Basu S, Li G, Bural G, Alavi A
Division of Nuclear Medicine, Hospital of University of Pennsylvania, Philadelphia 19104, USA.
Acta Radiol. 2009 Mar;50(2):201-4. doi: 10.1080/02841850802620689.
A relative paucity of data exists in the literature with regard to the utility of fluorodeoxyglucose positron emission tomography (FDG-PET) imaging in the clinical management of patients with primary lymphoma of the thyroid gland (PTL).
To explore the FDG-PET imaging characteristics and their potential role in PTL, and to compare the results with anatomical imaging modalities.
Patients with thyroid lymphoma who had undergone whole-body FDG-PET or PET/computed tomography (CT) during their course of the disease were identified by examination of case records. PET scans were reevaluated, and maximum standardized uptake value (SUV(max)) was calculated and used as the semiquantitative measure of FDG uptake for this analysis. CT and/or magnetic resonance imaging (MRI) studies carried out within 1 week of FDG-PET scan and without any therapeutic intervention between the two studies were considered for the purpose of comparison. A total of six patients with 20 studies (14 FDG-PET and six PET/CT examinations) were identified following the criteria. All patients were female (age 16-83 years). Among these, five were proven to have PTL. Two patients had localized PTL (stage IE), two patients had associated regional nodal involvement (IIE), and one patient had associated nodal involvement on both sides of the diaphragm (IIIE) at presentation. Except for one patient with follicular B-cell lymphoma, all others were diffuse large-B-cell lymphoma (DLBCL) subtype.
Avid FDG uptake was observed in both cases of untreated PTL, with SUV(max) of 23 and 7.6, respectively. One patient showed focal FDG uptake (SUV(max) 6.7) in the thyroid in the setting of a responding abdominal non-Hodgkin lymphoma (NHL) and was subsequently proven as adenomatous nodule with Hurthle cell changes. Following successful therapy, SUV(max) declined consistently with improvement in disease status. In one patient, complete response was noted earlier by FDG-PET compared to CT. Disease recurrence was detected earlier by FDG-PET compared to CT in two patients with increased FDG activity in both thyroid lobes without any corresponding CT abnormality.
FDG-PET is a useful and sensitive modality for assessing disease activity in thyroid lymphoma. Its ability to detect disease recurrence was found to be superior compared to CT in two patients.
关于氟脱氧葡萄糖正电子发射断层扫描（FDG-PET）成像在甲状腺原发性淋巴瘤（PTL）患者临床管理中的应用，文献中的数据相对较少。
探讨FDG-PET成像特征及其在PTL中的潜在作用，并将结果与解剖成像方式进行比较。
通过检查病例记录，确定在疾病过程中接受过全身FDG-PET或PET/计算机断层扫描（CT）的甲状腺淋巴瘤患者。重新评估PET扫描，并计算最大标准化摄取值（SUV(max)），将其用作本次分析中FDG摄取的半定量指标。为了进行比较，考虑在FDG-PET扫描后1周内进行的CT和/或磁共振成像（MRI）研究，且两项研究之间未进行任何治疗干预。按照标准共确定了6例患者，进行了20次检查（14次FDG-PET和6次PET/CT检查）。所有患者均为女性（年龄16 - 83岁）。其中，5例被证实患有PTL。2例患者为局限性PTL（IE期），2例患者伴有区域淋巴结受累（IIE期），1例患者在初诊时双侧膈肌均有淋巴结受累（IIIE期）。除1例滤泡性B细胞淋巴瘤患者外，其他均为弥漫性大B细胞淋巴瘤（DLBCL）亚型。
在2例未经治疗的PTL病例中均观察到FDG摄取活跃，SUV(max)分别为23和7.6。1例患者在腹部非霍奇金淋巴瘤（NHL）缓解的情况下，甲状腺出现局灶性FDG摄取（SUV(max) 6.7），随后被证实为具有许特耳细胞改变的腺瘤性结节。成功治疗后，SUV(max)随着疾病状态的改善而持续下降。在1例患者中，与CT相比，FDG-PET更早发现完全缓解。在2例甲状腺两叶FDG活性增加而CT无相应异常的患者中，与CT相比，FDG-PET更早检测到疾病复发。
FDG-PET是评估甲状腺淋巴瘤疾病活动的一种有用且敏感的方式。在2例患者中发现其检测疾病复发的能力优于CT。
