摘要
目的霍奇金淋巴瘤治疗后常见残存肿块,本研究旨在评价^(18)F-FDG PET-CT诊断肿瘤残存的准确性,并探讨延迟扫描的应用价值。方法回顾性分析了自2006年8月至2011年1月间,50例治疗结束后有纵隔残存肿块[最大径(2.9±2.0)cm]的霍奇金淋巴瘤患者,行PET-CT检查评价治疗疗效。所有患者临床和影像学随访至少1年,证实13例有肿瘤残存,37例无肿瘤残存。结果经过ROC曲线分析,确定SUV_(max)评价肿瘤残存的最佳临界值为2.2。根据此标准,PET-CT诊断肿瘤残存的敏感性为69.2%、特异性为81.1%、准确性为78.0%、阳性预期值为56.2%、阴性预期值为88.2%。其中34例行胸部延迟扫描,以SUV_(max)>2.2且延迟后升高10%作为延迟扫描判断肿瘤残存的标准,与常规扫描比较,延迟扫描减少了5例假阳性,增多2例假阴性。两者对肿瘤残存判断的准确性差异无统计学意义(P=0.355)。结论对于霍奇金淋巴瘤治疗后纵隔残存肿块,PET-CT是判断有无肿瘤残存的有效检查方法,延迟扫描可减少假阳性。
Objective The aim of this study was to evaluate the accuracy of18 FDG PET-CT and its dual time point scanning in a residual mediastinal disease after therapy completion in Hodgkin＇s lymphoma. Methods 50 consecutive HL patients with residual mediastinal disease （maximum diameter, 2. 9 ± 2. 0 cm） were analyzed retrospectively. 34 patients received scanning at two time points： the first at 60 -70 min （scan 1 ） and the second at 120 - 150 min, both were after FDG injection （ scan 2）. 37 patients were still disease-free during at least 1-year follow-up. 13 patients had residual tumor as either follow-up evidence of progress or of effective therapy. Results The cut-off point of SUVmax 2. 2 was determined by receiver operating characteristic （ROC） curves method in assessment of residual mediastinal disease. Thus, the sensi- tivity, specificity, accuracy, positive predictive value and negative predictive value were 69.2%, 81.1%, 78.0%, 56. 2% and 88.2% respectively in assessment of residual mediastinal disease. Dual time point scanning of 34 patients, with SUVmax 〉 2. 2 and a threshold value of 10% increase between scan 1 and scan 2, had decreased 5 false positive pa- tients and increased 2 false negative patients. No significant difference was noted between single time point scanning and dual time point scanning （ P 〉 0.05 ）. Conclusion 18 FDG PET-CT is a suitable non-invasive method in residual disease after therapy completion of Hodgkin＇s lymphoma. Dual time point scanning might be helpful to decrease false-positive rates.
出处
《癌症进展》
2012年第5期435-439,共5页
Oncology Progress
