García Vicente A M, Bellón Guardia M, Soriano Castrejón A, Calle Primo C, Cordero García J M, Palomar Muñoz A, Pilkington Woll J P, Talavera Rubio M P, Hernández Ruiz B
Servicio de Medicina Nuclear, Hospital General Universitario, Ciudad Real, España.
Rev Esp Med Nucl Imagen Mol. 2012 Jan-Feb;31(1):22-7. doi: 10.1016/j.remn.2011.04.009. Epub 2011 Jul 13.
To assess the diagnostic accuracy of (18)F-FDG-PET/CT in detecting asymptomatic recurrences in patients with lymphoma. To define uptake patterns of recurrence indicative of recurrence.
Those patients with lymphoma who fulfilled the following inclusion criteria of clinical complete remission and negative PET/CT study were included retrospectively and longitudinally. Conventional surveillance of these patients was performed only by (18)F-FDG PET/CT following a standardized procedure. Pathologic locations (supra- and infradiaphragmatic) and their character (single or multiple) were analyzed in order to determine reliable metabolic patterns of recurrence. The final diagnosis was established by histopathological analysis or clinical follow-up greater than 8 months.
A total of 199 explorations belonging to 106 patients with lymphoma were included. Of these patients, 59 had Hodgkin's lymphoma and 47 non-Hodgkin's lymphoma. There was suspicion of relapse from the metabolic point of view in 27 of the PET/CT scans. Of these, 14 (10 patients) were false positive (FP), and 13 (8 patients) true positive. The remaining studies were true negative, no false negatives being detected. The pattern most frequently related to recurrence was infradiaphragmatic lymph node involvement while most of the FP had isolated supradiaphragmatic involvement. Sensitivity, specificity, PPV, NPV and diagnostic accuracy of PET/CT parameters for the study were 100%, 92%, 48%, 100% and 93%, respectively.
(18)F-FDG-PET/CT is a sensitive technique in the detection of asymptomatic recurrences in patients with lymphoma during their follow-up. Multiple character and infradiaphragmatic locations were the patterns that best correlated to the diagnosis of recurrence.
评估¹⁸F-FDG-PET/CT在检测淋巴瘤患者无症状复发方面的诊断准确性。确定提示复发的复发摄取模式。
回顾性纵向纳入符合临床完全缓解且PET/CT检查阴性以下纳入标准的淋巴瘤患者。这些患者仅通过¹⁸F-FDG PET/CT按照标准化程序进行常规监测。分析病理位置（膈上和膈下）及其特征（单发或多发），以确定可靠的复发代谢模式。最终诊断通过组织病理学分析或大于8个月的临床随访确定。
共纳入106例淋巴瘤患者的199次检查。其中，59例为霍奇金淋巴瘤，47例为非霍奇金淋巴瘤。在27次PET/CT扫描中，从代谢角度怀疑有复发。其中，14例（10例患者）为假阳性（FP），13例（8例患者）为真阳性。其余检查为真阴性，未检测到假阴性。与复发最常相关的模式是膈下淋巴结受累，而大多数FP为孤立的膈上受累。该研究中PET/CT参数的敏感性、特异性、阳性预测值、阴性预测值和诊断准确性分别为100%、92%、48%、100%和93%。
¹⁸F-FDG-PET/CT是检测淋巴瘤患者随访期间无症状复发的敏感技术。多发特征和膈下位置是与复发诊断相关性最佳的模式。
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