^(18)F-FLT PET/CT在弥漫大B细胞淋巴瘤诊断及分期中的价值

Value of ^(18)F-FLT Positron Emission Tomography/Computed Tomography in Diagnosis and Staging of Diffuse Large B-cell Lymphoma

本研究旨在比较18F-FLT PET/CT与CT对弥漫大B细胞淋巴瘤(DLBCL)的诊断及分期的评估价值,分析DLBCL病灶的18F-FLT PET/CT显像及分布特点。收集2008年9月至2009年12月在本院经病理确诊的36例DLBCL患者,以18F-FLT PET/CT及CT扫描全身及头颅,用18F-FLT PET/CT及CT测量原发肿瘤的部位、大小及SUVmax,计算与主动脉弓血池SUVmax比值(T/MB)。结果表明,18F-FLT PET/CT及CT检测DLBCL病灶的一致率为79.10%,其敏感性分别为96.65%、85.44%,特异性分别为100%、57.14%,阳性预测值分别为100%、96.70%,阴性预测值分别为61.11%、21.05%,假阳性率分别为0%、42.86%,假阴性率分别为3.35%、14.56%,准确率分别为96.82%、83.64%。以上指标组间比较均有统计学差异(P<0.01)。结论:18F-FLT PET/CT对DLBCL检测的敏感性、特异性均明显好于CT,能够协助DLBCL准确分期,18F-FLT与18F-FDG PET/CT显像比较尚待进一步研究证实。

The aim of this study was to evaluate the role of 18F-FLT positron emission tomography/computed tomography（PET/CT） in diagnosis and staging of diffuse large B-cell lymphoma（DLBCL） patients and compare with CT.Thirty-six patients with DLBCL in our hospital from September 2008 to Desember 2009 were prospectively evaluated.All 36 patients underwent whole body and head 18F-FLT PET/CT and CT（chest,abdomen cavity and pelvis） were studied before therapy.The maximal standardized uptake value（SUVmax） of every single focus and the SUVmax of aortic arch blood pool were measured and used to calculate the median T/MB value（tumor SUVmax/mediastinal SUVmax） of every patient.The results showed that the consistancy of 18F-FLT PET/CT and CT examinations in focus of DLBCL was 79.10%,the sensitivity,specificity,positive predictive value,negative predictive value and accurate rate of 18F-FLT PET/CT were 96.65%,100%,100%,61.11% and 96.82%,respectively,which were much higher than that of CT（85.44%,57.14%,96.70%,21.05% and 83.64%）.It is concluded that the 18F-FLT PET/CT is a good means for DLBCL diagnosis and staging,which is more sensitive and specific than CT.