正电子发射断层扫描/计算机断层扫描引导下活检对淋巴瘤诊断的诊断准确性
Diagnostic accuracy of positron emission tomography/computed tomography-driven biopsy for the diagnosis of lymphoma.
作者信息
Broccoli Alessandro, Nanni Cristina, Cappelli Alberta, Bacci Francesco, Gasbarrini Alessandro, Tabacchi Elena, Piovani Carlo, Argnani Lisa, Ghermandi Riccardo, Sabattini Elena, Golfieri Rita, Fanti Stefano, Zinzani Pier Luigi
机构信息
Institute of Hematology "L. e A. Seràgnoli", University of Bologna, via Massarenti 9, 40138, Bologna, Italy.
Nuclear Medicine, Medicina Nucleare Metropolitana, Sant'Orsola-Malpighi Hospital, University of Bologna, via Massarenti 9, 40138, Bologna, Italy.
出版信息
Eur J Nucl Med Mol Imaging. 2020 Dec;47(13):3058-3065. doi: 10.1007/s00259-020-04913-9. Epub 2020 Jun 15.
INTRODUCTION
Biopsy of affected tissue is required for lymphoma diagnosis and to plan treatment. Open incisional biopsy is traditionally the method of choice. Nevertheless, it requires hospitalization, availability of an operating room, and sometimes general anesthesia, and it is associated with several drawbacks. Fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) can be potentially used to drive biopsy to the most metabolically active area within a lymph node or extranodal masses.
METHODS
A study of diagnostic accuracy was conducted to assess the performance of a PET-driven needle biopsy in patients with suspect active lymphoma.
RESULTS
Overall, 99 procedures have been performed: three (3.0%) were interrupted because of pain but were successfully repeated in two cases. Median SUVmax of target lesions was 10.7. In 84/96 cases, the tissue was considered adequate to formulate a diagnosis (diagnostic yield of 87.5%) and to guide the following clinical decision. The target specimen was a lymph node in 60 cases and an extranodal site in 36. No serious adverse events occurred. The sensitivity of this procedure was 96%, with a specificity of 100%, a positive predictive value of 100%, and a negative predictive value of 75%.
CONCLUSION
Patients can benefit from a minimally invasive procedure which allows a timely and accurate diagnosis of lymphoma at onset or relapse.
引言
淋巴瘤的诊断和治疗方案制定需要对受影响组织进行活检。传统上，开放式切口活检是首选方法。然而，它需要住院、手术室可用，有时还需要全身麻醉，并且存在一些缺点。氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（PET/CT）可潜在地用于引导活检至淋巴结或结外肿块内代谢最活跃的区域。
方法
进行了一项诊断准确性研究，以评估PET引导下针吸活检在疑似活动性淋巴瘤患者中的性能。
结果
总体而言，共进行了99例操作：3例（3.0%）因疼痛中断，但2例成功重复操作。目标病变的SUVmax中位数为10.7。在84/96例病例中，组织被认为足以做出诊断（诊断率为87.5%）并指导后续临床决策。目标标本为淋巴结60例，结外部位36例。未发生严重不良事件。该操作的敏感性为96%，特异性为100%，阳性预测值为100%，阴性预测值为75%。
结论
患者可受益于一种微创程序，该程序能够在淋巴瘤发病或复发时及时、准确地进行诊断。
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