The clinical application of 18F-fluorodeoxyglucose coincidence imaging in lymphoma

目的探讨氟[18F]-氟代脱氧葡萄糖(18F-FDG)符合探测正电子代谢显像(SPECT/PET)对淋巴瘤的临床应用价值.方法经确诊的18例非霍奇金淋巴瘤(NHL)患者在治疗前后进行18F-FDG符合线路显像,对显像结果用定性和半定量方法分析,并与B超和CT检查结果进行比较.结果 18例患者共进行30例次检查,真阳性21例次,真阴性6例次,假阳性2例次,假阴性1例次,其准确率90.0%,灵敏度95.5%,特异性75.0%,阳性预测值91.3%,阴性预测值85.7%.18F-FDG显像改变了16.7%(3/18)临床分期和46.7%(14/30)的治疗方案.治疗后18F-FDG对复发的阳性预测值100%,阴性预测值为80.0%.CT的阳性预测值50.0%,阴性预测值25.0%.治疗后阴性18F-FDG显像患者无疾病进展生存期为16 ～ 47个月,平均28.7个月,治疗后阳性18F-FDG显像的患者无疾病进展生存期为3 ～ 46个月,平均8.3个月.结论 18F-FDG SPECT/PET在NHL中具有重要的临床价值.To investigate clinical value of (18)F-fluorodeoxyglucose ((18)F-FDG) coincidence imaging (SPECT/PET) in diagnosis and treatment of lymphoma.(18)F-FDG metabolic imaging was performed in eighteen patients NHL before and after treatment using a Vertex(Plus) EPIC MCD/AC from ADAC Company. The findings of (18)F-FDG metabolic images were analyzed in qualitative and semi-quantitative ways. (18)F-FDG images were compared with synchronous routine images such as ultrasonography and CT.Thirty studies were performed in 18 patients with NHL in this study. There were 21 true positives, 6 true negatives, 2 false positives and 1 false negative. The accuracy, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were 90.0%, 95.5%, 75.0%, 91.3%, and 85.7%, respectively. (18)F-FDG imaging led to a change of 16.7% in clinical staging, and 46.7% in management. The PPV and NPV of recurrence detected by (18)F-FDG SPECT/PET were 100% and 80.0%, while these of CT were 50.0% and 25.0% after therapy. Four of five patients with negative entered clinical complete remission (CR), whereas all the 11 patients with abnormal (18)F-FDG uptake relapsed or reprogressed. Progression-free survival (PFS) with negative (18)F-FDG was 16 - 47 months (median: 28.7 months) and PFS with positive was 3 - 46 months (median: 8.3 months).SPECT/PET (18)F-FDG metabolic imaging plays an important role in clinical diagnosis and treatment of NHL.PubMed中文核心期刊要目总览(PKU)中国科学引文数据库(CSCD)04284-2874