Gómez León Nieves, Delgado-Bolton Roberto C, Del Campo Del Val Lourdes, Cabezas Beatriz, Arranz Reyes, García Marta, Cannata Jimena, González Ortega Saturnino, Pérez Sáez Mª Ángeles, López-Botet Begoña, Rodríguez-Vigil Beatriz, Mateo Marta, Colletti Patrick M, Rubello Domenico, Carreras José L
From the *University Hospital Research Institute, Department of Radiology, University Hospital La Princesa, Madrid; †Autonomous University of Madrid, Madrid; ‡Department of Diagnostic Imaging (Radiology) and Nuclear Medicine, San Pedro Hospital and Centre for Biomedical Research of La Rioja (CIBIR), University of La Rioja, Logroño, La Rioja; Departments of §Nuclear Medicine, and ∥Radiology, University Hospital Clínico San Carlos, Madrid; ¶Department of Haematology, University Hospital la Princesa of Madrid, Madrid; Departments of **Haematology, and ††Radiology, University Hospital Fundación Jiménez Díaz, Madrid; ‡‡Department of Radiology, University Hospital Txagorritxu, Vitoria; §§Department of Haematology, University Hospital Clínico San Carlos, Madrid, Spain; ∥∥Department of Radiology, University of Southern California, Los Angeles, CA; and ¶¶Department of Nuclear Medicine, Imaging and Clinical Pathology, Santa Maria della Misericordia Hospital, Rovigo, Italy.
Clin Nucl Med. 2017 Aug;42(8):595-602. doi: 10.1097/RLU.0000000000001718.
To compare staging correctness between contrast-enhanced FDG PET/ceCT and 64-slice multi-detector-row CT (ceCT64) for initial staging and response evaluation at the end of treatment (EOT) in patients with Hodgkin lymphoma, diffuse large B cell lymphoma (DLBCL), and follicular lymphoma.
This prospective study compared initial staging and response evaluation at EOT. One hundred eighty-one patients were randomly assigned to either ceCT64 or FDG PET/ceCT. A nuclear medicine physician and a radiologist read FDG PET/ceCT scans independently and achieved post hoc consensus, whereas another independent radiologist interpreted ceCT64 separately. The reference standard included all clinical information, all tests, and follow-up. Ethics committees of the participating centers approved the study, and all participants provided written consent.
Ninety-one patients were randomized to ceCT64 and 90 to FDG PET/ceCT; 72 had Hodgkin lymphoma, 72 had DLBCL, and 37 had follicular lymphoma. There was excellent correlation between the reference standard and initial staging for both FDG PET/ceCT (κ = 0.96) and ceCT64 (κ = 0.84), although evaluation of the response at EOT was excellent only for FDG PET/ceCT (κ = 0.91).
Our study demonstrated satisfactory agreement between FDG PET/ceCT (κ = 0.96) and ceCT64 (κ = 0.84) in initial staging compared with the reference standard (P = 0.16). Response evaluation at EOT with FDG PET/ceCT (κ = 0.91) was superior compared with ceCT64 (κ = 0.307) (P < 0.001).
比较对比增强FDG PET/ceCT与64层多排探测器CT（ceCT64）在霍奇金淋巴瘤、弥漫性大B细胞淋巴瘤（DLBCL）和滤泡性淋巴瘤患者初始分期及治疗结束时（EOT）疗效评估中的分期准确性。
这项前瞻性研究比较了初始分期及EOT时的疗效评估。181例患者被随机分为ceCT64组或FDG PET/ceCT组。一名核医学医师和一名放射科医师独立解读FDG PET/ceCT扫描结果并达成事后共识，而另一名独立放射科医师单独解读ceCT64。参考标准包括所有临床信息、所有检查及随访情况。参与研究中心的伦理委员会批准了该研究，所有参与者均提供了书面同意书。
91例患者被随机分配至ceCT64组，90例被分配至FDG PET/ceCT组；其中72例为霍奇金淋巴瘤，72例为DLBCL，37例为滤泡性淋巴瘤。FDG PET/ceCT（κ = 0.96）和ceCT64（κ = 0.84）的参考标准与初始分期之间均具有良好的相关性，不过仅FDG PET/ceCT对EOT时疗效的评估结果良好（κ = 0.91）。
我们的研究表明，与参考标准相比，FDG PET/ceCT（κ = 0.96）和ceCT64（κ = 0.84）在初始分期方面具有令人满意的一致性（P = 0.16）。与ceCT64（κ = 0.307）相比，FDG PET/ceCT在EOT时的疗效评估更具优势（κ = 0.91）（P < 0.001）。
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