Zhou Li-Li, Wang Chun, Zhao Jin-Hua, Yan Shi-Ke, Gao Yan-Rong, Cai Qi, Jiang Jie-Ling, Wan Li-Ping, Yang Juan, Wei Ju, Zhao Min, Bai Hai-Tao
Department of Hematology, Shanghai Jiaotong University Affiliated Shanghai First People's Hospital, Shanghai 200080, China.
Zhonghua Xue Ye Xue Za Zhi. 2009 Apr;30(4):233-6.
To evaluate the application of 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) to the staging and detecting residual masses of lymphoma.
The clinical data of 179 patients with lymphoma were analyzed retrospectively. The results of FDG-PET, computed tomography (CT) and bone marrow biopsy (BMB) were compared for detection of lymph node/extranodal lymphoid tissue and bone marrow infiltration. Therapeutic efficiency was assessed by International Workshop Criteria (IWC) and Revised Integrated International Workshop Criteria (IWC + PET).
In the detection of 286 disease focuses in 98 patients before chemotherapy, the sensitivities of FDG-PET and CT were 73% and 70% (P < 0.01) in detecting nodal focus,and 87% and 45% (P < 0.01) in detecting extranodal lymphoma respectively. In detection of 104 lesions in 81 patients after chemotherapy,the sensitivities of FDG-PET and CT were 81% and 55% respectively (P < 0.01), and the specificities were 68% and 33%, respectively (P < 0.01) in detecting residual masses. According to IWC criteria, 33 patients achieved complete response/unconfirmed complete response (CR/CRu) , and 8 (24%) relapsed. Patients with PET-positive residual masses had a relapse rate of 40%, whereas only 21% of those with no such masses relapsed. Based on IWC + PET criteria, 25 patients achieved CR, with a relapse rate of 20%. Both FDG-PET and BMB produced positive results in 133/179 (74%) patients. Twenty-two patients with positive FDG-PET results were not detected by BMB. The sensitivities and specificities of FDG-PET for BM infiltration were 52% and 83%, respectively.
FDG-PET is a high sensitive and specific technique in staging and detecting residual masses of lymphoma.
评估18F-氟脱氧葡萄糖正电子发射断层扫描（FDG-PET）在淋巴瘤分期及检测残留肿块中的应用。
回顾性分析179例淋巴瘤患者的临床资料。比较FDG-PET、计算机断层扫描（CT）及骨髓活检（BMB）检测淋巴结/结外淋巴组织及骨髓浸润的结果。采用国际研讨会标准（IWC）及修订后的综合国际研讨会标准（IWC + PET）评估治疗效果。
在化疗前98例患者的286个病灶检测中，FDG-PET和CT检测淋巴结病灶的敏感度分别为73%和70%（P < 0.01），检测结外淋巴瘤的敏感度分别为87%和45%（P < 0.01）。在化疗后81例患者的104个病灶检测中，FDG-PET和CT检测残留肿块的敏感度分别为81%和55%（P < 0.01），特异度分别为68%和33%（P < 0.01）。根据IWC标准，33例患者达到完全缓解/未确认完全缓解（CR/CRu），8例（24%）复发。PET阳性残留肿块患者的复发率为40%，而无此类肿块患者的复发率仅为21%。基于IWC + PET标准，25例患者达到CR，复发率为20%。FDG-PET和BMB在133/179（74%）例患者中均呈阳性结果。22例FDG-PET结果阳性的患者未被BMB检测到。FDG-PET检测骨髓浸润的敏感度和特异度分别为52%和83%。
FDG-PET是淋巴瘤分期及检测残留肿块的一种高敏感且特异的技术。
