Medical Oncology Department, King Abdullah Centre for Oncology and Liver Diseases.
Nuclear Medicine/Radiology Department.
Nucl Med Commun. 2021 Aug 1;42(8):899-906. doi: 10.1097/MNM.0000000000001406.
Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) is an uncommon subtype of Hodgkin lymphoma. Data are limited regarding 18F-labelled fluoro-2-deoxyglucose (FDG)-PET use in NLPHL. We are reporting our experience with FDG-PET utility in staging and response assessment NLPHL patients.
We retrospectively studied a population of all newly diagnosed or relapsed/refractory patients who underwent both pre-treatment contrast-enhanced computed tomography (CeCT) and an FDG-PET and also at the end of planned treatment.
We identified 68 patients found to have in total 312 scans, 78 paired pre-therapeutic and post-treatment CeCT and FDG-PET scans. Among them, 55 were male, with a median follow-up was 48 months. Median SUV-max was 8.3 (2.0-21.0). FDG-PET and CeCT were concordant in 80% (62/78) of staging scans. In 20% (16/78) of patients in whom a discordance was observed, FDG-PET resulted in upstaging in 13 scans and downstaging in 3 scans. The sensitivity of CeCT was 92% for nodal staging and 42% for extralymphatic staging when compared to FDG-PET. The specificity of CeCT was 98% as compared to FDG-PET. For response assessment, there was poor agreement between the CeCT and FDG-PET in assigning complete remission of disease scores as FDG-PET was able to identify the absence of disease despite the presence of a radiologically evident residual mass on CeCT. The sensitivity for CeCT compared to FDG-PET was 100% while the specificity was 43% for detection of post-treatment response.
For NLPHL, pre-therapeutic FDG-PET scan is better than CeCT staging. FDG-PET has much better specificity for response assessment than CeCT.
结节性淋巴细胞为主型霍奇金淋巴瘤（NLPHL）是霍奇金淋巴瘤的一种罕见亚型。关于氟代脱氧葡萄糖（FDG）-正电子发射断层扫描（PET）在 NLPHL 中的应用，数据有限。我们报告了 FDG-PET 在 NLPHL 患者分期和反应评估中的应用经验。
我们回顾性研究了所有接受治疗前对比增强计算机断层扫描（CeCT）和 FDG-PET 检查且在计划治疗结束时也进行了检查的新诊断或复发/难治性患者人群。
我们共确定了 68 例患者，共进行了 312 次扫描，其中 78 对治疗前和治疗后 CeCT 和 FDG-PET 扫描。其中，55 例为男性，中位随访时间为 48 个月。中位 SUV-max 为 8.3（2.0-21.0）。FDG-PET 和 CeCT 在 80%（62/78）的分期扫描中是一致的。在观察到不一致的 20%（16/78）患者中，FDG-PET 在 13 次扫描中导致分期上调，在 3 次扫描中导致分期下调。CeCT 对淋巴结分期的敏感性为 92%，对结外分期的敏感性为 42%，而 FDG-PET 的敏感性为 100%。CeCT 的特异性为 98%，而 FDG-PET 的特异性为 98%。对于反应评估，CeCT 和 FDG-PET 在评估疾病完全缓解评分方面的一致性较差，尽管 CeCT 上存在放射学上明显的残留肿块，但 FDG-PET 仍能识别出疾病的不存在。CeCT 对 FDG-PET 的敏感性为 100%，而特异性为 43%，用于检测治疗后反应。
对于 NLPHL，治疗前 FDG-PET 扫描优于 CeCT 分期。与 CeCT 相比，FDG-PET 对反应评估具有更好的特异性。
