非霍奇金淋巴瘤患者的 FDG PET/CT 随访：对临床评估和患者管理的价值。

Follow-up FDG PET/CT in Patients With Non-Hodgkin Lymphoma: Value to Clinical Assessment and Patient Management.

机构信息

From the *Russell H Morgan Department of Radiology and Radiological Sciences, Johns Hopkins School of Medicine; Departments of †Oncology, ‡Pathology, and §Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.

出版信息

Clin Nucl Med. 2016 Feb;41(2):e93-7. doi: 10.1097/RLU.0000000000001034.

DOI:10.1097/RLU.0000000000001034

PMID:26545018

Abstract

OBJECTIVE

The aim of this study was to evaluate the value of each follow-up PET/CT in the clinical assessment of recurrence as well as determining its impact on management in patients with non-Hodgkin lymphoma (NHL).

PATIENTS AND METHODS

All patients diagnosed with NHL who had at least 1 follow-up PET/CT study, 6 months after primary treatment completion, were included. There were 204 eligible NHL patients with 560 follow-up PET/CT scans. The change in management was recorded after each follow-up PET/CT scan in comparison to the management plan before the study.

RESULTS

Among the 560 scans, 388 scans (69.3%) were done without clinical suspicion and 172 scans (30.7%) were done with prior clinical suspicion of recurrence. Follow-up scan results suggested disease in 12.4% of the scans performed without clinical suspicion and ruled out disease in 16.3% scans performed with prior clinical suspicion. The management of NHL patients was changed after 37.8% of follow-up scans with prior clinical suspicion of recurrence and after 8.3% of scans in patients without prior clinical suspicion of recurrence. The management of NHL patients was not changed after 50.6% scans with prior clinical suspicion of recurrence of which 23.3% had no treatment before and after the scan and 27.3% had the same treatment continued before and after the scan.

CONCLUSIONS

Follow-up FDG PET/CT performed with prior clinical suspicion of recurrence added value to patients with NHL for clinical assessment in 16.3% of the scan times and influenced the management in 37.8% of scan times. The management change was only 8.3% in patients without prior clinical suspicion of recurrence, and hence, surveillance FDG PET/CT in NHL should be avoided.

摘要

目的

本研究旨在评估每个随访 PET/CT 在评估复发方面的价值，并确定其对非霍奇金淋巴瘤（NHL）患者治疗管理的影响。

方法

所有在完成初始治疗后至少进行了 1 次随访 PET/CT 检查且诊断为 NHL 的患者均纳入本研究。共纳入 204 例 NHL 患者，共计 560 次随访 PET/CT 扫描。记录每次随访 PET/CT 扫描与研究前治疗计划相比的管理变化。

结果

在 560 次扫描中，388 次（69.3%）无临床怀疑，172 次（30.7%）有临床怀疑复发。无临床怀疑时，随访扫描结果提示疾病的比例为 12.4%，有临床怀疑时，排除疾病的比例为 16.3%。在有临床怀疑复发的 172 次随访扫描中，有 37.8%的患者治疗管理发生改变，在无临床怀疑复发的 388 次扫描中，有 8.3%的患者治疗管理发生改变。在有临床怀疑复发的 172 次随访扫描中，有 50.6%的扫描未改变治疗方案，其中 23.3%在扫描前后未进行治疗，27.3%在扫描前后继续进行相同的治疗。