Whole-body diffusion-weighted MRI and 18F-FDG PET/CT can discriminate between different lymphoma subtypes
Whole-body diffusion-weighted MRI and 18F-FDG PET/CT can discriminate between different lymphoma subtypes
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DOI：
10.1016/j.crad.2015.06.087
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发表时间：
2015-11-01
影响因子：
2.6
通讯作者：
Ahlstrom, H.
中科院分区：
文献类型：
--
作者：
Mosavi, F.;Wassberg, C.;Ahlstrom, H.
目的：探讨联合应用2-[F-18]-氟-2-脱氧-D-葡萄糖(F-18-FDG)正电子发射断层扫描(PET)/计算机体层摄影(CT)和弥散加权成像(DWI)对不同亚型(惰性和侵袭性)淋巴瘤的鉴别诊断价值，以及评价全身(WB)DWI和F-18-FDG PET/CT不同定量指标对淋巴瘤患者预后的预测价值。评价不同的定量DWI和F-18-FDG PET/CT参数对不同淋巴瘤亚型的诊断价值。这些参数也分别或联合与总生存期(OS)和无进展生存期(PFS)相关。结果：50例患者分为3组：霍奇金淋巴瘤(HL)12例，侵袭性非霍奇金淋巴瘤(NHL)29例(其中弥漫性大B细胞淋巴瘤20例)，惰性NHL 9例(P=0.013)。侵袭性非霍奇金淋巴瘤的最大血流速度高于非霍奇金淋巴瘤。所有患者的OS分析显示，平均ADC值的增加与OS的延长之间存在关系(p=0.006)。同时具有SUV均值和均值ADC的模型增强了预测PFS的可能性；然而，对DLBCL患者的单独分析显示，没有一个定量参数可以预测OS或PFS。结论：ADC可以区分惰性和侵袭性NHL。这一发现可用于评估从惰性非霍奇金淋巴瘤向侵袭性非霍奇金淋巴瘤转变的可能性。ADC、ADC/SUV和SUV不能独立于淋巴瘤亚型预测OS/PFS。(C)2015年皇家放射科医师学会。爱思唯尔有限公司出版。保留所有权利。
AIM: To determine whether combined 2-[F-18]-fluoro-2-deoxy-D-glucose (F-18-FDG) positron-emission tomography (PET)/computed tomography (CT) and diffusion-weighted imaging (DWI) can be used for characterisation of different lymphoma subtypes, i.e., indolent versus aggressive lymphoma, and also to assess the prognostic value of different quantitative parameters of whole-body (WB) DWI and F-18-FDG PET/CT.MATERIALS AND METHODS: Pre-therapeutic WB magnetic resonance imaging (MRI) including DWI and F-18-FDG PET/CT were performed in lymphoma patients. Different quantitative DWI and F-18-FDG PET/CT parameters were evaluated for characterisation of different lymphoma subtypes. These parameters were also correlated, both separately and in combination, against overall survival (OS) and progression-free survival (PFS). A lesion-by-lesion analysis was performed for correlation analysis between maximum standardised uptake value (SUVmax), mean standardised uptake value (SUVmean) and mean apparent diffusion coefficient (ADC).RESULTS: Fifty patients were included in the study and divided into three groups: Hodgkin's lymphoma (HL), n = 12; aggressive non-Hodgkin's lymphoma (NHL), n = 29 (including 20 patients with diffuse large B-cell lymphoma, DLBCL); and indolent NHL, n = 9. Indolent NHL showed significantly lower mean ADC values than the other two lymphoma groups (p = 0.013). Aggressive NHL had a higher SUVmax than HL. The OS analysis of all patients showed a relationship (p = 0.006) between increased mean ADC and longer OS. A model with both SUVmean and mean ADC, strengthened the possibility to predict PFS; however, a separate analysis of the DLBCL patients showed that none of the quantitative parameters could predict OS or PFS.CONCLUSION: ADC can discriminate between indolent and aggressive NHL. This finding can be useful in assessing possible transformation from indolent to aggressive NHL. ADC, ADC/SUV, and SUV cannot predict OS/PFS independent of lymphoma subtype. (C) 2015 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.