King's College London and Guy's and St Thomas' PET Centre, School of Biomedical Engineering and Imaging Sciences, King's College London, King's Health Partners, London, UK.
Haematology Department, Concord Repatriation General, Hospital, University of Sydney, Sydney, NSW, Australia.
Lancet Haematol. 2021 Jan;8(1):e80-e93. doi: 10.1016/S2352-3026(20)30365-3. Epub 2020 Dec 22.
This Review focuses on the use of F-fluorodeoxyglucose (F-FDG) PET in the assessment of diffuse large B-cell lymphoma, follicular lymphoma, and peripheral T-cell lymphoma. PET is important for staging and prognostication with stage migration compared with CT. Better outcomes for patients with early stage diffuse large B-cell lymphoma and follicular lymphoma suggests better delineation of disease has translated to improved outcomes in such patients beyond simple stage migration. The aim of treatment of diffuse large B-cell lymphoma and peripheral T-cell lymphoma is potential cure, during which PET is mainly used to assess remission. Interim PET can assess chemosensitivity in these lymphomas, but it does not predict treatment success sufficiently well to enable treatment modification, particularly in the absence of more effective therapies for patients who remain PET-positive on interim scanning. In follicular lymphoma, traditionally viewed as an incurable lymphoma, the aim of treatment is to control disease for several years, while maintaining quality of life. PET can predict prognosis for patients with follicular lymphoma with high tumour burden at the end of induction chemotherapy, and it is being evaluated as a platform for response-adapted treatment of follicular lymphoma.
本综述重点介绍了 F-氟脱氧葡萄糖（F-FDG）PET 在弥漫性大 B 细胞淋巴瘤、滤泡性淋巴瘤和外周 T 细胞淋巴瘤评估中的应用。与 CT 相比，PET 对分期和预后具有重要意义，可导致分期迁移。弥漫性大 B 细胞淋巴瘤和滤泡性淋巴瘤早期患者的治疗结果更好，这表明疾病的更好描绘已转化为这些患者的更好结局，而不仅仅是简单的分期迁移。弥漫性大 B 细胞淋巴瘤和外周 T 细胞淋巴瘤的治疗目的是潜在治愈，在此期间，PET 主要用于评估缓解情况。中期 PET 可评估这些淋巴瘤的化疗敏感性，但它不能充分预测治疗效果，从而无法进行治疗修改，尤其是对于那些在中期扫描时仍为 PET 阳性的患者，因为缺乏更有效的治疗方法。在滤泡性淋巴瘤中，该病传统上被视为一种不可治愈的淋巴瘤，治疗目的是在维持生活质量的同时控制疾病数年。PET 可预测诱导化疗结束时肿瘤负荷较高的滤泡性淋巴瘤患者的预后，并且正在作为滤泡性淋巴瘤的反应适应性治疗平台进行评估。
