^18氟-脱氧葡萄糖PET在儿童恶性淋巴瘤分期、疗效评估及随诊中的意义

Role of ^18F-FDG-PET in diagnosis and treatment of lymphoma in children

目的探讨^18氟-脱氧葡萄糖（^18F—FDG）正电子发射断层显像（PET）在儿童恶性淋巴瘤分期、疗效评估及随诊中的意义。方法回顾性分析88例儿童恶性淋巴瘤初诊时、化疗中期及停药后随诊过程中^18F—FDG—PET扫描结果，并与同期的CT扫描相比较。结果67例初诊儿童淋巴瘤患者，化疗前共评估了1072个解剖部位，PET和CT均提示瘤灶阳性及阴性部位分别为11．10％和77．52％，PET阳性CT阴性的部位占6．81％，而PET阴性CT阳性的占4．57％，PET在化疗前受累部位的诊断方面优于CT扫描。对26例随诊患者，在治疗中期、停药时及停药后进行了35次PET检查，32例次患儿瘤灶为阴性，PET扫描瘤灶真阴性为28例次（真阴性率为87．50％），CT为16例次（真阴性率为57．14％），在假阳性方面，CT比较高，为16例次（假阳性率为50．00％），而PET仅为4例次（假阳性率为12．50％），临床吻合度PET大于CT。结论PET对于儿童恶性淋巴瘤的临床分期、鉴别残余病灶的性质以避免不必要的过度治疗或二次活检，以及发现肿瘤的早期复发具有一定的意义。

Objective To investigate the value of Fluorine-18 fluorodeoxyglucose positron emission tomography （^18F-FDG-PET） in staging and detecting residual disease during follow-up of non-Hodgkin＇s lymphoma in children. Methods The results of lSF-FDG-PET of 88 pediatric NHL before and after chemotherapy was analyzed respectively. The results were compared with CT scans simuhaneously. Results 67 cases were performed for initial staging. Of the 1072 anatomy regions were analyzed by PET and CT with concordance of 88.62 % regions （positive in 11.10 % and negative in 77.52 %）. Disconcordance were found in 11.38 % regions （PET positive but CT negative in 6.81%, PET negative but CT positive in 4.57 %）. PET was significantly better than CT scan in the staging of pediatric NHL. 35 scans were performed in the follow-up. The true residual disease positive rate of PET and CT were 87.50 % and 57.14 % respectively. The false positive rate of PET and CT were 12.50 % and 50.00 % respectively. Conclusion ISF-FDG-PET imaging is of great value for the staging of the pediatric patients with NHL. It＇s a useful technique to identify the residual disease, avoid unnecessary treatment and biopsy and can predict early relapse.