Richman S D, Levenson S M, Jones A E, Johnston G S
Semin Nucl Med. 1975 Jan;5(1):103-8. doi: 10.1016/s0001-2998(75)80008-0.
A rational, multidisciplinary approach to Hodgkin's disease and the non-Hodgkin's lymphomas has been responsible for major advances in therapy. Invasive diagnostic procedures and exploratory laparotomy, with their associated complications, make nontraumatic radionuclide imaging most appealing in both the clinical staging of disease and in evaluating therapy. Gallium-67-citrate, the tumor scanning agent of the early 1970's, has demonstrated a marked affinity for Hodgkin's disease and the other lymphomas. False positives are few, with sensitivity greater than 70% throughout the spectrum of Hodgkin's disease and the histiocytic lymphomas. In addition to confirming sites of suspected neoplasm, this agent has proved useful in the detection of occult involvement. Moreover, resolution of abnormal gallium-67 concentrations on follow-up studies functions as a visual ancillary index of therapeutic response. The value of wholebody gallium-67 scintigraphy is further enhanced when used in conjunction with routine technetium brain, bone, liver, and spleen scans. While the diagnostic accuracy of gallium-67 studies has been limited in the abdomen due to bowel activity, our attempts to improve these results with the tumor-seeking radiopharmaceutical indium-111-Bleomycin were unrewarding and subsequently were discontinued. Finally, radionuclide lymphography has also been explored. Its diagnostic usefulness in detecting pelvic and abdominal lymph node involvement warrants further investigation.
对霍奇金病和非霍奇金淋巴瘤采用合理的多学科治疗方法已使治疗取得了重大进展。侵入性诊断程序和剖腹探查术及其相关并发症，使得非创伤性放射性核素成像在疾病的临床分期和评估治疗方面极具吸引力。20世纪70年代早期的肿瘤扫描剂枸橼酸镓-67，已显示出对霍奇金病和其他淋巴瘤具有明显的亲和力。假阳性很少，在整个霍奇金病和组织细胞淋巴瘤范围内，敏感性大于70%。除了确认疑似肿瘤的部位外，这种药物已被证明在检测隐匿性受累方面很有用。此外，随访研究中镓-67浓度异常的消退可作为治疗反应的视觉辅助指标。当全身镓-67闪烁扫描与常规的锝脑、骨、肝和脾扫描联合使用时，其价值会进一步提高。虽然由于肠道活动，镓-67研究在腹部的诊断准确性受到限制，但我们用亲肿瘤放射性药物铟-111-博来霉素改善这些结果的尝试没有取得成效，随后便停止了。最后，放射性核素淋巴管造影也已被探索。其在检测盆腔和腹部淋巴结受累方面的诊断价值值得进一步研究。
