de-Bonilla-Damiá Á, Fernández-López R, Capote-Huelva F J, de la Cruz-Vicente F, Egea-Guerrero J J, Borrego-Dorado I
Servicio de Medicina Nuclear, Hospital Universitario Virgen del Rocío, Sevilla, España.
Servicio de Medicina Nuclear, Hospital Universitario Virgen del Rocío, Sevilla, España.
Rev Esp Med Nucl Imagen Mol. 2017 Sep-Oct;36(5):298-303. doi: 10.1016/j.remn.2017.03.006. Epub 2017 Apr 21.
To study the usefulness of F-FDG PET/CT in the initial evaluation and in the response assessment in primary brain lymphoma.
A retrospective analysis was carried out on 18 patients diagnosed with primary brain lymphoma, a histological subtype of diffuse large B-cell lymphoma, on whom an initial F-FDG PET/CT and MRI was performed, with 7 of the cases being analysed after the completion of treatment in order to assess response and clinical follow up.
Initial F-FDG PET/CT showed 26 hypermetabolic foci, whereas 46 lesions were detected by MRI. The average SUV maximum of the lesions was 17.56 with T/N 3.55. The concordance of both tests for identifying the same number of lesions was moderate, obtaining a kappa index of 0.395 (P<.001). In the evaluation of treatment, MRI identified 16 lesions compared to 7 pathological accumulations observed by F-FDG PET/CT. The concordance of both tests to assess type of response to treatment was moderate (kappa index 0.41) (P=.04). In both the initial evaluation and the assessment of the response to treatment, PET/CT led to a change strategy in 22% of patients who had lesions outside the cerebral parenchyma.
MRI appears to be the method of choice for detecting brain disease in patients with primary brain lymphoma, whereas F-FDG PET/CT seems to play a relevant role in the assessment of extra-cerebral disease.
研究F-FDG PET/CT在原发性脑淋巴瘤的初始评估及疗效评估中的应用价值。
对18例诊断为原发性脑淋巴瘤（弥漫性大B细胞淋巴瘤的一种组织学亚型）的患者进行回顾性分析，这些患者均接受了初始F-FDG PET/CT及MRI检查，其中7例在完成治疗后进行分析以评估疗效及临床随访情况。
初始F-FDG PET/CT显示26个高代谢灶，而MRI检测到46个病灶。病灶的平均最大标准摄取值（SUV）为17.56，靶/非靶比值（T/N）为3.55。两种检查在识别相同数量病灶方面的一致性为中等，kappa指数为0.395（P<0.001）。在治疗评估中，MRI识别出16个病灶，而F-FDG PET/CT观察到7个病理性积聚。两种检查在评估治疗反应类型方面的一致性为中等（kappa指数0.41）（P = 0.04）。在初始评估及治疗反应评估中，PET/CT使22%脑实质外有病灶的患者改变了治疗策略。
MRI似乎是检测原发性脑淋巴瘤患者脑部疾病的首选方法，而F-FDG PET/CT在评估脑外疾病方面似乎发挥着重要作用。
