Kuo Phillip H, McClennan Bruce L, Carlson Kacie, Wilson Lynn D, Edelson Richard L, Heald Peter W, Girardi Michael
Department of Diagnostic Radiology, Yale University School of Medicine, 333 Cedar Street, P.O. Box 208042, New Haven, CT, 06520-8042, USA.
Mol Imaging Biol. 2008 Mar-Apr;10(2):74-81. doi: 10.1007/s11307-007-0127-y. Epub 2008 Jan 15.
This comprehensive case series illustrates the findings on 2-deoxy-2-[F-18]fluoro-D: -glucose (FDG) positron-emission tomography/computed tomography (PET/CT) of patients with varying stages of cutaneous T-cell lymphoma (CTCL). Patients were imaged with full-body scanning using a General Electric Discovery ST 16-slice PET/CT machine. Patients were assessed by PET/CT for cutaneous, nodal, and solid organ FDG uptake, indicative of highly metabolically active (i.e., putatively malignant cells) disease, and comparisons were made to CT data alone and to the physical examination. Several key observations strongly suggested that information afforded by PET/CT scan may be valuable. Various cutaneous lesions, from thin subtle plaques to thick tumors, were revealed and corresponded accurately to the cutaneous examination. In the case of subcutaneous lesions, PET/CT outperformed physical exam. CT also provided the depth/thickness of lesions. The differing levels of FDG uptake in enlarged nodes found within an individual patient as well as among different patients may potentially distinguish reactive from malignant adenopathy. Additionally, lymph nodes that did not meet staging size criteria (e.g., were not > 1 cm) revealed increased metabolic activity and, therefore, could be targeted for subsequent monitoring or biopsy. In addition, PET/CT identified visceral involvement in cases with advanced disease. In summary, PET/CT can provide physiologic and anatomic information on the wide diversity of external and internal lesions in CTCL and, therefore, may have great potential for improving the staging and monitoring of response to therapy of cutaneous, nodal, and visceral disease.
这个综合性病例系列展示了不同分期皮肤T细胞淋巴瘤（CTCL）患者的2-脱氧-2-[F-18]氟-D-葡萄糖（FDG）正电子发射断层扫描/计算机断层扫描（PET/CT）结果。患者使用通用电气Discovery ST 16层PET/CT机进行全身扫描成像。通过PET/CT评估患者皮肤、淋巴结和实体器官的FDG摄取情况，以指示高代谢活性（即推测为恶性细胞）疾病，并与单独的CT数据及体格检查结果进行比较。几项关键观察结果强烈表明，PET/CT扫描提供的信息可能很有价值。从薄而细微的斑块到厚肿瘤等各种皮肤病变均被显示出来，且与皮肤检查结果精确对应。对于皮下病变，PET/CT比体格检查表现更优。CT还提供了病变的深度/厚度。在个体患者以及不同患者中发现的肿大淋巴结内FDG摄取水平的差异，可能潜在地区分反应性与恶性腺病。此外，未达到分期大小标准（例如直径不大于1厘米）的淋巴结显示出代谢活性增加，因此可作为后续监测或活检的目标。此外，PET/CT在晚期疾病病例中识别出内脏受累情况。总之，PET/CT可以提供关于CTCL中广泛多样的外部和内部病变的生理和解剖学信息，因此在改善皮肤、淋巴结和内脏疾病的分期及治疗反应监测方面可能具有巨大潜力。
