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18F-FDG PET/CT与CT的比较:淋巴瘤患者治疗后的诊断性能

Comparison of 18F-FDG Pet/CT and CT: diagnosis performance in lymphoma patient after treatment.

作者信息

Chiewvit Sunanta, Thephamongkhol Kullathorn, Ubolnuch Kritaya, Pooliam Julaporn, Phongsawat Nopparat, Chiewvit Pipat

出版信息

J Med Assoc Thai. 2014 Jan;97(1):85-94.

Abstract

OBJECTIVE

Retrospectively comparing 18F-FDG PET/CT and CT findings at the same anatomic locations in patients with lymphoma by using a combined PET/CT scanner and to analyze the lesions on both metabolic and anatomic bases to evaluate their sensitivity specificity positive predictive value (PPV), negative predictive value (NPV), and accuracy. We analyzed all studies, all patients, common cell type in this study such as diffuse large B cell lymphoma (DLBCL) and Hodgkin's lymphoma and indication of the study such as restaging for recurrence post-therapy and evaluate residual disease within two months after chemotherapy.

MATERIAL AND METHOD

Sixty-seven lymphoma patients were studied PET/CT between January 2007 and December 2012 in Siriraj Hospital. We excluded six patients due to no medial report in our hospital. Sixty-one patients (29 male, 32 female, mean age 46.6 +/- 17.7 years, range 8-75) with NHL and with HL) were analyzed for the result of dual-modality PET/CT They underwent 77 18F-FDG PET/CT studies for restaging, for recurrence post-therapy based on 41 studies and evaluation of residual disease within two months after chemotherapy in 36 studies.

RESULTS

The statistical parameters of 18F-FDG PET/CT imaging of lymphoma patients after treatment show significantly better specificity than CT and insignificant high accuracy for all studies, all patients, histology of DLBCL, indication of evaluation of active lymphoma within two months after chemotherapy. The 18F-FDG PET/CT parameters of accuracy and PPV are higher than CT without statistical significance. The 18F-FDG PET/CT is not significantly better than CT for histology of Hodgkin's lymphoma and indication of restaging for recurrence post-therapy Nevertheless, the 18F-FDG PET/CT shows slightly improved specificity PPV and accuracy than CT The sensitivity of CT in this study is high and may be from most of our cases selected post-treatment lymphoma that had a residual mass after treatment. Therefore, the sensitivity of PET scan is not significantly higher when compared with CT scan.

CONCLUSION

The PET/CT is better than CT for post-treatment lymphoma patient particularly for cell type of DLBCL and indication for evaluation of active lymphoma within two months after chemotherapy.

摘要

目的

通过使用PET/CT联合扫描仪,回顾性比较淋巴瘤患者同一解剖部位的18F-FDG PET/CT和CT检查结果,并从代谢和解剖学基础上分析病变,以评估其敏感性、特异性、阳性预测值(PPV)、阴性预测值(NPV)和准确性。我们分析了本研究中的所有研究、所有患者、常见细胞类型(如弥漫性大B细胞淋巴瘤(DLBCL)和霍奇金淋巴瘤)以及研究指征(如治疗后复发的再分期和化疗后两个月内评估残留疾病)。

材料与方法

2007年1月至2012年12月期间,在诗里拉吉医院对67例淋巴瘤患者进行了PET/CT检查。因我院无相关医学报告,我们排除了6例患者。对61例患者(29例男性,32例女性,平均年龄46.6±17.7岁,范围8-75岁)进行了非霍奇金淋巴瘤(NHL)和霍奇金淋巴瘤(HL)的双模态PET/CT检查结果分析。他们接受了77次18F-FDG PET/CT检查,其中41次用于再分期、治疗后复发检查,36次用于化疗后两个月内残留疾病评估。

结果

治疗后淋巴瘤患者18F-FDG PET/CT成像的统计参数显示,对于所有研究、所有患者、DLBCL组织学类型以及化疗后两个月内活动性淋巴瘤评估指征,其特异性显著优于CT,准确性虽高但无统计学意义。18F-FDG PET/CT的准确性和PPV参数高于CT,但无统计学意义。对于霍奇金淋巴瘤组织学类型和治疗后复发再分期指征,18F-FDG PET/CT并不显著优于CT。然而,18F-FDG PET/CT的特异性、PPV和准确性比CT略有提高。本研究中CT的敏感性较高,这可能是因为我们选择的大多数病例为治疗后有残留肿块的淋巴瘤患者。因此,与CT扫描相比,PET扫描的敏感性没有显著提高。

结论

PET/CT对于治疗后的淋巴瘤患者优于CT,特别是对于DLBCL细胞类型和化疗后两个月内活动性淋巴瘤评估指征。

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