18F-FDG PET in malignant lymphoma: significance of positive findings
18F-FDG PET in malignant lymphoma: significance of positive findings
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18F-FDG PET 在恶性淋巴瘤中的应用：阳性结果的意义
DOI：
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发表时间：
2005
影响因子：
9.1
通讯作者：
S. Fanti
中科院分区：
文献类型：
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作者：
P. Castellucci;P. Zinzani;M. Pourdehnad;L. Alinari;C. Nanni;M. Farsad;G. Battista;M. Tani;V. Stefoni;R. Canini;N. Monetti;D. Rubello;A. Alavi;R. Franchi;S. Fanti
目的探讨恶性淋巴瘤（malignant lymphoma，ML）患者正电子发射断层显像（positron emission tomography，PET）18F-脱氧葡萄糖（18F-fluorodeoxyglucose，FDG）摄取增高的意义。所有患者均诊断为ML [574例非霍奇金淋巴瘤（NHL）和274例霍奇金病（HD）]，并在治疗完成时、疑似复发时或随访期间进行研究。在静脉注射370 MBq的18F-FDG后进行PET;在60-90 min后记录图像。选择报告显示FDG摄取增加的患者。当摄取发生在既往疾病部位、不对称淋巴结或不太可能受炎症影响的淋巴结（纵隔，除肺门和腹部外）时，PET结果被认为是淋巴瘤定位阳性。在以下情况下，PET结果被判定为肿瘤定位阴性：生理性摄取（无MALT患者的尿液、肌肉、胸腺或胃肠道）、对称性淋巴结摄取、在PET扫描时已通过其他成像方法确定的与淋巴瘤无关的病变中的摄取、淋巴瘤非典型部位的摄取、极低摄取和非局灶性摄取。将PET结果与其他诊断程序的结果进行比较（包括CT和超声）、活检结果和随访数据。（256例患者）显示FDG摄取增加（NHL中244次扫描和HD中110次扫描）：在286例病例中，FDG摄取被认为是病理性的，并指示ML，在41例病例中，结果被描述为不确定或不明确，在37例病例中，FDG摄取被认为与ML无关（在10次扫描中，获得了归因于ML的异常FDG摄取和归因于其他原因的摄取的并发结果）。在PET结果阳性的286例患者中，发现274例（95.8%）有残留或复发性ML（即真阳性）。在41例不确定结果的患者中，有4例被证实患有ML，而在13例患者中，ML以外的病理过程可以被确定为FDG摄取的原因。在所有报告为非病理性结果的患者中排除ML（100%真阴性率）。因此，本系列的假阳性率约为5%。模拟ML的FDG摄取增加的主要原因是inflammation.ConclusionOur数据证实，18F-FDG-PET具有非常高的，但不是绝对的特异性ML。如前所述，在无活动性疾病的患者中也可观察到FDG摄取增加;然而，在大多数情况下，可正确识别非病理性FDG蓄积。不太常见的情况下，遇到不确定的扫描;这些病例通常由炎症引起，随后消退。
PurposeThe aim of this study was to evaluate the significance of increased uptake of 18F-fluorodeoxyglucose (FDG) in patients with malignant lymphoma (ML) studied by positron emission tomography (PET).MethodsA total of 1,120 consecutive scans carried out in 848 patients were reviewed; all patients had a diagnosis of ML [574 non-Hodgkin’s lymphoma (NHL) and 274 Hodgkin’s disease (HD)] and were studied at completion of therapy, for suspected recurrence or during follow-up. PET was carried out after intravenous injection of 370 MBq of 18F-FDG; images were recorded after 60–90 min. Patients were selected whose reports indicated areas of increased FDG uptake. PET findings were considered positive for lymphomatous localisation when uptake occurred at sites of previous disease, in asymmetrical lymph nodes or in nodes unlikely to be affected by inflammation (mediastinal, except for hilar, and abdominal). PET findings were adjudged negative for neoplastic localisations in the following instances: physiological uptake (urinary, muscular, thymic or gastrointestinal in patients without MALT), symmetrical nodal uptake, uptake in lesions unrelated to lymphoma that had already been identified by other imaging methods at the time of PET scan, uptake at sites atypical for lymphoma, very low uptake and non-focal uptake. PET findings were compared with the results of other diagnostic procedures (including CT and ultrasound), biopsy findings and follow-up data.ResultsOverall, 354 scans (in 256 patients) showed increased FDG uptake (244 scans in NHL and 110 in HD): in 286 cases, FDG uptake was considered pathological and indicative of ML, in 41 cases the findings were described as uncertain or equivocal and in 37 cases, FDG uptake was considered unrelated to ML (in ten scans, concurrent findings of abnormal FDG uptake attributed to ML and uptake assigned to other causes were obtained) . Of the 286 patients with positive PET findings, 274 (95.8%) were found to have residual or recurrent ML (i.e. true positives). Four of the 41 patients with inconclusive findings turned out to have ML, while in 13 patients, pathological processes other than ML could be identified as the cause of FDG uptake. ML was excluded in all patients with findings reported as non-pathological (100% true-negative rate). Therefore, the false-positive rate in our series was about 5%. The main cause of increased FDG uptake mimicking ML was inflammation.ConclusionOur data confirm that 18F-FDG-PET has very high but not absolute specificity for ML. As already suggested, increased FDG uptake may also be observed in patients without active disease; in most cases, however, non-pathological FDG accumulation is properly identified. Less frequently, inconclusive scans are encountered; these cases are usually caused by inflammation, which subsequently resolves.
影响因子：
5.5
作者：
Shreve, PD;Anzai, Y;Wahl, RL
通讯作者：
Wahl, RL