Detection of lymphoma in bone marrow by whole-body positron emission tomography
Detection of lymphoma in bone marrow by whole-body positron emission tomography
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DOI：
10.1182/blood.v91.9.3340.3340_3340_3346
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发表时间：
1998-05-01
期刊：
影响因子：
20.3
通讯作者：
Timothy, AR
中科院分区：
文献类型：
--
作者：
Carr, R;Barrington, SF;Timothy, AR
正电子发射断层扫描(PET)是一种利用18氟脱氧葡萄糖(FDG)在肿瘤细胞中摄取增加的全身成像技术。已发表的研究表明，PEI是一种有效的淋巴瘤分期方法，在检测结外疾病时比CT更敏感。这项研究的目的是确定一些淋巴瘤患者在常规分期PET扫描中观察到的骨髓FDG摄取增加是否代表疾病对骨髓的损害。50例霍奇金淋巴瘤(12例)和非霍奇金淋巴瘤(38例)的PET扫描由三个独立的观察者进行分析，并使用目视分级系统将骨髓分级为正常或异常。所有患者均行单侧髂骨骨髓抽吸和活检。PET扫描与骨髓组织学符合39例(78%)，13例符合阳性，26例阴性。在8例患者中，PET扫描显示FDG摄取增加，但分期活检为阴性；在这8例患者中，4例PET扫描显示骨髓背景正常，焦点FDG“热点”远离活检部位。3例骨髓活检标本阳性，但PET扫描正常；其中2例为非霍奇金淋巴瘤，其恶性细胞在淋巴结或骨髓病变部位不摄取FDG。因此，只有5例患者(10%)的PET扫描结果与活检结果存在差异，无法完全解释。全身分期PET扫描中骨髓FDG摄取的目测解释可以正确评估高比例淋巴瘤患者的骨髓疾病状态。PET有可能减少分期骨髓活检的需要。(C)1998年由美国血液病学会主办。
Positron emission tomography (PET) is a whole-body imaging technique using 18 fluorine-fluorodeoxyglucose (FDG), whose uptake is increased in tumor cells. Published studies have shown PEI to he an effective method of staging lymphoma and to be more sensitive than CT at detecting extranodal disease. The purpose of this study was to determine whether the increased marrow uptake of FDG observed in some lymphoma patients during routine staging PET scans represented marrow involvement by disease. PET scans of 50 patients with Hodgkin's (12) and non-Hodgkin's (38) lymphoma were analyzed by three independent observers and the marrow graded as normal or abnormal using a visual grading system. Unilateral iliac crest marrow aspirates and biopsies were performed on all patients. The PET scan and marrow histology agreed in 39 patients (78%), being concordant positive in 13 and concordant negative in 26 patients. In 8 patients the PET scan showed increased FDG uptake but staging biopsy was negative; in 4 of these 8 patients the PET scan showed a normal marrow background with focal FDG "hot spots" distant from the site biopsied. In 3 patients the marrow biopsy specimen was positive but the PET scan normal; 2 of these 3 patients had non-Hodgkin's lymphoma whose malignant cells did not take up FDG at lymph node or marrow disease sites. Therefore, there were only 5 patients (10%) in whom there was a difference between the PET scan and biopsy result which could not be fully explained. Visual interpretation of marrow FDG uptake during whole-body staging PET scans can correctly assess marrow disease status in a high proportion of lymphoma patients. PET has the potential to reduce the need for staging marrow biopsy. (C) 1998 by The American Society of Hematology.