^(18)FDG PET显像在恶性淋巴瘤诊治中的应用

^(18)FDG PET in the Management of Malignant Lymphoma

目的总结FDGPET显像用于恶性淋巴瘤诊治的临床经验并探讨其应用前景。方法回顾性分析1998年9月～2003年5月在本中心检查的44例病理确诊为非霍奇金淋巴瘤(NHL)和霍奇金病(HD)患者共73次18FDGPET显像。采用视觉分析和半定量分析相结合的方法。结果(1)受淋巴瘤侵犯的各组淋巴结和多种脏器均能摄取18FDG,呈现放射性增高阳性显像;(2)6例诊断前做PET显像患者中5例在PET帮助下得以确诊,1例脑显像假阴性可能因激素治疗影响显像结果。另6例治疗前显像的患者,PET使其中4例改变了原分期。16例其他检查显示可疑残存或复发病灶,经18FDGPET显像5例证实、9例除外复发、2例发现新病灶;(3)3例治疗前后PET显像对比及16例治疗后随访,均对早期治疗反应及疗效做出正确评价。结论18FDGPET可用于恶性淋巴瘤的诊断、分期、观察治疗反应,评价疗效,鉴别复发或有无残存病灶,以及预测预后等。

To study the role and prospect of 18FDG PET imaging in patients with malignant lymphoma. Methods Forty-four patients(73 studies)with malignant lymphoma underwent 18FDG PET imaging. Final diagnoses were proved histopathologically. Images obtained were analyzed using visual and semiquantitative analysis(SUV). Results Either nodal or extranodal tumor foci showed high 18FDG uptake. 18FDG PET led to correct diagnosis in 5 of 6 cases except 1 false negative case. PET imaging changed the staging in 4 of 6 cases pretherapeutically. Of the 16 cases in which either residual tumor mass or suspicious recurrence suggested by other imaging modalities, 18FDG PET confirmed relapse in 5, detected more lesions in 2 and showed no evidence of active tumor mass in 9. For the 3 patients with comparison between pre- or post-treatment PET imaging and 16 patients who only underwent post-treatment PET follow-up studies, therapeutic response was correctly evaluated. Conclusions 18FDG PET is a valuable non-invasive metabolic imaging modality in facilitating diagnosis and staging, evaluating therapeutic response,assessing clinical outcome and predicting prognosis in patients with lymphoma.