Picardi Marco, Soricelli Andrea, Pane Fabrizio, Zeppa Pio, Nicolai Emanuele, De Laurentiis Michele, Grimaldi Francesco, Rotoli Bruno
Departments of Biochemistry and Medical Biotechnology, Histopathology, and Oncology, Federico II University Medical School, and Fondazione SDN, Naples, Italy.
Radiology. 2009 May;251(2):574-82. doi: 10.1148/radiol.2512081293.
To prospectively compare contrast material-enhanced harmonic compound ultrasonography (US), computed tomography (CT), and fluorine 18 fluorodeoxyglucose (FDG) positron emission tomography (PET) in detecting nodular infiltration in the spleen of patients with newly diagnosed Hodgkin lymphoma.
After institutional review board approval and informed consent, 100 consecutive patients with Hodgkin lymphoma during pretreatment staging were prospectively investigated for possible spleen involvement by comparing harmonic compound US (integrated with intravenous infusion of microbubbles in 33 patients) with CT and FDG PET. Findings indicative of malignant nodules with the imaging procedures were regarded as lymphoma infiltration; in case of discrepancy, response to treatment was regarded as evidence of lymphoma.
Malignant nodules were detected with CT in 13 patients, with FDG PET in 13 patients, and with contrast-enhanced harmonic compound US in 30 patients. Coincidental findings of malignancy with all three imaging techniques occurred in 13 patients; 17 patients had only US-detectable malignant nodules, which showed disappearance or relevant decrease after chemotherapy. Overall, the spleen had nodular infiltration in 30 patients (13 for imaging finding concordance; 17 for typical contrast-enhanced harmonic compound US findings and chemotherapy-related nodule size modifications). Thus, both CT and FDG PET provided false-negative results in 17 of 30 patients compared with contrast-enhanced harmonic compound US, the results of which translated into disease upstaging in 13 patients.
Harmonic compound US with contrast enhancement for the characterization of possible nodules provides a higher sensitivity than does CT or FDG PET in the detection of splenic involvement by Hodgkin lymphoma.
前瞻性比较对比剂增强谐波复合超声检查（US）、计算机断层扫描（CT）和氟-18氟脱氧葡萄糖（FDG）正电子发射断层扫描（PET）在新诊断的霍奇金淋巴瘤患者脾脏结节浸润检测中的应用。
经机构审查委员会批准并获得知情同意后，对100例连续的霍奇金淋巴瘤患者在预处理分期时进行前瞻性研究，通过将谐波复合超声（33例患者静脉注射微泡）与CT和FDG PET进行比较，以确定是否可能存在脾脏受累。影像学检查中提示恶性结节的发现被视为淋巴瘤浸润；若结果存在差异，则以治疗反应作为淋巴瘤的证据。
CT检测到13例患者有恶性结节，FDG PET检测到13例，对比剂增强谐波复合超声检测到30例。三种成像技术均检测到恶性结节的情况共13例；17例患者仅超声检测到恶性结节，化疗后这些结节消失或显著缩小。总体而言，30例患者的脾脏有结节浸润（13例为影像学检查结果一致；17例为典型的对比剂增强谐波复合超声检查结果及化疗相关的结节大小改变）。因此，与对比剂增强谐波复合超声相比，CT和FDG PET在30例患者中有17例出现假阴性结果，其中13例患者的结果导致疾病分期上调。
用于可能结节特征性分析的对比增强谐波复合超声在检测霍奇金淋巴瘤脾脏受累方面比CT或FDG PET具有更高的敏感性。
