Mainolfi C, Maurea S, Varrella P, Alaia C, Imparato C, Alfano B, Abate G, Bazzicalupo L
Istituto Nazionale dei Tumori, Università degli Studi Federico I, Napoli.
Radiol Med. 1998 Jan-Feb;95(1-2):98-104.
The clinical applications of fluorine-18-deoxyglucose Positron Emission Tomography (FDG PET) have been proposed on account of experimental evidence of increased glucose metabolism in tumor cells.
We examined 98 lymphoma patients--33 with Hodgkin and 65 with non-Hodgkin disease--with FDG PET and compared its findings with those of clinical and conventional radiologic studies. FDG PET was also used to follow-up 32 patients and the results were once again compared with clinical and radiologic data.
During staging, 138 lesions were found, 82 of them (59%) in nodal and 56 (41%) in extranodal locations. Extranodal tumor sites were found in 39 patients (40%), namely 4 with Hodgkin (12%) and 35 with non-Hodgkin (54%) disease. FDG PET findings were in agreement with clinical and radiologic results in all nodal and extranodal lesions, since all of them exhibited abnormally increased FDG uptake. PET detected new tumor sites in 6 patients. In the follow-up, agreement was observed in the majority (78%) of lesions, 30 of them in complete regression, 15 in partial regression and 17 in progression; however, the diagnostic results were in disagreement in the remaining (22%) tumor sites: no abnormal FDG uptake was found in 9 cases despite the persistence of radiologic abnormalities (post-treatment fibrosclerosis). Slightly increased FDG uptake (residual disease) was found in the other 8 lesions, where there was no clinical and/or radiologic evidence of disease.
FDG PET is a functional imaging technique useful to diagnose lymphomas and providing metabolic characterization of cancer abnormalities. Whole body PET permits the simultaneous assessment of nodal and extranodal lymphoma localizations. During the follow-up, FDG PET permits better monitoring of treatment effects than clinical and radiologic examinations.
鉴于肿瘤细胞中葡萄糖代谢增加的实验证据，已提出氟 - 18 - 脱氧葡萄糖正电子发射断层扫描（FDG PET）的临床应用。
我们对98例淋巴瘤患者进行了FDG PET检查，其中33例为霍奇金淋巴瘤患者，65例为非霍奇金淋巴瘤患者，并将其检查结果与临床和传统放射学研究结果进行了比较。FDG PET还用于对32例患者进行随访，并再次将结果与临床和放射学数据进行比较。
在分期过程中，共发现138个病灶，其中82个（59%）位于淋巴结，56个（41%）位于结外部位。39例患者（40%）发现有结外肿瘤部位，其中4例霍奇金淋巴瘤患者（12%），35例非霍奇金淋巴瘤患者（54%）。FDG PET检查结果与所有淋巴结和结外病灶的临床及放射学结果一致，因为所有病灶均表现为FDG摄取异常增加。PET在6例患者中检测到新的肿瘤部位。在随访中，大多数（78%）病灶结果一致，其中30例完全缓解，15例部分缓解，17例进展；然而，其余（22%）肿瘤部位的诊断结果不一致：9例尽管存在放射学异常（治疗后纤维化）但未发现FDG摄取异常。另外8个病灶发现FDG摄取略有增加（残留病灶），但无临床和/或放射学疾病证据。
FDG PET是一种功能性成像技术，有助于诊断淋巴瘤并提供癌症异常的代谢特征。全身PET可同时评估淋巴结和结外淋巴瘤的定位。在随访期间，FDG PET比临床和放射学检查能更好地监测治疗效果。
