical outcome.
本文回顾了用于淋巴瘤分期及随访的基于CT的标准化标准以及FDG-PET的当前作用。当前基于CT的国际研讨会标准（IWC）仍具有主要优势，即代表了标准化标准，使得淋巴瘤患者的临床试验具有可比性。然而，将IWC与FDG-PET相结合的功能成像可提供更准确的疗效评估，并对当前模式提出了挑战。尽管将FDG-PET纳入IWC需要在大量患者的前瞻性试验中进行验证，但可能需要设计新的长期临床和治疗试验，采用这些新的且有望标准化的功能标准。这有可能使侵袭性淋巴瘤的治疗采用更具风险适应性的方法：对无反应者采用强化（加强）治疗，而对反应良好者采用强度较低的治疗，主要目标是改善临床结局。
