^(18)F-FDG PET显像在淋巴瘤诊断和分期中的应用研究  

^(18)F-FDG PET on Detection and Clinical Staging of Malignant Lymphoma

作　　者：华逢春[1] 管一晖[1] 赵军[1] 左传涛[1] 刘永昌[1] 林祥通[1] 

机构地区：[1]复旦大学华山医院核医学科PET中心,200040

出　　处：《中国医学计算机成像杂志》2002年第3期198-202,共5页Chinese Computed Medical Imaging

摘　　要：目的 :探讨18F -FDGPET在淋巴瘤分期、再分期中的价值以及在评价骨髓浸润中的作用。材料和方法 :59例临床拟诊或确诊为淋巴瘤的患者全身18F -FDGPET显像后 ,就临床分期、病理结果、骨髓浸润、随访结果进行回顾性分析。其中40例未治疗的患者进行分期和骨髓浸润的相关分析 ,19例治疗后的患者进行再分期。结果 :18F -FDGPET诊断淋巴瘤的灵敏度和特异性及准确性分别为100 % ,76.9%及92.5 %。在分期方面 ,27例真阳性患者中40.7%的患者临床分期得到纠正 ,其中上调29.6 % ,下调11.1 %。19例淋巴瘤患者中有5例患者因PET显像证实为临床缓解期 ,避免了不必要的再治疗 ,8例患者的治疗方案得以重新制定。在评价骨髓浸润方面 ,26例未治疗的NHL患者中 ,PET与骨髓穿刺符合率为80.8%。结论 :18F -FDGPET在对淋巴瘤的分期优于传统影像方法,通过PET全身显像 ,使淋巴瘤准确分期 ,对重新制定治疗方案有指导意义。对于淋巴瘤骨髓浸润的诊断可提供有价值的信息。Purpose:Accurate staging and restaging in primary and posttherapic malignant lymphoma are important for treatment management.In this study,the utility of whole-body PET with -fluorodeoxyglucose was performed as an imaging modality for initial staging and restaging,as well as evaluating bone marrow infiltration of non-Hodgkin's lymphoma.Materials and Methods:18F-FDG PET studies were performed on 59 patients.The patients were divided into 2 groups:group 1,suspected or diagnostic malignant lymphoma(n=40),and group 2,post-treatment malignant lymphoma(n=19).Lymphoma-suspicious patients were followed up with histology,cytology.Whole-body images were acquired 1h after intravenous injection of 370～555 MBq 18F-FDG using a PET scanner with an axial field of view of 15.5 cm.Results:In groups 1,thirty patients had positive scans,which were proven to be true positive in 27 patients,whereas the other 3 patients had false-positive findings.Ten patients had negative scans,which were proven to be true-negative.The sensitivity and specificity of 18F-FDG PET for untreated malignant lymphoma were 100%(27 of 27) and 76.9%(10 of 13).The accuracy of 18F-FDG PET was 92.5%(37 of 40).In the 27 true-positive patients,PET led to a change in the clinical staging in 40.7% of patients:29.6% were upstaged and 11.1% were downstaged.In evaluation of bone marrow infiltration of non-Hodgkin's lymphoma,the PET scan and marrow histology agreed in 21 patients (80.8%,21 of 26),being concordant positive in 9 and concordant negative in 12.In three patients the PET scan showed increasing 18F-FDG uptakes but bone marrow biopsy was negative;and MRI proved 2 of these 3 patients,another was proven by bone marrow biopsy after 1 month.2 patients' bone marrow biopsy was positive but PET scan found that bone marrow only had mild uptake of 18F-FDG.In-group 2,only 6 patients were proven in complete remission by other imaging modalities,while 18F-FDG PET scan found out another 5 patients in complete remission.In another 8 patients,new treatment has been planned.Co

关 键 词：淋巴瘤 正电子发射断层显像 诊断 

分 类 号：R733.1[医药卫生—肿瘤]