Bangerter M, Moog F, Buchmann I, Kotzerke J, Griesshammer M, Hafner M, Elsner K, Frickhofen N, Reske S N, Bergmann L
Department of Medicine III (Hematology, Oncology, Clinical Immunology and Infectious Diseases), University of Ulm, Germany.
Ann Oncol. 1998 Oct;9(10):1117-22. doi: 10.1023/a:1008486928190.
Staging of Hodgkin's disease (HD) is accomplished by a variety of invasive and non-invasive modalities. This prospective study was undertaken to investigate the value of whole-body positron emission tomography (PET) with 2-[18F]-fluoro-2-deoxy-D-glucose (FDG) in defining regions involved by lymphoma compared with conventional staging methods in patients with HD.
Fourty-four newly diagnosed patients with HD underwent FDG-PET as part of their initial staging work-up. PET findings were correlated with findings of conventional staging including computed tomography, ultrasound, bone scanning, bone marrow biopsy, liver biopsy and laparotomy. When results of FDG-PET differed to those obtained by conventional methods reevaluation was performed by biopsy, if possible, or magnetic resonance imaging.
The results of FDG-PET were compared with three hundred twenty-one conventional staging procedures performed in 44 patients. FDG-PET was positive in 38 of 44 (86%) patients at sites of documented disease. PET detected additional lesions in five cases previously not identified by conventional staging methods. In another case a nodal lesion suspect on CT was negative at FDG-PET and was settled as true negative by biopsy. As a consequence of PET findings five patients had to be upstaged and one patient had to be downstaged, resulting in changes in treatment strategy in all six cases (14%). FDG-PET failed to visualize sites of HD in four patients. In two of our patients a false positive PET result was obtained.
Our data indicate that FDG-PET provides an imaging technique that appears to visualize involved lesions in most patients with HD and is useful in the management of these patients.
霍奇金淋巴瘤（HD）的分期可通过多种有创和无创方法完成。本前瞻性研究旨在探讨采用2-[18F]-氟-2-脱氧-D-葡萄糖（FDG）的全身正电子发射断层扫描（PET）在确定HD患者淋巴瘤受累区域方面相对于传统分期方法的价值。
44例新诊断的HD患者接受了FDG-PET检查，作为其初始分期检查的一部分。PET检查结果与包括计算机断层扫描、超声、骨扫描、骨髓活检、肝活检和剖腹术在内的传统分期结果进行了对比。当FDG-PET结果与传统方法所得结果不同时，如有可能则通过活检或磁共振成像进行重新评估。
将FDG-PET的结果与44例患者进行的321项传统分期检查的结果进行了比较。在44例（86%）有记录疾病部位的患者中，FDG-PET呈阳性。PET在5例先前传统分期方法未发现的病例中检测到了额外的病变。在另一例病例中，CT上可疑的淋巴结病变在FDG-PET检查中为阴性，经活检确定为真阴性。由于PET检查结果，5例患者分期上调，1例患者分期下调，所有6例（14%）患者的治疗策略均发生了改变。4例患者的HD部位FDG-PET未能显示。在我们的2例患者中获得了假阳性的PET结果。
我们的数据表明，FDG-PET提供了一种成像技术，似乎能使大多数HD患者的受累病变显影，对这些患者的管理很有用。
