淋巴瘤化疗后行受侵区域PET—CT扫描评价疗效的可行性研究  

Minimizing radiation dose with PET-CT limited to involved sites in the assessment ofpostchemotherapy lymphoma

作　　者：粱颖[1] 吴宁[1] 耿建华[1] 方艳[1] 郑容[1] 张雯杰[1] 刘瑛[1] 张瀚[1] 李小萌[1] 

机构地区：[1]北京协和医学院中国医学科学院肿瘤医院PET-CT中心,100021

出　　处：《中华放射医学与防护杂志》2013年第5期536-539,共4页Chinese Journal of Radiological Medicine and Protection

摘　　要：目的 为降低辐射剂量,探讨淋巴瘤化疗后采用受侵区域PET-CT扫描评价疗效的可行性.方法 回顾性分析53例化疗前、后均行全身PET-CT扫描的淋巴瘤初诊患者.将化疗前PET-CT所示的淋巴瘤侵犯范围定义为受侵区域,化疗后假设采用受侵区域PET-CT扫描,比较其与全身PET-CT扫描在疗效评价方面的差异.对全身和受侵区域PET-CT扫描疗效评价结果一致者,比较其有效剂量和扫描时间的差异.结果 在评价淋巴瘤化疗后疗效方面,全身PET-CT扫描示37例达到完全缓解（CR）、13例部分缓解（PR）、3例进展（PD）,受侵区域PET-CT示37例达到CR、14例PR、2例PD.37例CR者全身和受侵区域PET-CT扫描的有效剂量分别为（15.0±1.7）和（12.0±2.5）mSv（Z=-5.307,P＜0.05）、扫描时间分别为（19.5±2.6）与（11.3±4.4）s（Z=-5.324,P＜0.05）.结论 化疗后达到CR者行受侵区域PET-CT扫描,其疗效与全身PET-CT扫描相同,减少了PET-CT扫描的有效剂量和时间.化疗后PR或PD者受侵区域PET-CT扫描的疗效评价结果与全身扫描不同,应行全身PET-CT扫描评价化疗后疗效.Objective To assess PET-CT scanning limited to involved sites in postchemotherapy lymphoma and explore possible radiation dose reductions.Methods Fifty-three lymphoma patients with prechemotherapy and postchemotherapy whole-body PET-CT were analyzed retrospectively.The involved sites were determined on prechemotherapy PET-CT scanning.Whole-body PET-CT scanning and hypothetical PET-CT limited to involved sites were compared in assessing clinical response to chemotherapy.The potential reductions in effective dose and total acquisition time achieved with PET-CT scanning limited to involved sites were calculated.Results Whole-body PET-CT scanning revealed CR in 37 cases,PR in 13 cases and PD in 3 cases in postchemotherapy lymphoma patients,while PET-CT scanning limited to involved sites revealed CR in 37 cases,PR in 14 cases and PD in 2 cases.The mean effective dose was（15.0 ± 1.7）mSv for per patients of CR with whole-body PET-CT scanning,and was （12.0 ± 2.5）mSv for per patients of CR with PET-CT scanning limited in involved sites（Z=-5.307,P〈0.05）.The mean acquisition time was（19.5 ±2.6）s for per patients of CR with whole-body PET-CT scanning,and（11.3 ± 4.4）s for per patient of CR with PET-CT scanning limited in involved sites（Z=-5.324,P〈0.05）.Conclusions Response assessment with PET-CT scanning limited in involved sites has good agreement with whole-body PET-CT scanning in postchemotherapy lymphoma patients with CR.Lymphoma patients with CR may benefit from reduced radiation dose and total acquisition time.PET-CT scanning limited in involved sites is not advisable in patients with PR or PD for poor agreement with whole-body PET-CT scanning in response assessment.

关 键 词：淋巴瘤 PET-CT扫描 疗效评价 有效剂量 

分 类 号：R730.44[医药卫生—肿瘤]