Fuertes Silvia, Setoain Xavier, López-Guillermo Armando, Montserrat Emilio, Fuster David, Paredes Pilar, Lomeña Francisco, Pons Francesca
Servicio de Medicina Nuclear, Hospital Clínic de Barcelona, Villaroel 170, Barcelona, Spain.
Med Clin (Barc). 2007 Nov 17;129(18):688-93. doi: 10.1157/13112510.
The aim of this study was to evaluate the role of positron emission tomography/computed tomography (PET/CT) in improving the staging and changing the management of aggressive lymphoma patients in comparison with the conventional imaging modalities (CT, and 67Ga scintigraphy).
Forty consecutive patients with diffuse large B-cell non Hodgkin lymphoma, were prospectively evaluated. All 40 patients underwent a whole body FDG PET/CT and conventional staging techniques (chest and abdomen CT, 67Ga scintigraphy) were studied before therapy. Sixty minutes after the intravenous administration of 370 MBq FDG, a whole body PET/CT was acquired. We hypothesize that PET/CT improves the diagnostic staging of lymphoma and changes the clinical management of patients.
PET/CT and CT were concordant in 28 patients (65%). However, PET/CT detected more lesions than CT in 11 patients (27.5%). Only in one patient, CT revealed more extensive disease than PET/CT. Additional information of PET/CT had lead to a change in staging (upstaging) in 6 patients (15%), in turn leading to a change in treatment strategy in 1 patient. PET/CT and 67Ga scintigraphy were concordant in 23 patients (60.5%). PET/CT detected more lesions than 67Ga scintigraphy in 14 patients (42%). PET/CT results changed staging (upstaging) in 4 patients (15%), leading to a change of treatment strategy in one patient.
The impression is that PET/CT detected more lesions than conventional examination, but this rarely translates into changes of staging and treatment strategy in aggressive lymphoma.
本研究旨在评估正电子发射断层扫描/计算机断层扫描（PET/CT）与传统成像方式（CT和67镓闪烁扫描）相比，在改善侵袭性淋巴瘤患者分期及改变其治疗管理方面的作用。
对连续40例弥漫性大B细胞非霍奇金淋巴瘤患者进行前瞻性评估。所有40例患者均接受了全身氟代脱氧葡萄糖（FDG）PET/CT检查，且在治疗前研究了传统分期技术（胸部和腹部CT、67镓闪烁扫描）。静脉注射370兆贝可FDG 60分钟后，进行全身PET/CT检查。我们假设PET/CT可改善淋巴瘤的诊断分期并改变患者的临床管理。
PET/CT与CT结果一致的患者有28例（65%）。然而，PET/CT在11例患者（27.5%）中检测到的病灶比CT更多。仅1例患者中，CT显示的病变范围比PET/CT更广泛。PET/CT的额外信息导致6例患者（15%）分期改变（分期上调），进而使1例患者的治疗策略发生改变。PET/CT与67镓闪烁扫描结果一致的患者有23例（60.5%）。PET/CT在14例患者（42%）中检测到的病灶比67镓闪烁扫描更多。PET/CT结果使4例患者（15%）分期改变（分期上调），导致1例患者的治疗策略改变。
PET/CT检测到的病灶比传统检查更多，但这很少转化为侵袭性淋巴瘤分期和治疗策略的改变。
