Efficacy of (18)F-2-fluoro-2-deoxy-D-glucose Positron Emission Tomography/Computerized Tomography for Bone Marrow Infiltration Assessment in the Initial Staging of Lymphoma.
Efficacy of (18)F-2-fluoro-2-deoxy-D-glucose Positron Emission Tomography/Computerized Tomography for Bone Marrow Infiltration Assessment in the Initial Staging of Lymphoma.
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DOI：
10.4274/mirt.54376
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发表时间：
2017-06-01
影响因子：
0.9
通讯作者：
Undar L
中科院分区：
文献类型：
--
作者：
Öner AO;Sürer Budak E;Aydın F;Salim O;Yücel OK;Akkaya B;Toptaş T;Boz A;Yıldız A;Güngör F;Undar L
目前，18F-2-氟-2-脱氧-D-葡萄糖(18F-FDG)正电子发射断层扫描/计算机断层扫描(PET/CT)正被成功地用于霍奇金淋巴瘤(HL)和非霍奇金淋巴瘤(NHL)的分期和随访。各种研究表明，PET/CT能有效检测骨髓受累(BMI)，并与骨髓活检(BMB)结果一致，可作为一种补充方法。本研究旨在评价18F-FDG-PET/CT检测非霍奇金淋巴瘤和非霍奇金淋巴瘤患者体重指数的价值。这项研究包括在阿克德尼兹大学医学院核医学系接受PET/CT初步分期的172例淋巴瘤患者。对病例的PET/CT扫描结果进行目测和半定量评估。最大标准摄取(SUVmax)值是18F-FDG-PET扫描的定量参数。在肉眼评估中，骨髓代谢活动大于肝脏被认为是病理的。对于半定量评估，提取感兴趣区域用于SUVmax估计，其中包括弥漫性代谢活动增加的病例的髂骨峰和局灶性受累的病例的最高活动区域。以BMB为参照物。在所有病例的目测评估中，PET/CT检测BMI的敏感度和特异度分别为31%和85%。在目测方面，HL的敏感度为80%，特异度为78%，而NHL的敏感度为24%，特异度为90%。以SUVmax≥4为标准，半定量诊断HL的敏感性为80%，特异性为68%。在非霍奇金淋巴瘤患者中，以SUVmax≥为3.2时，敏感性为65%，特异性为58%。在这项研究中，PET/CT和BMB检查结果有较高的一致性。PET/CT是检测BMI的一种重要方法。虽然PET/CT不能替代BMB，但我们认为它可以作为BMB活检部位的指导和一种补充影像技术。
Currently 18F-2-fluoro-2-deoxy-D-glucose (18F-FDG) positron emission tomography/computerized tomography (PET/CT) is being successfully used for staging and follow-up of Hodgkin’s lymphoma (HL) and non-Hodgkin’s lymphoma (NHL). Various studies have demonstrated that PET/CT effectively detects bone marrow involvement (BMI) and is concordant with bone marrow biopsy (BMB) findings, thus it is deemed as a complementary method. This study was aimed to evaluate 18F-FDG-PET/CT efficiency for detection of BMI in HL and NHL. The study included 172 lymphoma cases who were admitted to Akdeniz University Medical School Department of Nuclear Medicine for initial staging with PET/CT. Visual and semiquantitative assessments were performed for PET/CT scan findings of the cases. The maximum standard uptake (SUVmax) value was the quantitative parameter used for 18F-FDG-PET scan. In visual assessment, bone marrow metabolic activity that is greater than the liver was considered as pathologic. For semiquantitative assessment, regions of interest were drawn for SUVmax estimation, which included iliac crest in cases with diffusely increased metabolic activity and the highest activity area in cases with focal involvement. BMB was considered as the reference test. On visual assessment of all the cases, PET/CT was found to yield 31% sensitivity and 85% specificity rate for detection of BMI. On visual assessment of HL cases, sensitivity rate was determined as 80%, and specificity as 78%, while in NHL cases the corresponding values were 24% and 90%, respectively. On semiquantitative assessment of HL cases, considering SUVmax≥4, sensitivity was found as 80% and specificity as 68%. In NHL patients, considering SUVmax≥3.2, sensitivity rate was detected as 65% and specificity as 58%. In this study, a moderately high concordance was observed between PET/CT and BMB findings. PET/CT appears to be a significant method for detecting BMI. Although PET/CT is not a substitute for BMB, we suggest it can be used as a guide to biopsy site and a complementary imaging technique for BMB.