正电子发射断层扫描-计算机断层扫描（PET-CT）作为一种有效的成像方式，可用于实体器官移植后移植后淋巴增殖性疾病的分期和随访。

PET-CT as an effective imaging modality in the staging and follow-up of post-transplant lymphoproliferative disorder following solid organ transplantation.

机构信息

Department of Diagnostic Imaging, Serdang Hospital, Jalan Puchong, Serdang 43000, Malaysia.

出版信息

Singapore Med J. 2009 Dec;50(12):1189-95.

PMID:20087557

Abstract

INTRODUCTION

To establish the role of positron-emission tomography (PET)-computed tomography (CT) in post-transplant lymphoproliferative disorder (PTLD) patients, compared to conventional imaging (ultrasonography/CT/magnetic resonance imaging) in relation to its accuracy, sensitivity and specificity.

METHODS

30 patients (26 males and 4 females), with a median age of 49.5 (range 18-74) years, were retrospectively evaluated. In 29 cases, the diagnosis was confirmed by histopathology. Malignant lymphoma was detected in 20 cases, polymorphic lymphoproliferative disorder in six cases, multiple myeloma in two cases and Hodgkin's disease in one case. A total of 49 PET-CTs (13 studies for staging at diagnosis and 36 studies at follow-up as assessment post-therapy) were compared to conventional imaging. Imaging results in accordance with disease status were assessed at a median follow-up of 17.8 (range 1.5-42.2) months post-PET-CT.

RESULTS

In 41 of 49 examinations performed for staging and on follow-up, PET-CT and conventional imaging findings were concordant. Compared to conventional imaging, PET-CT showed comparable sensitivity (75 percent vs. 83 percent), similar specificity (100 percent in both modalities) and comparable accuracy (77 percent vs. 85 percent) during staging at diagnosis. PET-CT was found to be superior to conventional imaging modalities at follow-up, with greater sensitivity (100 percent vs. 81 percent), specificity (80 percent vs. 100 percent) and accuracy (97 percent vs. 83 percent).

CONCLUSION

PET-CT is an accurate diagnostic tool for staging and for the follow-up of PTLD patients. It represents a good alternative imaging method to avoid contrast-related nephrotoxicity in patients who often develop impaired renal function secondary to chronic immunosuppressive therapy. However, further studies are recommended before considering PET-CT as a routine diagnostic tool in PTLD.

摘要

简介

为了确定正电子发射断层扫描（PET）-计算机断层扫描（CT）在移植后淋巴组织增生性疾病（PTLD）患者中的作用，与常规成像（超声/CT/磁共振成像）相比，评估其准确性、敏感性和特异性。

方法

回顾性评估了 30 名患者（26 名男性和 4 名女性），中位年龄为 49.5 岁（范围 18-74 岁）。29 例经组织病理学证实诊断。20 例为恶性淋巴瘤，6 例为多形性淋巴组织增生性疾病，2 例为多发性骨髓瘤，1 例为霍奇金病。总共进行了 49 次 PET-CT（13 次用于诊断分期，36 次用于治疗后随访评估），并与常规成像进行了比较。在 PET-CT 后中位随访 17.8 个月（范围 1.5-42.2）时，评估了与疾病状态相符的影像学结果。

结果

在诊断分期和随访的 49 次检查中，41 次 PET-CT 和常规成像结果一致。与常规成像相比，在诊断分期时，PET-CT 的敏感性（75%对 83%）相似，特异性（两种方法均为 100%）相当，准确性（77%对 85%）相当。在随访时，PET-CT 优于常规成像方法，敏感性（100%对 81%）、特异性（80%对 100%）和准确性（97%对 83%）更高。