^(18)F-FDG符合探测正电子显像在恶性淋巴瘤诊治评估中的应用

Application of ^(18)F-FDG SPECT/PET in the detection and evaluating therapeutic response of malignant lymphoma

目的探讨18F-FDG符合探测正电子显像(SPECT/PET)在恶性淋巴瘤诊治中的应用。方法回顾性分析2006年1月~2010年9月在本院经病理确诊为恶性淋巴瘤67例患者共102次18F-FDGSPECT/PET显像结果。霍奇金淋巴瘤患者9例,1例治疗前行SPECT/PET显像,8例为治疗中、后行检查。非霍奇金淋巴瘤患者58例,16例治疗前SPECT/PCT显像,9例治疗前、后均进行SPECT/PET检查,33例治疗后显像。结果 9例霍奇金淋巴瘤患者中治疗前阳性显像1例,化疗中和(或)放疗后SPECT/PET显像共8例,其中5例完全缓解,1例未见明显缓解,1例部分缓解,1例进展。58例非霍奇金淋巴瘤患者中25例治疗前患者中的SPECT/PET显像24例为阳性(96.0%)。42例接受治疗的非霍奇金淋巴瘤患者(包括9例治疗前后均行检查患者),其中16例SPECT/PET显像为完全缓解(38.09%),10例部分缓解(23.81%),9例病灶有进展(21.43%),7例缓解后又复发(16.67%)。结论 18F-FDGSPECT/PET在淋巴瘤的临床诊断分期与疗效评估中具有重要的临床价值。

Objective To investigate the clinical value of 18F-fluorodeoxyglucose （FDG） SPECT with dual-head coincidence detecting system in the detection and the therapeutic efficiency evaluation of malignant lymphoma. Methods 67 patients （102 studies） histopathologically diagnosed as malignant lymphoma underwent 18F-FDG SPECT/PET imaging from Jan 2006 to Sep 2010. The imaging was retrospectively reviewed. In 9 patients with HD, 1 patient underwent SPECT/PET imaging before treatment, 8 cases were scanned during or post treatment. In 58 patients with NHL,16 patients underwent SPECT/PET imaging before treatment, 9 patients were carried out SPECT/PET examination before and after treatment, 33 patients was scanned post treatment. Results According to the SPECT/PET imaging, in 9 cases with HD, 1 case of pre-treatment showed positive result,8 cases who were scanned during or post treatment,5 cases showed complete response,1 case with no significant improvement, partial response in 1 case, the other 1 case was in progressing. Among 58 patients with NHL,25 cases of which before therapy, positive finding were detected in 24 patients （96.0%）. From the SPECT/PET scans of 42 NHL patients after therapy（including 9 patients underwent scans before and after treatment）, 16 patients showed complete response （38.09%）, partial response in 10 cases （23.81%）, 9 patients with lesions progressing （21.43%）, 7 cases were in recurring after relief （16.67%）. Conclusion 18F-FDG SPECT/PET has important clinical value in the diagnosis, staging, evaluating therapeutic response, recurrence and residual in patients with lymphoma.