Mucosa-associated lymphoid tissue (MALT) lymphoma usually originates from the stomach and presents with low ^(18)F-fluorodeoxyglucose (FDG) avidity with average maximum standard uptake value of 3.6. Colorectal MALT ly...Mucosa-associated lymphoid tissue (MALT) lymphoma usually originates from the stomach and presents with low ^(18)F-fluorodeoxyglucose (FDG) avidity with average maximum standard uptake value of 3.6. Colorectal MALT lymphoma is a rare entity that contributes to 1.6% of all MALT lymphomas and < 0.2% of large intestinal malignancies. The case reported herein firstly revealed stage Ⅱ MALT lymphoma with unexpected higher ^(18)F-FDG avidity of 18.9 arising at the colorectal anastomosis in a patient with a surgical history for sigmoid adenocarcinoma, which was strongly suspected as local recurrence before histopathological and immunohistochemical examinations. After accurate diagnosis, the patient received four cycles of standard R-CVP regimen (rituximab, cyclophosphamide, vincristine and prednisone), combined target therapy and chemotherapy, instead of radiotherapy recommended by National Comprehensive Cancer Network guidelines. He tolerated the treatment well and reached complete remission.展开更多
Objective:The primary aim of this study was to assess the efficacy of whole-body diffusion-weighted imaging(WB-DWI)in detecting tumour recurrence and metastasis of gastrointestinal cancers by comparison with 18F-2-flu...Objective:The primary aim of this study was to assess the efficacy of whole-body diffusion-weighted imaging(WB-DWI)in detecting tumour recurrence and metastasis of gastrointestinal cancers by comparison with 18F-2-fluoro-2-deoxy-Dglucose positron emission tomography or computed tomography(18F-FDG-PET/CT).A secondary aim was to evaluate the change of apparent diffusion coefficient(ADC)value between metastases and normal tissues.Methods:Twenty-eight previously confirmed gastrointestinal cancer patients with suspected tumour recurrence or metastasis were recruited.WB-DWI and PET/CT images were evaluated by two radiologists and a nuclear medicine physician.Agreement between WB-DWI and PET/CT for detective efficacy was compared using kappa statistics.Additionally,diagnostic accuracy,sensitivity,specificity,negative predictive value(NPV),and positive predictive value(PPV)were also statistically analysed.ADC values between metastatic and normal tissues were compared.Results:There was no statistically significant difference(P>0.05)in the overall diagnostic performances of PET/CT(accuracy 98.9%;sensitivity 95.2%;specificity 99.8%;PPV 98.9%;NPV 98.9%)and WB-DWI(accuracy 95.9%;sensitivity 81.7%;specificity 99.1%;PPV 95.0%;NPV 96.1%).WB-DWI showed agreement with PET/CT(j=0.877)for detecting recurrence and distant metastases.A statistically significant difference in ADC value was observed between tissues of normal healthy volunteers and metastases in lymph nodes,liver and bones(P<0.05).Conclusions:WB-DWI is reliable in detecting tumour recurrence and metastasis of colorectal cancer and offers the same diagnostic performance as 18F-PET/CT without ionizing radiation.The quantitative value of ADC provides extra information to determine cancer metastasis.展开更多
文摘Mucosa-associated lymphoid tissue (MALT) lymphoma usually originates from the stomach and presents with low ^(18)F-fluorodeoxyglucose (FDG) avidity with average maximum standard uptake value of 3.6. Colorectal MALT lymphoma is a rare entity that contributes to 1.6% of all MALT lymphomas and < 0.2% of large intestinal malignancies. The case reported herein firstly revealed stage Ⅱ MALT lymphoma with unexpected higher ^(18)F-FDG avidity of 18.9 arising at the colorectal anastomosis in a patient with a surgical history for sigmoid adenocarcinoma, which was strongly suspected as local recurrence before histopathological and immunohistochemical examinations. After accurate diagnosis, the patient received four cycles of standard R-CVP regimen (rituximab, cyclophosphamide, vincristine and prednisone), combined target therapy and chemotherapy, instead of radiotherapy recommended by National Comprehensive Cancer Network guidelines. He tolerated the treatment well and reached complete remission.
文摘Objective:The primary aim of this study was to assess the efficacy of whole-body diffusion-weighted imaging(WB-DWI)in detecting tumour recurrence and metastasis of gastrointestinal cancers by comparison with 18F-2-fluoro-2-deoxy-Dglucose positron emission tomography or computed tomography(18F-FDG-PET/CT).A secondary aim was to evaluate the change of apparent diffusion coefficient(ADC)value between metastases and normal tissues.Methods:Twenty-eight previously confirmed gastrointestinal cancer patients with suspected tumour recurrence or metastasis were recruited.WB-DWI and PET/CT images were evaluated by two radiologists and a nuclear medicine physician.Agreement between WB-DWI and PET/CT for detective efficacy was compared using kappa statistics.Additionally,diagnostic accuracy,sensitivity,specificity,negative predictive value(NPV),and positive predictive value(PPV)were also statistically analysed.ADC values between metastatic and normal tissues were compared.Results:There was no statistically significant difference(P>0.05)in the overall diagnostic performances of PET/CT(accuracy 98.9%;sensitivity 95.2%;specificity 99.8%;PPV 98.9%;NPV 98.9%)and WB-DWI(accuracy 95.9%;sensitivity 81.7%;specificity 99.1%;PPV 95.0%;NPV 96.1%).WB-DWI showed agreement with PET/CT(j=0.877)for detecting recurrence and distant metastases.A statistically significant difference in ADC value was observed between tissues of normal healthy volunteers and metastases in lymph nodes,liver and bones(P<0.05).Conclusions:WB-DWI is reliable in detecting tumour recurrence and metastasis of colorectal cancer and offers the same diagnostic performance as 18F-PET/CT without ionizing radiation.The quantitative value of ADC provides extra information to determine cancer metastasis.
