Mosavi F, Wassberg C, Selling J, Molin D, Ahlström H
Section of Radiology, Department of Radiology, Oncology and Radiation Science, Uppsala University Hospital, Uppsala, Sweden.
Section of Nuclear Medicine, Department of Radiology, Oncology and Radiation Science, Uppsala University Hospital, Uppsala, Sweden.
Clin Radiol. 2015 Nov;70(11):1229-36. doi: 10.1016/j.crad.2015.06.087. Epub 2015 Jul 22.
To determine whether combined 2-[(18)F]-fluoro-2-deoxy-d-glucose ((18)F-FDG) positron-emission tomography (PET)/computed tomography (CT) and diffusion-weighted imaging (DWI) can be used for characterisation of different lymphoma subtypes, i.e., indolent versus aggressive lymphoma, and also to assess the prognostic value of different quantitative parameters of whole-body (WB) DWI and (18)F-FDG PET/CT.
Pre-therapeutic WB magnetic resonance imaging (MRI) including DWI and (18)F-FDG PET/CT were performed in lymphoma patients. Different quantitative DWI and (18)F-FDG PET/CT parameters were evaluated for characterisation of different lymphoma subtypes. These parameters were also correlated, both separately and in combination, against overall survival (OS) and progression-free survival (PFS). A lesion-by-lesion analysis was performed for correlation analysis between maximum standardised uptake value (SUVmax), mean standardised uptake value (SUVmean) and mean apparent diffusion coefficient (ADC).
Fifty patients were included in the study and divided into three groups: Hodgkin's lymphoma (HL), n=12; aggressive non-Hodgkin's lymphoma (NHL), n=29 (including 20 patients with diffuse large B-cell lymphoma, DLBCL); and indolent NHL, n=9. Indolent NHL showed significantly lower mean ADC values than the other two lymphoma groups (p=0.013). Aggressive NHL had a higher SUVmax than HL. The OS analysis of all patients showed a relationship (p=0.006) between increased mean ADC and longer OS. A model with both SUVmean and mean ADC, strengthened the possibility to predict PFS; however, a separate analysis of the DLBCL patients showed that none of the quantitative parameters could predict OS or PFS.
ADC can discriminate between indolent and aggressive NHL. This finding can be useful in assessing possible transformation from indolent to aggressive NHL. ADC, ADC/SUV, and SUV cannot predict OS/PFS independent of lymphoma subtype.
确定联合使用2-[(18)F]-氟-2-脱氧-d-葡萄糖（(18)F-FDG）正电子发射断层扫描（PET）/计算机断层扫描（CT）和扩散加权成像（DWI）是否可用于鉴别不同淋巴瘤亚型，即惰性淋巴瘤与侵袭性淋巴瘤，并评估全身（WB）DWI和(18)F-FDG PET/CT不同定量参数的预后价值。
对淋巴瘤患者进行包括DWI的治疗前WB磁共振成像（MRI）和(18)F-FDG PET/CT检查。评估不同的定量DWI和(18)F-FDG PET/CT参数以鉴别不同淋巴瘤亚型。这些参数还分别及联合与总生存期（OS）和无进展生存期（PFS）进行相关性分析。对最大标准化摄取值（SUVmax）、平均标准化摄取值（SUVmean）和平均表观扩散系数（ADC）之间的相关性分析进行逐病灶分析。
50例患者纳入研究并分为三组：霍奇金淋巴瘤（HL），n = 12；侵袭性非霍奇金淋巴瘤（NHL），n = 29（包括20例弥漫性大B细胞淋巴瘤，DLBCL）；惰性NHL，n = 9。惰性NHL的平均ADC值显著低于其他两组淋巴瘤（p = 0.013）。侵袭性NHL的SUVmax高于HL。所有患者的OS分析显示平均ADC升高与OS延长之间存在相关性（p = 0.006）。一个包含SUVmean和平均ADC的模型增强了预测PFS的可能性；然而，对DLBCL患者的单独分析显示，没有一个定量参数能够预测OS或PFS。
ADC可区分惰性和侵袭性NHL。这一发现有助于评估惰性NHL向侵袭性NHL可能的转化。ADC、ADC/SUV和SUV不能独立于淋巴瘤亚型预测OS/PFS。
