Nakachi Sawako, Okada Masahiro, Morishima Satoko, Agarie Yurika, Kitamura Sakiko, Uchibori Sachie, Tomori Shouhei, Hanashiro Taeko, Shimabukuro Natsuki, Tamaki Keita, Tedokon Iori, Morichika Kazuho, Nishi Yukiko, Tomoyose Takeaki, Karube Kennosuke, Fukushima Takuya, Murayama Sadayuki, Masuzaki Hiroaki
a Division of Endocrinology, Diabetes and Metabolism, Hematology and Rheumatology (Second Department of Internal Medicine), Graduate School of Medicine , University of the Ryukyus , Nishihara , Japan.
b Department of Radiology, Graduate School of Medical Science , University of the Ryukyus , Nishihara , Japan.
Hematology. 2017 Oct;22(9):536-543. doi: 10.1080/10245332.2017.1312088. Epub 2017 Apr 11.
The aim was to explore undefined useful indices for clinically grading adult T-cell leukemia (ATL) using [F] 2-fluoro-2-deoxyglucose (FDG) - positron emission tomography/computed tomography (PET/CT).
A total of 28 patients with ATL (indolent, 9; aggressive, 19) were enrolled; all patients with aggressive ATL underwent FDG-PET/CT before chemotherapy. Patients with indolent ATL underwent FDG-PET/CT at the time of suspected disease progression and/or transformation; some received lymph node biopsy. The quantitative parameters maximum standardized uptake values (SUVmax), and mean and peak SUV, metabolic tumor volume (MTV), and volume-based total lesion glycolysis were calculated with the margin threshold as 25%, and 50% of the SUVmax for all lesions.
All parameters except for MTV-25% showed significant differences (P ≤ 0.05) in differentiating the aggressive type from the indolent type of ATL. Areas under the curve for receiver-operating characteristic (ROC) analysis regarding the series of parameters investigated ranged from 0.75 to 0.92; this indicated relatively high accuracy in distinguishing the aggressive type from the indolent type. No malignant findings were detected in lymph node biopsies in indolent ATL patients with lymphadenopathy.
We performed evaluation of a line of parameters of FDG-PET, thereby demonstrating their significantly high accuracy for grading malignancy in ATL patients. In particular, low accumulation of FDG in indolent ATL patients with lymphadenopathy might predict that it is not a sign of disease transformation, but rather a reactive manifestation.
FDG-PET/CT findings could be useful for clinically grading ATL.
旨在探索使用[F]2-氟-2-脱氧葡萄糖（FDG）-正电子发射断层扫描/计算机断层扫描（PET/CT）对成人T细胞白血病（ATL）进行临床分级的未明确有用指标。
共纳入28例ATL患者（惰性型9例；侵袭性型19例）；所有侵袭性ATL患者在化疗前均接受FDG-PET/CT检查。惰性ATL患者在疑似疾病进展和/或转化时接受FDG-PET/CT检查；部分患者接受了淋巴结活检。计算定量参数最大标准化摄取值（SUVmax）、平均和峰值SUV、代谢肿瘤体积（MTV）以及基于体积的总病变糖酵解，所有病变的边界阈值为SUVmax的25%和50%。
除MTV-25%外，所有参数在区分侵袭性ATL和惰性ATL类型方面均显示出显著差异（P≤0.05）。所研究系列参数的受试者操作特征（ROC）分析曲线下面积范围为0.75至0.92；这表明在区分侵袭性类型和惰性类型方面具有相对较高的准确性。在有淋巴结病的惰性ATL患者的淋巴结活检中未发现恶性病变。
我们对FDG-PET的一系列参数进行了评估，从而证明它们在ATL患者恶性分级方面具有显著的高准确性。特别是，有淋巴结病的惰性ATL患者中FDG的低积聚可能预示这不是疾病转化的迹象，而是一种反应性表现。
FDG-PET/CT检查结果可能有助于ATL的临床分级。
