Dong Aisheng, Cui Yong, Gao Lei, Wang Yang, Zuo Changjing, Yang Jijin
Department of Nuclear Medicine, Changhai Hospital, Second Military Medical University, 168 Changhai Road, Yangpu, Shanghai, 200433, China.
Abdom Imaging. 2014 Feb;39(1):175-86. doi: 10.1007/s00261-013-0041-5.
The aim of this study was to evaluate the pattern of FDG uptake in pancreatic non-Hodgkin's lymphoma (NHL) lesions.
The study included 9 consecutive patients with newly diagnosed NHL with pancreatic involvement who underwent an F-18 fluorodeoxyglucose positron emission tomography/computed tomography (F-18 FDG PET/CT) scan. The location, size, maximal standardized uptake value (SUVmax), and FDG uptake patterns of the pancreatic lesions were reviewed.
Four different patterns of FDG uptake could be distinguished in the affected pancreas corresponding to different types of lymphoma lesions. These included focal FDG uptake by distinct solitary lesions (5 patients), multiple foci of FDG uptake corresponding to separate lymphoma lesions (1 patient), segmental FDG uptake caused by lymphoma infiltration limited to a pancreatic segment (1 patient), and diffuse FDG uptake related to diffuse lymphomatous infiltration of the entire pancreas (2 patients). All types of lesions showed increased metabolic activity with maximal standardized uptake values (SUVmax) ranging from 7.4 to 26.5. On CT images, the segmental and diffuse patterns of FDG uptake correlated to segmental and diffuse pancreatic enlargement accordingly. All lesions showed isodensity or slight hypodensity in relation to pancreatic tissue. The pancreatic head was the most frequent site of involvement (8/9). Mildly dilated pancreatic duct was noted only in 2 patients.
The described patterns of FDG uptake and correlative CT findings may be helpful for a better characterization of NHL involving the pancreas and for differential diagnosis with other lesions, including pancreatic adenocarcinomas.
本研究旨在评估胰腺非霍奇金淋巴瘤(NHL)病灶中氟代脱氧葡萄糖(FDG)摄取模式。
本研究纳入9例新诊断为累及胰腺的NHL患者,这些患者均接受了F-18氟代脱氧葡萄糖正电子发射断层扫描/计算机断层扫描(F-18 FDG PET/CT)检查。回顾胰腺病灶的位置、大小、最大标准化摄取值(SUVmax)及FDG摄取模式。
在受累胰腺中可区分出四种不同的FDG摄取模式,分别对应不同类型的淋巴瘤病灶。这些模式包括由单个孤立病灶引起的局灶性FDG摄取(5例患者)、对应多个独立淋巴瘤病灶的多个FDG摄取灶(1例患者)、局限于胰腺某一段的淋巴瘤浸润导致的节段性FDG摄取(1例患者)以及与整个胰腺弥漫性淋巴瘤浸润相关的弥漫性FDG摄取(2例患者)。所有类型的病灶均显示代谢活性增加,最大标准化摄取值(SUVmax)范围为7.4至26.5。在CT图像上,FDG摄取的节段性和弥漫性模式分别相应地与胰腺节段性和弥漫性肿大相关。所有病灶相对于胰腺组织均表现为等密度或轻度低密度。胰头是最常受累的部位(8/9)。仅2例患者发现胰管轻度扩张。
所描述的FDG摄取模式及相关CT表现可能有助于更好地鉴别累及胰腺的NHL,并与其他病变(包括胰腺腺癌)进行鉴别诊断。