PET/CT在恶性淋巴瘤疗效评估及复发诊断中的临床价值

Clinical value of PET/CT in evaluation of curative effects on malignant lymphoma and diagnosis of recurrence

目的探讨PET/CT用于恶性淋巴瘤的疗效预测、评估及复发诊断的临床应用价值。方法选择经病理证实的78例恶性淋巴瘤患者,男性51例,女性27例,年龄17～74岁,均行4～6疗程化疗或化疗加局部放疗。均分别分别在治疗前、治疗中及治疗后行18F-FDG全身PET/CT扫描检查2～6次,对PET、CT及PET/CT图像进行综合分析。结果本组78例中,16例治疗过程中用18F-FDG PET/CT监测发现疗效不佳,更换了治疗方案。PET/CT图像标准化摄取值(SUV值)呈阳性的43例中,39例为肿瘤残存或复发,4例为炎症;SUV值呈阴性的35例中,3例复发。本组疗效:完全缓解(CR)36例;部分缓解(PR)21例;稳定(SD)8例:进展(PD)13例。结论18F-FDG PET/CT在性淋巴瘤早期疗效预测、疗效评估及残留肿块的性质鉴别、预后及生存率评估等方面,均有很高的临床应用价值。

Objective To discuss the clinical application value of PET/CT in the prediction and evaluation of curative effects on malignant lymphoma and in the diagnosis of recurrence. Methods Seventy eight patients, who were pathologically diagnosed as malignant lymphoma（51 male and 27 female ones aged from 17 to 74 years old）,were selected and received the chemotherapy or chemotherapy plus local radiotherapy for 4 to 6 course of treatment. They received the examination by whole - body 18F - FDG PET/CT scanning two to six times before, during, and after the treatment. A comprehensive analysis was made in their PET, CT, and PET/CT images. Results Among the 78 cases,the curative effects in 16 ones were identified poor by the 18F - FDG PET/CT monitoring during the treatment, and then their therapeutic schedule was changed. In 43 cases, the standard uptake values （SUV） of the PET/CT images were positive; in 39 ones, there were residual tumor or recurrence; there were 4 cases of inflammation; in 35 ones, the SUVs were negative, and there were 3 cases of recurrence. The results showed complete relief（CR） in 36 cases, partial relief（PR） in 21 ones, stable disease（SD） in 8 ones, and progressing disease（PD） in 13 ones. Conclusion 18 F - FDG PET/CT has a high clinical application value in the prediction and evaluation of the early curative effects on malignant lymphoma and the identification, prognosis, and the survival rate evaluation of the residual tumor.