Limitations of PET for imaging lymphoma
Limitations of PET for imaging lymphoma
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PET 对淋巴瘤成像的局限性
DOI：
--
复制
发表时间：
2003
影响因子：
9.1
通讯作者：
M. O'Doherty
中科院分区：
文献类型：
--
作者：
S. Barrington;M. O'Doherty
氟-18氟脱氧葡萄糖（FDG）的摄取在糖酵解增强的过程中增加，包括恶性肿瘤。正电子发射断层扫描（PET）成像淋巴瘤正是利用FDG的这一特性。FDG虽然是一种良好的肿瘤示踪剂，但并不完美，其使用也有局限性。FDG在某些类型的淋巴瘤中可能具有低摄取，主要是低级别淋巴瘤。高生理摄取可发生在肠、泌尿道、肌肉、唾液腺和淋巴组织内。FDG对恶性肿瘤没有特异性，在糖酵解增加的良性疾病（如感染、炎症和肉芽肿性疾病）中摄取增加。良性疾病通常比恶性肿瘤摄取低，但有重叠。FDG的这些局限性意味着肿瘤可能被其他病理学"遗漏"、"掩盖"或"模仿"。本文将介绍这些限制，并讨论在可能的情况下规避这些限制的方法。这些措施包括在淋巴瘤出现时进行基线扫描，以与治疗后扫描进行比较，简单的操作以减少生理摄取，如给予速尿和地西泮，并对免疫抑制患者的替代病理学的可能性保持警惕。患有人类免疫缺陷病毒继发性疾病的患者在这方面特别具有挑战性，因为他们通常具有双重或多重病理。PET报告中最重要的技能之一可能是认识到其局限性，并在无法对转诊临床医生的问题给出明确答案时明确。这可能需要使用PET来指导临床医生对最有可能产生正确诊断的部位进行活检。
The uptake of fluorine-18 fluorodeoxyglucose (FDG) is increased in processes with enhanced glycolysis, including malignancy. It is this property of FDG which is exploited in positron emission tomography (PET) imaging for lymphoma. FDG, whilst a good oncology tracer, is not perfect and there are limitations to its use. FDG may have low uptake in some types of lymphoma, predominantly low-grade lymphomas. High physiological uptake may occur within the bowel, urinary tract, muscle, salivary glands and lymphoid tissue. FDG is not specific for malignancy and increased uptake occurs in benign conditions with increased glycolysis such as infection, inflammation and granulomatous disease. Benign conditions usually have lower uptake than malignancy but there is overlap. These limitations of FDG mean that tumour may be 'missed', 'masked' or 'mimicked' by other pathology. These limitations are described in this article and methods to circumvent them where possible are discussed. These include performing baseline scans at presentation with lymphoma for comparison with post-treatment scans, simple manoeuvres to reduce physiological uptake such as administration of frusemide and diazepam and remaining alert to the possibility of alternative pathology in immunosuppressed patients. Patients with disease secondary to human immunodeficiency virus are a particular challenge in this regard as they often have dual or multiple pathology. One of the most important skills in PET reporting may be to recognise its limitations and be clear when a definitive answer cannot be given to the referring clinician's question. This may require using PET to direct the clinician to biopsy the site most likely to yield the correct diagnosis.
粒细胞集落刺激因子治疗增加脾脏氟脱氧葡萄糖摄取：PET 成像结果。
DOI：
--
发表时间：
1999
期刊：
Journal of nuclear medicine : official publication, Society of Nuclear Medicine
影响因子：
--
作者：
Sugawara,Y;Zasadny,KR;Kison,PV;Baker,LH;Wahl,RL
通讯作者：
Wahl,RL
影响因子：
3.3
作者：
Harris, Kenneth R.
通讯作者：
Harris, Kenneth R.