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[正电子发射断层扫描联合计算机断层扫描在原发性中枢神经系统淋巴瘤的初始评估和疗效评估中的应用]

[Positron emission tomography combined with computed tomography in the initial evaluation and response assessment in primary central nervous system lymphoma].

作者信息

Mercadal Santiago, Cortés-Romera Montserrat, Vélez Patricia, Climent Fina, Gámez Cristina, González-Barca Eva

机构信息

Servicio de Hematología, Institut Català d'Oncologia, Hospital Duran i Reynals, Instituto de Investigación Biomédica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, España.

Unidad PET-TC, Institut de Diagnòstic per la Imatge (IDI), Hospital Universitario de Bellvitge, L'Hospitalet del Llobregat, Barcelona, España.

出版信息

Med Clin (Barc). 2015 Jun 8;144(11):503-6. doi: 10.1016/j.medcli.2014.09.010. Epub 2014 Nov 26.

Abstract

OBJECTIVE

To evaluate the role of positron emission tomography combined with computed tomography (PET-CT) in the initial evaluation and response assessment in primary central nervous system lymphoma (PCNSL).

MATERIAL AND METHOD

Fourteen patients (8 males) with a median age 59.5 years diagnosed of PCNSL. A brain PET-CT and magnetic resonance imaging (MRI) were performed in the initial evaluation. In 7 patients a PET-CT after treatment was performed.

RESULTS

PET-CT showed at diagnosis 31 hypermetabolic focuses and MRI showed 47 lesions, with a good grade of concordance between both (k = 0.61; P = .005). In the response assessment, correlation between both techniques was good, and PET-CT was helpful in the appreciation of residual MRI lesions. Overall survival at 2 years of negative vs. positive PET-CT at the end of treatment was 100 vs. 37.5%, respectively (P = .045).

CONCLUSIONS

PET-CT can be useful in the initial evaluation of PCNSL, and especially in the assessment of response. Despite the fact that PET-CT detects less small lesions than MRI, a good correlation between MRI and PET-CT was observed. It is effective in the evaluation of residual lesions. Prospective studies are needed to confirm their possible prognostic value.

摘要

目的

评估正电子发射断层扫描联合计算机断层扫描(PET-CT)在原发性中枢神经系统淋巴瘤(PCNSL)初始评估及疗效评估中的作用。

材料与方法

14例患者(8例男性)被诊断为PCNSL,中位年龄59.5岁。初始评估时进行脑部PET-CT及磁共振成像(MRI)检查。7例患者在治疗后进行了PET-CT检查。

结果

诊断时PET-CT显示31个高代谢灶,MRI显示47个病灶,两者之间具有良好的一致性(k = 0.61;P = 0.005)。在疗效评估中,两种技术之间的相关性良好,PET-CT有助于识别残留的MRI病灶。治疗结束时PET-CT阴性与阳性患者的2年总生存率分别为100%和37.5%(P = 0.045)。

结论

PET-CT在PCNSL的初始评估中可能有用,尤其是在疗效评估方面。尽管PET-CT检测到的小病灶比MRI少,但MRI与PET-CT之间观察到良好的相关性。它在评估残留病灶方面有效。需要进行前瞻性研究以证实其可能的预后价值。

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