Kostakoglu Lale, Evens Andrew M
Mount Sinai Medical Center, New York, New York.
Tufts Medical Center, Boston, Massachusetts.
Clin Adv Hematol Oncol. 2014 Jan;12(1):20-35.
A significant amount of data has been published over the past decade regarding the clinical utility of F-fluorodeoxyglucose positron emission tomography (FDG-PET) in the diagnosis and management of Hodgkin lymphoma (HL). This includes studies examining interim FDG-PET, which has been shown to be a strong tool for predicting relapse and survival, especially in advanced- stage HL. Despite progress, a number of questions remain regard- ing the precise role and value of FDG-PET in the diagnosis, risk stratification, and management of HL. These questions include the need for concomitant contrast enhanced computed tomography with FDG-PET, reproducibility and interpretability of FDG-PET, optimal imaging for the treatment surveillance of HL following definitive treatment, and the use of FDG-PET for patients with relapsed/refractory disease, including stem cell transplantation. In this review, these issues are critically examined and the study designs and results of observational and prospective FDG-PET response-adaptive clinical trials in HL are described in detail. In addition, novel techniques and future applications of FDG- PET, such as metabolic tumor volume, tumor proliferation via 3'-deoxy-3'-18F-fluorothymidine, and integrated PET/magnetic resonance imaging are discussed.
在过去十年里，已经发表了大量关于氟脱氧葡萄糖正电子发射断层扫描（FDG-PET）在霍奇金淋巴瘤（HL）诊断和管理中的临床应用的数据。这包括对中期FDG-PET的研究，中期FDG-PET已被证明是预测复发和生存的有力工具，尤其是在晚期HL中。尽管取得了进展，但关于FDG-PET在HL诊断、风险分层和管理中的确切作用和价值仍存在一些问题。这些问题包括FDG-PET是否需要与对比增强计算机断层扫描同时进行、FDG-PET的可重复性和可解释性、确诊治疗后HL治疗监测的最佳成像方法，以及FDG-PET在复发/难治性疾病患者（包括干细胞移植患者）中的应用。在本综述中，对这些问题进行了批判性审视，并详细描述了HL中观察性和前瞻性FDG-PET反应适应性临床试验的研究设计和结果。此外，还讨论了FDG-PET的新技术和未来应用，如代谢肿瘤体积、通过3'-脱氧-3'-18F-氟胸苷进行肿瘤增殖分析以及PET/磁共振成像融合技术。
