Hanaoka Kohei, Hosono Makoto, Usami Kimio, Tatsumi Yoichi, Yamazoe Yuzuru, Komeya Yoshihiro, Tsuchiya Norio, Ishii Kazunari, Sumita Mitsugu
Department of Radiology, Kinki University Hospital, Osaka-Sayama, Japan.
Nucl Med Commun. 2011 Aug;32(8):678-83. doi: 10.1097/MNM.0b013e328346b32a.
To clarify the change in the fluorodeoxyglucose (FDG) uptake by the bone marrow over time after administration of granulocyte colony-stimulating factor (G-CSF), we evaluated the correlation between the interval from the last day of administration of G-CSF to positron emission tomography/computed tomography (PET/CT) study and spinal bone marrow accumulation in patients with non-Hodgkin's lymphoma.
A total of 127 patients with confirmed non-Hodgkin's lymphoma who underwent FDG PET within 60 days from the last administration of G-CSF were retrospectively reviewed. Thirty age-matched and sex-matched healthy controls were also included to evaluate physiological FDG uptake. PET/CT examinations were retrospectively reviewed, and maximum standardized uptake value (SUVmax) was measured by placing volumetric regions of interest over each thoracic and lumbar vertebra on PET images referring to CT images. Bone marrow SUV was defined as the mean SUVmax of the vertebra. The correlation between the interval after G-CSF and the bone marrow SUV was plotted and analyzed with polynomial approximation.
In controls, physiological bone marrow SUV of the spine was determined. In patients with lymphoma, bone marrow SUV decreased over time and reached a plateau at about 14 days after G-CSF administration, and this was higher by 5% than the plateau at 10 days. SUV declined to the 'physiological range', that is, mean+1 standard deviation of patients, at about 7 days.
For a PET/CT study, an interval of 10 days after G-CSF administration is recommended to minimize the influence of G-CSF on the bone marrow when evaluating treatment response in patients with non-Hodgkin's lymphoma.
为了阐明粒细胞集落刺激因子（G-CSF）给药后骨髓中氟脱氧葡萄糖（FDG）摄取随时间的变化，我们评估了从G-CSF给药最后一天到正电子发射断层扫描/计算机断层扫描（PET/CT）检查的时间间隔与非霍奇金淋巴瘤患者脊柱骨髓摄取之间的相关性。
回顾性分析了127例确诊为非霍奇金淋巴瘤且在最后一次使用G-CSF后60天内接受FDG PET检查的患者。还纳入了30例年龄和性别匹配的健康对照者以评估生理性FDG摄取。对PET/CT检查进行回顾性分析，并通过参考CT图像在PET图像上对每个胸椎和腰椎放置体积感兴趣区来测量最大标准化摄取值（SUVmax）。骨髓SUV定义为椎体的平均SUVmax。绘制G-CSF给药后时间间隔与骨髓SUV之间的相关性，并采用多项式近似法进行分析。
在对照组中，确定了脊柱生理性骨髓SUV。在淋巴瘤患者中，骨髓SUV随时间下降，并在G-CSF给药后约14天达到平台期，且该平台期比10天时高5%。SUV在约7天时降至“生理范围”，即患者的平均值+1个标准差。
对于PET/CT研究，在评估非霍奇金淋巴瘤患者的治疗反应时，建议在G-CSF给药后间隔10天，以尽量减少G-CSF对骨髓的影响。
