18F-氟代脱氧葡萄糖正电子发射断层扫描/计算机断层扫描在套细胞淋巴瘤中的应用。
Application of 18F-fluorodeoxyglucose positron emission tomography/computerized tomography in mantle cell lymphoma.
机构信息
Department of Nuclear Medicine, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang.
PET Center, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong.
出版信息
Nucl Med Commun. 2020 May;41(5):477-484. doi: 10.1097/MNM.0000000000001170.
OBJECTIVE
The study is to investigate the application of F-fluorodeoxyglucose (F-FDG) PET/computerized tomography (CT) for the evaluation of mantle cell lymphoma (MCL).
METHODS
We retrospectively analyzed 39 patients who were pathologically diagnosed with MCL and underwent F-FDG PET/CT before treatment between August 2007 and August 2018. We compared the clinical information and PET/CT imaging characteristics in different groups based on bone marrow invasion, spleen invasion or International Prognostic Index (IPI) score. We also assessed the efficacy of PET/CT evaluation basing on the follow-up PET CT findings of 21 MCL patients and their biopsies.
RESULTS
Thirty-five patients were stage IV according to the Revised Ann Arbor Staging System. Lymph node involvement was observed in all 39 cases. The maximum diameter of the affected lymph nodes (4.33 ± 3.09 cm) and maximum standardized uptake value (SUVmax) (8.38 ± 4.99) was positively correlated (r = 0.486, P = 0.002). Extranodal invasion was identified in 38 patients with MCL, and the SUVmax of extranodal invasion was 7.34 ± 3.31. Extranodal invasion was most common in the spleen (25/38) and bone marrow (18/38). The group with bone marrow invasion was more prone to nasopharyngeal, lung and renal invasions (all P < 0.05). The groups with bone marrow invasion or spleen invasion were more likely to have decreased hemoglobin (Hgb) and platelets (all P < 0.01). The IPI high-risk group was more prone to lung involvement, elevated LDH and CRP, and decreased Hgb (all P < 0.05). Among the follow-up of 30 MCL patients, the 2-year progression-free survival and overall survival rates were 73.33 and 87.50%, respectively. PET/CT reexaminations of 21 MCL patients after treatment showed that the sensitivity, specificity, negative predictive value, positive predictive value and accuracy of the efficacy evaluation were 80, 90.91, 88.89, 83.33 and 85.71%, respectively.
CONCLUSION
F-FDG PET/CT imaging has important application value in the diagnosis, staging, treatment efficacy assessment and prognosis monitoring of MCL, especially in the systemic assessment of advanced MCL.
目的
本研究旨在探讨 F-氟代脱氧葡萄糖（F-FDG）正电子发射断层扫描/计算机断层扫描（PET/CT）在套细胞淋巴瘤（MCL）评估中的应用。
方法
我们回顾性分析了 2007 年 8 月至 2018 年 8 月期间 39 例经病理诊断为 MCL 并在治疗前接受 F-FDG PET/CT 检查的患者。我们根据骨髓侵犯、脾脏侵犯或国际预后指数（IPI）评分，比较了不同组的临床信息和 PET/CT 影像学特征。我们还根据 21 例 MCL 患者及其活检的后续 PET CT 随访结果评估了 PET/CT 评估的疗效。
结果
根据修订后的 Ann Arbor 分期系统，35 例患者为 IV 期。所有 39 例均存在淋巴结受累。受累淋巴结的最大直径（4.33±3.09cm）和最大标准化摄取值（SUVmax）（8.38±4.99）呈正相关（r=0.486，P=0.002）。38 例 MCL 患者存在结外侵犯，结外侵犯的 SUVmax 为 7.34±3.31。结外侵犯最常见于脾脏（25/38）和骨髓（18/38）。骨髓侵犯组更易发生鼻咽、肺和肾侵犯（均 P<0.05）。骨髓侵犯或脾脏侵犯组更易出现血红蛋白（Hgb）和血小板降低（均 P<0.01）。IPI 高危组更易发生肺侵犯、乳酸脱氢酶（LDH）和 C 反应蛋白（CRP）升高以及 Hgb 降低（均 P<0.05）。在 30 例 MCL 患者的随访中，2 年无进展生存率和总生存率分别为 73.33%和 87.50%。21 例 MCL 患者治疗后进行了 PET/CT 复查，疗效评估的敏感性、特异性、阴性预测值、阳性预测值和准确性分别为 80%、90.91%、88.89%、83.33%和 85.71%。
结论
F-FDG PET/CT 成像在 MCL 的诊断、分期、治疗效果评估和预后监测中具有重要的应用价值，特别是在晚期 MCL 的全身评估中。
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