F-FDG PET/CT 在诊断初诊弥漫性大 B 细胞淋巴瘤患者骨髓浸润中的诊断效能。
Diagnostic Efficacy of F-FDG PET/CT in Detecting Bone Marrow Infiltration in Patients with Newly Diagnosed Diffuse Large B-Cell Lymphoma.
机构信息
Department of Hematology, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing 100853, China.
Department of Hematology, The Fifth Medical Center, Chinese PLA General Hospital, Beijing 100071, China.
出版信息
Biomed Environ Sci. 2023 Jun 20;36(6):510-516. doi: 10.3967/bes2023.062.
OBJECTIVE
Diffuse large B-cell lymphoma (DLBCL) is often associated with bone marrow infiltration, and 2-deoxy-2-(18F) fluorodeoxyglucose positron emission tomography/computed tomography ( F-FDG PET/CT) has potential diagnostic significance for bone marrow infiltration in DLBCL.
METHODS
A total of 102 patients diagnosed with DLBCL between September 2019 and August 2022 were included. Bone marrow biopsy and F-FDG PET/CT examinations were performed at the time of initial diagnosis. Kappa tests were used to evaluate the agreement of F-FDG PET/CT with the gold standard, and the imaging features of DLBCL bone marrow infiltration on PET/CT were described.
RESULTS
The total detection rate of bone marrow infiltration was not significantly different between PET/CT and primary bone marrow biopsy ( = 0.302) or between the two bone marrow biopsies ( = 0.826). The sensitivity, specificity, and Youden index of PET/CT for the diagnosis of DLBCL bone marrow infiltration were 0.923 (95% , 0.759-0.979), 0.934 (95% , 0.855-0.972), and 0.857, respectively.
CONCLUSION
F-FDG PET/CT has a comparable efficiency in the diagnosis of DLBCL bone marrow infiltration. PET/CT-guided bone marrow biopsy can reduce the misdiagnosis of DLBCL bone marrow infiltration.
目的
弥漫性大 B 细胞淋巴瘤（DLBCL）常伴有骨髓浸润，2-脱氧-2-[18F]氟代脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（F-FDG PET/CT）对 DLBCL 骨髓浸润具有潜在的诊断意义。
方法
纳入 2019 年 9 月至 2022 年 8 月期间诊断为 DLBCL 的 102 例患者。在初诊时进行骨髓活检和 F-FDG PET/CT 检查。使用 Kappa 检验评估 F-FDG PET/CT 与金标准的一致性，并描述 PET/CT 上 DLBCL 骨髓浸润的影像学特征。
结果
PET/CT 与原发性骨髓活检（ = 0.302）或两次骨髓活检（ = 0.826）之间骨髓浸润的总检出率无显著差异。PET/CT 诊断 DLBCL 骨髓浸润的灵敏度、特异度和 Youden 指数分别为 0.923（95%CI，0.759-0.979）、0.934（95%CI，0.855-0.972）和 0.857。
结论
F-FDG PET/CT 对 DLBCL 骨髓浸润的诊断效能相当。PET/CT 引导的骨髓活检可减少 DLBCL 骨髓浸润的误诊。
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