F-18氟代脱氧葡萄糖正电子发射断层显像/计算机断层扫描（F-18 FDG PET/CT）在非结膜起源的眼附属器黏膜相关淋巴组织（MALT）淋巴瘤中的作用
Role of F-18 FDG PET/CT in non-conjunctival origin ocular adnexal mucosa-associated lymphoid tissue (MALT) lymphomas.
作者信息
Park Hye Lim, O Joo Hyun, Park Sonya Youngju, Jung Seung-Eun, Park Gyeongsin, Choi Byung-Ock, Kim Sung Hoon, Jeon Young-Woo, Cho Seok-Goo, Yang Suk-Woo
机构信息
Division of Nuclear Medicine, Department of Radiology, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Division of Nuclear Medicine, Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea.
出版信息
EJNMMI Res. 2019 Nov 21;9(1):99. doi: 10.1186/s13550-019-0562-1.
BACKGROUND
Despite the widespread use of F-18 fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) in the diagnosis and response assessment of patients with lymphoma, few studies have assessed its value in ocular adnexal lymphomas. The purpose of this study was to evaluate the role of FDG PET/CT in staging of non-conjunctival origin ocular adnexal mucosa-associated lymphoid tissue (MALT) lymphomas (OAML). In addition, the diagnostic sensitivity of FDG PET/CT was compared with magnetic resonance imaging (MRI). FDG PET/CT of 123 consecutive patients with pathologically proven OAML between January 2009 and February 2016 were retrospectively reviewed. The patients with MALT lymphoma originating from conjunctiva were excluded. A total 50 patients with non-conjunctival origin OAML were assessed. Maximum standardized uptake value (SUVmax) and additional PET parameters were measured for all lesions. Sensitivity for primary tumor detection was compared with MRI.
RESULTS
Ten patients had bilateral OAML and total 60 OAML lesions were analyzed. MRI was missing in one patient. The tumor locations were as follows: eyelid, 9; lacrimal gland, 18; orbit, 33. Fifty lesions (83.3%) were FDG-avid tumors with mean ± SD SUVmax 4.8 ± 2.4 (range 2.011.1). The mean SUVmax according to tumor location were as follows: eyelid, 3.7 ± 1.1 (2.85.3); lacrimal gland, 3.6 ± 1.4 (2.16.4); orbit, 5.7 ± 2.6 (2.011.1). Mean SUVmax among the 3 locations were statistically different (P = 0.010). The sensitivity was calculated as 83.1% (49/59) for FDG PET/CT and 89.8% (53/59) for MRI, which were statistically comparable (P = 0.219 by McNemar's test). Seven of 50 patients (14%) were upstaged by detection of extraocular lesions by FDG PET/CT (1 kidney and lung, 1 tonsil, 4 cervical LNs, 1 sacral foramen).
CONCLUSION
83.3% of the non-conjunctival origin OAML were FDG-avid tumors, with FDG PET/CT showing comparable sensitivity to that of MRI. FDG PET/CT detected unsuspected extraocular lymphoma involvement in 14% of the patients. FDG PET/CT performed for staging of non-conjunctival origin OAML may thus guide therapeutic management.
背景
尽管F-18氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（FDG PET/CT）在淋巴瘤患者的诊断和疗效评估中广泛应用，但很少有研究评估其在眼附属器淋巴瘤中的价值。本研究的目的是评估FDG PET/CT在非结膜起源的眼附属器黏膜相关淋巴组织（MALT）淋巴瘤（OAML）分期中的作用。此外，还比较了FDG PET/CT与磁共振成像（MRI）的诊断敏感性。回顾性分析了2009年1月至2016年2月期间连续123例经病理证实的OAML患者的FDG PET/CT检查结果。排除起源于结膜的MALT淋巴瘤患者。共评估了50例非结膜起源的OAML患者。测量了所有病变的最大标准化摄取值（SUVmax）及其他PET参数。将FDG PET/CT对原发性肿瘤的检测敏感性与MRI进行比较。
结果
10例患者为双侧OAML，共分析60个OAML病变。1例患者未行MRI检查。肿瘤部位如下：眼睑9个；泪腺18个；眼眶33个。50个病变（83.3%）为FDG摄取阳性肿瘤，平均±标准差SUVmax为4.8±2.4（范围2.011.1）。根据肿瘤部位的平均SUVmax如下：眼睑3.7±1.1（2.85.3）；泪腺3.6±1.4（2.16.4）；眼眶5.7±2.6（2.011.1）。3个部位的平均SUVmax在统计学上有差异（P = 0.010）。FDG PET/CT的敏感性计算为83.1%（49/59），MRI的敏感性为89.8%（53/59），两者在统计学上具有可比性（McNemar检验，P = 0.219）。50例患者中有7例（14%）因FDG PET/CT检测到眼外病变而分期上调（1例肾脏和肺部、1例扁桃体、4例颈部淋巴结、1例骶孔）。
结论
83.3%的非结膜起源OAML为FDG摄取阳性肿瘤，FDG PET/CT显示出与MRI相当的敏感性。FDG PET/CT在14%的患者中检测到未被怀疑的眼外淋巴瘤受累。因此，用于非结膜起源OAML分期的FDG PET/CT可能指导治疗管理。
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