Ding Chong-Yang, Liu Hong-Yu, Guo Zhe, Li Tian-Nyu
Department of Nuclear Medcine, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province,China.
Department of Radiology, Zhejiang Taizhou Central Hospital, Taizhou 318000, Zhejiang Province,China.
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2017 Apr;25(2):438-443. doi: 10.7534/j.issn.1009-2137.2017.02.023.
To investigate the value of pretherapeutic F-FDG PET/CT in the focus detection, staging and prognosis evaluation of adult Burkitt's lymphoma(BL).
The clinical data and detection results of F-FDG PET/CT scan of 18 patients with BL before the treatment from December 2008 to February 2015 were analyzed retrospectively. The lesions distribution were observed, the maximal standard uptake value(SUV) of F-FDG by lesions and the maximal diameter of lymph nodes were measured. One-way analysis of variance was used to analyze the SUV, and the Spearman correlation was used to analyze the relationship between SUV and the maximum diameter of lymph nodes. The prognostic factors were analyzed by using Kaplan-Meier survival analysis.
F-FDG PET/CT showed 100% positive detection rate for 18 adults with BL, lymph nodal lesions were found in all the patients, and the most common area was lymphonodi coeliaci (9/18, 50%), 8 cases showed extranodal soft tissue involvement, 6 cases showed gastrointestinal tract, bone marrow involvement was detected in 7 cases, out of which the mutiple-focal involvement was found in 4 cases. The median SUV of lymph nodes, extranodal soft tissue and bone marrow was 11.7 (range of 3.4 to 28.5), 9.85 (range of 6.7 to 21.9) and 11.8(range of 5.6 to 23.8), respectively, there were no significant differences among these 3 types of lesions (F=1.013, P=0.369). And the median SUV of all lesions was 16.5 (range of 8.8 to 28.5). The clinical staging of 2 patients (2/8, 11.1%) was changed by F-FDG PET/CT imaging. The univariate analysis revealed that only the IPI (international prognostic index) could be the prognostic factor (χ=6.602, P=0.010), but the prognosis was not different between the patients below and above the median SUV of all lesions and lymph node (all P>0.05).
BL in adult is an intensely F-FDG-avid tumor, the F-FDG PET/CT is an effective imaging tool for the detection and staging of this disease. In our study, the prognostic value of pretherapeutic F-FDG PET/CT still is unclear, that is not recommended for the prognosis of the adult BL patients.
探讨治疗前F-FDG PET/CT在成人伯基特淋巴瘤（BL）病灶检测、分期及预后评估中的价值。
回顾性分析2008年12月至2015年2月期间18例治疗前BL患者的临床资料及F-FDG PET/CT扫描检测结果。观察病灶分布，测量病灶的F-FDG最大标准摄取值（SUV）及淋巴结最大径。采用单因素方差分析SUV，采用Spearman相关性分析SUV与淋巴结最大径之间的关系。采用Kaplan-Meier生存分析对预后因素进行分析。
F-FDG PET/CT对18例成人BL的检出率为100%，所有患者均发现有淋巴结病灶，最常见部位为腹腔淋巴结（9/18，50%），8例显示结外软组织受累，6例显示胃肠道受累，7例检测到骨髓受累，其中4例为多灶性受累。淋巴结、结外软组织及骨髓的SUV中位数分别为11.7（范围3.4至28.5）、9.85（范围6.7至21.9）及11.8（范围5.6至23.8），这3种类型病灶之间差异无统计学意义（F=1.013，P=0.369）。所有病灶的SUV中位数为16.5（范围8.8至28.5）。F-FDG PET/CT成像改变了2例患者（2/8，11.1%）的临床分期。单因素分析显示，只有国际预后指数（IPI）可作为预后因素（χ=6.602，P=0.010），但所有病灶及淋巴结SUV中位数以下和以上患者的预后无差异（所有P>0.05）。
成人BL是一种F-FDG摄取强烈的肿瘤，F-FDG PET/CT是检测和分期该疾病的有效影像学工具。在本研究中，治疗前F-FDG PET/CT的预后价值仍不明确，不建议用于成人BL患者的预后评估。
