Bednaruk-Młyński Ewa, Pieńkowska Joanna, Skórzak Adam, Małkowski Bogdan, Kulikowski Waldemar, Subocz Edyta, Dzietczenia Justyna, Zalewska Marta, Leśniewski-Kmak Krzysztof, Zaucha Renata, Wróbel Tomasz, Zaucha Jan M
Department of Oncology and Radiotherapy, Medical University of Gdansk , Gdansk , Poland.
Leuk Lymphoma. 2015 Feb;56(2):377-82. doi: 10.3109/10428194.2014.919635. Epub 2014 Jun 27.
We compared initial computed tomography (CT) and positron emission tomography (PET)/CT in 96 patients with Hodgkin lymphoma (HL), assessing the role of baseline PET/CT in stage migration and treatment selection. The number of patients with stage I, II, III and IV disease based on CT versus PET/CT was: 5 vs. 7, 49 vs. 37, 28 vs. 22 and 14 vs. 30, respectively. In 33 (34%) patients, PET/CT changed HL stage: 27 (28%) were upstaged and six (6.3%) downstaged. Upstaging was caused by detection of new extranodal involvements (47 sites in 26 patients): bone marrow (10 patients), spleen (five patients) and lung (two patients). In nine patients≥2 further coexisting locations were detected. Downstaging resulted from the absence of fluorodeoxyglucose (18F-FDG) uptake in enlarged nodes (>15 mm) in the abdomen and pelvis. PET/CT modified HL stage in 34% of patients leading to treatment modification in the majority. Our results indicate that PET/CT should be mandatory in the initial staging of HL.
我们对96例霍奇金淋巴瘤（HL）患者的初始计算机断层扫描（CT）和正电子发射断层扫描（PET）/CT进行了比较，评估基线PET/CT在分期迁移和治疗选择中的作用。基于CT与PET/CT的I、II、III和IV期疾病患者数量分别为：5例对7例、49例对37例、28例对22例和14例对30例。在33例（34%）患者中，PET/CT改变了HL分期：27例（28%）分期上调，6例（6.3%）分期下调。分期上调是由于发现新的结外受累（26例患者共47个部位）：骨髓（10例患者）、脾脏（5例患者）和肺部（2例患者）。在9例患者中检测到≥2个其他并存部位。分期下调是由于腹部和盆腔肿大淋巴结（>15 mm）未摄取氟脱氧葡萄糖（18F-FDG）。PET/CT在34%的患者中改变了HL分期，大多数情况下导致治疗方案改变。我们的结果表明，PET/CT应作为HL初始分期的必要检查。
