Longo D L, Schilsky R L, Blei L, Cano R, Johnston G S, Young R C
Am J Med. 1980 May;68(5):695-700. doi: 10.1016/0002-9343(80)90256-9.
The records of 122 patients with non-Hodgkin's lymphoma were reviewed, and the findings of the gallium scan analyzed. The scans of 93 patients were reread without knowledge of the previous readings. Two nuclear medicine physicians agreed with the original readings in 70 per cent of the cases and with each other in 89 per cent of the cases. When the data are analyzed case by case, 52 per cent true positive, 13 per cent false positive and 34 per cent false negative scans were found with only 17 per cent of the scans locating disease not found by routine physical examination and roentgenograms. Looking at individual sites of disease, the gallium scan yields an over-all detection of diseased sites of 18.5 per cent, with 72 per cent of all sites being correctly classified as positive or negative. The diffuse histiocytic, mixed and undifferentiated histologies were detected more accurately than all others, with mediastinal and extranodal sites being identified more frequently than any nodal site. The gallium scan revealed a site of disease which advanced the clinical stage in only one of 122 patients (upstaged). Only one of 122 patients was upstaged as a result of gallium scanning. These data suggest that gallium scanning may not be cost effective in the routine staging of patients with non-Hodgkin's lymphoma.
回顾了122例非霍奇金淋巴瘤患者的记录，并分析了镓扫描结果。93例患者的扫描结果在不知先前读数的情况下重新读取。两位核医学医师在70%的病例中与原读数一致，在89%的病例中彼此意见一致。逐例分析数据时，发现真阳性扫描占52%，假阳性扫描占13%，假阴性扫描占34%，只有17%的扫描发现了常规体格检查和X线检查未发现的疾病。就疾病的各个部位而言，镓扫描对病变部位的总体检测率为18.5%，所有部位中72%被正确分类为阳性或阴性。弥漫性组织细胞型、混合型和未分化型组织学的检测比其他类型更准确，纵隔和结外部位比任何淋巴结部位更常被识别。镓扫描仅在122例患者中的1例中发现了使临床分期提前的病变部位（分期上调）。122例患者中只有1例因镓扫描而分期上调。这些数据表明，镓扫描在非霍奇金淋巴瘤患者的常规分期中可能不具有成本效益。
