Nuclear Medicine Department, Eugène Marquis Anticancer Centre, Rennes, France.
Eur J Nucl Med Mol Imaging. 2010 Dec;37(12):2307-14. doi: 10.1007/s00259-010-1539-5. Epub 2010 Aug 18.
The aim of this study was to assess the usefulness of positron emission tomography/computed tomography in staging, prognosis evaluation and restaging of patients with follicular lymphoma.
A retrospective study was performed on 45 patients with untreated biopsy-proven follicular lymphoma who underwent 18F-fluorodeoxyglucose PET/CT (FDG PET/CT) and CT before and after chemoimmunotherapy induction treatment (rituximab combined with cyclophosphamide, doxorubicin, vincristine and prednisone).
PET/CT detected more nodal (+51%) and extranodal (+89%) lesions than CT. PET/CT modified Ann Arbor staging in eight patients (18%). Five patients (11%) initially considered as being early stage (I/II) were eventually treated as advanced stage (III/IV). In this study, an initial PET/CT prognostic score was significantly more accurate than the Follicular Lymphoma International Prognostic Index score in identifying patients with poor prognosis (i.e. patients with incomplete therapeutic response or early relapse). The accuracy of PET/CT for therapeutic response assessment was higher than that of CT (0.97 vs 0.64), especially due to its ability to identify inactive residual masses. In addition, post-treatment PET/CT was able to predict patients' outcomes. The median progression-free survival was 48 months in the PET/CT-negative group as compared with 17.2 months for the group with residual uptake (p<10(-4)).
FDG PET/CT is useful for staging and assessing the prognosis and therapeutic response of patients with follicular lymphoma.
本研究旨在评估正电子发射断层扫描/计算机断层扫描（PET/CT）在滤泡性淋巴瘤患者分期、预后评估和再分期中的作用。
对 45 例未经治疗的活检证实为滤泡性淋巴瘤患者进行了回顾性研究，这些患者在化疗免疫诱导治疗（利妥昔单抗联合环磷酰胺、多柔比星、长春新碱和泼尼松）前后均接受了 18F-氟脱氧葡萄糖 PET/CT（FDG PET/CT）和 CT 检查。
PET/CT 比 CT 检测到更多的淋巴结（+51%）和结外（+89%）病灶。PET/CT 在 8 例患者（18%）中修改了 Ann Arbor 分期。5 例（11%）最初被认为处于早期（I/II 期）的患者最终被治疗为晚期（III/IV 期）。在这项研究中，初始 PET/CT 预后评分在识别预后不良的患者（即治疗反应不完全或早期复发的患者）方面明显比滤泡性淋巴瘤国际预后指数评分更准确。PET/CT 对治疗反应评估的准确性高于 CT（0.97 比 0.64），尤其是因为其能够识别无活性的残留肿块。此外，治疗后 PET/CT 能够预测患者的结局。PET/CT 阴性组的中位无进展生存期为 48 个月，而残留摄取组为 17.2 个月（p<10(-4)）。
FDG PET/CT 对滤泡性淋巴瘤患者的分期、预后评估和治疗反应评估均有帮助。
