18F-FDG PET-CT在肾癌诊断中的应用价值

目的评价~(18)F-FDG PET-CT在肾癌诊断中的应用价值。方法回顾性分析了2006年至2011年间27例其他影像学方法发现肾脏肿物患者的~(18)F-FDG PET-CT检查,并与手术/穿刺病理或长期随访结果进行对照。结果对于肾脏肿瘤,~(18)F-FDG PET-CT诊断良恶性的敏感性为60%,特异性为50%,准确率为59.3%。肾癌病灶的常规扫描与延迟扫描的SUV_(max)没有显著差异[(4.0±3.0)vs(4.6±4.4)]。FDG阳性肾癌病灶的最大径显著大于FDG阴性肾癌病灶[(5.6±2.0)cm vs(2.5±1.0)cm]。FDG阳性肾癌病灶的病理分级显著高于FDG阴性肾癌病灶[(3.1±0.8)vs(1.9±0.6)]。合并转移的肾癌原发病灶的SUV_(max)显著高于未合并转移的肾癌原发病灶[(7.7±3.7)vs(3.0±2.3)]。结论 ~(18)F-FDG PET-CT对鉴别肾脏肿物的良恶性作用有限。由于最大径越大、分化越差、存在转移的肾癌越容易被~(18)F-FDG PET-CT发现,因此对于肾脏肿物患者其仍是一项有意义的检查,可以作为常规影像学方法的有效补充。     

18F-FDG PET-CT显像诊断非小细胞肺癌的价值

目的 探讨18F-FDG PET-CT显像诊断非小细胞肺癌(NSCLC)的价值.方法 对2004年2月至2005年5月91例NSCLC和10例肺良性病变患者的PET-CT检查结果、临床诊断和治疗资料进行分析.结果 91例NSCLC病灶标准摄取值(SUV)均阳性,PET-CT均能正确诊断.10例肺良性病变,SUV阳性3例,包括结核2例和炎性假瘤1例,SUV阴性7例.PET-CT正确诊断9例,1例结核患者PET-CT误诊为肺癌.PET-CT显像诊断NSCLC的敏感性、特异性和准确性分别为100%、90%和99%.91例NSCLC根治手术治疗48例.纵隔淋巴结转移30例,PET-CT正确诊断28例,假阴性2例.纵隔淋巴结无转移18例,PET-CT正确诊断17例,假阳性1例.PET-CT显像诊断NSCLC纵隔淋巴结转移的敏感性、特异性和准确性分别为93.3%、94.4%和93.8%.远处转移33例,PET-CT均能正确诊断.结论 PET-CT显像融合了功能代谢和图像解剖,对肺原发灶和其他脏器的转移能作出正确的诊断.对NSCLC诊断的准确性达90%以上.     

手术前PET-CT对非小细胞肺癌纵隔淋巴结转移的诊断价值

目的探讨术前PET-CT显像对非小细胞肺癌(NSCLC)纵隔淋巴结转移的诊断价值。方法选取2011年10月至2012年8月间进行手术根治或纵隔淋巴结活检的25例NSCLC患者。所有患者术前均行PET-CT检查,并根据手术或纵隔镜结果进行诊断及分期,计算PET-CT对诊断纵隔淋巴结的准确性、灵敏度、特异度、阳性预测值和阴性预测值。结果 25例患者中,纵隔淋巴结阳性率为28.0%。PET-CT对诊断纵隔淋巴结转移的准确性、灵敏度、特异度、阳性和阴性预测值分别为76.0%、57.1%、83.3%、57.1%和83.3%。3例假阴性患者的纵隔最大淋巴结短径分别为1.0、0.9和0.7cm。3例假阳性患者均为炎性增生。结论 PET-CT对NSCLC手术患者纵隔淋巴结转移的诊断灵敏度较低,特异度和阴性预测值较高。因此,PET-CT显示为阳性的纵隔淋巴结,有必要行纵隔镜检查;而阴性者则可不需行纵隔镜检查。     

^(68)Ga-FAPI-04 PET/CT在胰腺癌与胰腺炎鉴别诊断中的价值北大核心

目的:探讨^(68)Ga-FAPI-04 PET/CT在胰腺癌与胰腺炎鉴别诊断中的应用价值。方法:回顾性分析西南医科大学附属医院核医学科2020年09月至2021年03月61例^(68)Ga-FAPI-04 PET/CT胰腺摄取阳性患者的影像学资料,并根据术后病理、病史、血淀粉酶、血清肿瘤标志物、彩超及MRI检查、随访结果等将病例分为胰腺癌组(16例),急性胰腺炎组(12例),慢性胰腺炎组(11例)及非特异性摄取组(22例),并对这四组病例进行分析。结果:四组间SUV_(max)值比较,差异有统计学意义(P<0.05);Post hoc分别比较,急性胰腺炎组与胰腺癌组的SUV_(max)值均显著大于慢性胰腺炎组及非特异性摄取组;慢性胰腺炎组SUV_(max)值大于非特异性摄取组,差异有统计学意义(P<0.05);当尤登指数为0.773时,SUV_(max)分界值为6.45,此时^(68)Ga-FAPI-04 PET/CT对应的灵敏度为90.9%,特异度为86.4%,准确性为87.9%,阳性预测值76.9%,阴性预测值95.0%;急性胰腺炎组与胰腺癌组的SUV_(max)值差异没有统计学意义,但通过摄取示踪剂的形态及同机CT表现可进行鉴别;胰腺癌肿块大小与SUV_(max)值呈正相关关系。结论:^(68)Ga-FAPI-04作为一种新的示踪剂,通过PET/CT显像在胰腺疾病的诊断上有很大的潜力,在鉴别胰腺病灶良恶性方面有重要价值。     

淋巴瘤患者化疗后胸腺反应性增生临床分析

目的 分析淋巴瘤患者化疗后胸腺反应性增生的临床发生情况.方法 对2010年1月至2015年5月初治的22例淋巴瘤患者行CT评估疗效,当出现前上纵隔肿块时,推荐行PET-CT或活组织检查明确肿块性质,CT密切监测肿块变化情况.结果22例淋巴瘤患者中,14例在全部化疗结束后随诊期间出现胸腺增生,8例在化疗期间出现胸腺增生.CT显示胸腺中位最大直径为3.7 cm(2.5~6.8 cm).11例患者行PET-CT检查,均显示纵隔肿块无肿瘤活性,1例进一步行纵隔肿块穿刺活组织检查明确为胸腺反应性增生.结论 恶性淋巴瘤患者在强化疗后可出现胸腺反应性增生,临床上应注意鉴别,避免过度治疗.     

11C-胆碱PET-CT与电视纵隔镜在肺及中纵隔良恶性疾病诊断中价值的研究

目的:探讨正电子发射体层扫描及电视纵隔镜在中纵隔肿物(包括肿瘤及淋巴结)的诊断价值。方法:35例患者在4周内进行CT、11C-胆碱PET-CT及电视纵隔镜检查。应用11C-胆碱作为PET示踪剂,应用标准摄取值(SUV)作为PET检测指标,并与病理结果对照。结果:单纯纵隔病灶中,诊断为结节病的患者12例,结核5例,淋巴瘤7例,无典型“结节”的非干酪性肉芽肿3例。非小细胞肺癌或高度怀疑肺癌的患者8例中,有7例证实为纵隔淋巴结转移(N2或N3),1例纵隔淋巴结病理为反应性增生。根据良恶性分类,CT、11C-胆碱PET-CT及电视纵隔镜对纵隔肿物的诊断准确性分别为51.4%(18/35)、74.3%(26/35)及100%(35/35),电视纵隔镜优于11C-胆碱PET-CT(χ2=22.453,P=0.000)。恶性病灶的SUV值6.9(3.2～9.8,n=14)略高于良性病灶4.9(2.9～8.3,n=21),但差异无统计学意义,P=0.051。结论:电视纵隔镜对中纵隔疾病的诊断仍然是金标准,具有较高的准确性。11C-胆碱PET-CT对良恶性病灶的鉴别上有一定价值,单纯CT及单纯PET(SUV值)在一定程度上导致误诊。     

PET-CT在淋巴瘤中应用的最新进展:第54届美国血液学会年会深度报道

 【摘要】　由于PET-CT兼具解剖和组织功能学表现,其在淋巴瘤中的应用日益广泛。PET-CT主要被用于弥漫大B细胞淋巴瘤（DLBCL）和霍奇金淋巴瘤（HL）的分期和预后评估。目前有多项正在进行中的临床试验研究了PET-CT的应用。此外,PET-CT的评价标准如视觉评估（Deauville 5分制）、最大标准摄取值（SUV）差值（ΔSUVmaxPET0-i）和基线肿瘤代谢活性体积（MTV0）对疾病预后评价的能力不同。但目前的研究仍限于临床试验,如何提高PET-CT的阳性和阴性预测能力及判断预后优劣还有待进一步探究,以期指导临床治疗方案的选择。     

儿童恶性淋巴瘤化疗后胸腺反应性增生的临床分析

背景与目的：恶性肿瘤患者化疗后胸腺反应性增生不易与肿瘤残留或复发鉴别。常被误诊为肿瘤残留或复发而过度治疗。本研究通过分析儿童恶性淋巴瘤化疗后胸腺反应性增生的病例．探讨化疗后胸腺反应性增生的临床特征,以加深对此种病征的认识。方法：收集1999年3月至2004年3月初治淋巴瘤患者经化疗后胸腺反应性增生者共13例。其中霍奇金淋巴瘤5例。非霍奇金淋巴瘤8例。确诊后均予化疗。常规行CT检查评价疗效或追踪观察。纵隔出现新增肿块后,部分患者行正电子发射计算机断层扫描（positive electron tomography computed tomography,PET／CT）检查,明确肿块性质,再决定进一步的治疗;因经济条件所限而不能做PET／CT检查者,予密切追踪观察。结果：10例患者起病时肿瘤即侵犯纵隔,3例患者起病时纵隔无肿瘤侵犯。9例在化疗结束后随诊期间出现胸腺增生,4例在维持治疗期间出现（均为淋巴母细胞性非霍奇金淋巴瘤患者）。CT显示纵隔新增肿块影最大横径为2．2～6．0cm。平均3．7cm。胸腺增生距离上次化疗结束时间2～12个月,平均4个月。5例患者行PET／CT检查,均显示纵隔肿块无肿瘤活性。3例胸腺增生患者被误诊为肿瘤进展或复发,予二线治疗。所有患者随访1-6年（中位时间4年）,无肿瘤复发征象。结论：儿童淋巴瘤患者在强烈化疗后胸腺可出现反应性增生．临床上须避免误诊为胸腺恶性肿瘤而过度治疗。     

PET-CT联合肿瘤标志物在评价晚期非小细胞肺癌化放疗疗效中的应用

晚期非小细胞肺癌(NSCLC)放化疗后,肿瘤组织的代谢变化早于其形态的变化,因此正电子发射断层显像-计算机断层成像(PET-CT)能更早地评价疗效和判断预后.但PET-CT检查会出现假阴性和假阳性,而联合肿瘤标志物水平的检测可以更准确客观地对晚期NSCLC患者作出疗效评价和预后判断.     

18F-FDG PET-CT显像在淋巴瘤疗效评价中的应用

 目的　研究PET-CT 对淋巴瘤治疗后评估的临床价值。方法　40 例经治疗的淋巴瘤患者行18F-FDG PET-CT显像,其中5例于治疗前后多次显像,评价其疗效,与临床疗效评价作对比。结果　5例患者行多次显像,其中2 例治疗后病灶消失,2例缓解,1例肿瘤复发,皆与临床相符。35例患者治疗后行PET-CT显像,30 例临床疗效为完全缓解和部分缓解的患者中,PET-CT显像阳性者25 例;5 例临床确认有肿瘤复发或明显残余,PET-CT显像均为阳性,PET-CT显像后改变了进一步临床治疗方案。结论　18F-FDG PET-CT显像能灵敏、准确地检出淋巴瘤复发及残余病灶,对疗效评价及指导临床治疗有重要价值。     

FDG—PET显像技术在恶性淋巴瘤诊断与治疗中的应用

对大多数肿瘤而言，^18F—FDGPET具有敏感性高、特异性强的优点。在淋巴结和结外淋巴瘤的诊断检出率、淋巴瘤分期和再分期、疗效预测和评估、检测微小残留病灶、监测复发和预后判断均优于CT或^67Ga。PET常上调淋巴瘤分期（约40％），PET的检出效能随淋巴瘤的组织类型而变动，尤其对弥漫性大B细胞淋巴瘤（DLBCL）和霍奇金病诊断率高。对骨髓累及的检出PET／CT可补充骨髓活检（BMB），但不能取代BMB。PET较^67Ga对脾淋巴瘤有更高的检出率。治疗早中期PET／CT是无进展生存期和总生存期独立的预后指标。FDG并非肿瘤特异性物质，FDG—PET存在假阳性和假阴性，需注意鉴别，可能时进行组织活检。     

The role of PET-CT in the differential diagnosis of thymic mass after treatment of patients with lymphoma

Thymic hyperplasia is a common phenomenon in both children and young adults after chemotherapy and may explain the finding of a mediastinal mass in patients with malignant lymphoma after complete remission. In the present study, we report 5 cases with malignant lymphoma presenting with a mediastinal mass on CT scan after completion of chemotherapy diagnosed as thymic hyperplasia by PET-CT imaging. We retrospectively analyzed 5 patients who presented with anterior mediastinal masses a median of 4 months (range 3–6) after achieving complete remission following successful treatment for malignant lymphoma. Three patients were diagnosed with Hodgkin’s lymphoma (HL) and the others with non-Hodgkin’s lymphoma (NHL). The median age of the patients was 23 (range of 18–47). PET-CT was performed on these patients to determine the characteristics of a mass which had been detected on CT. PET-CT was performed for all patients, and the thymic masses demonstrated only mild FDG uptake considered to be consistent with thymic hyperplasia. During a median of 24 months of follow-up, all patients were recurrence-free with a median survival of 15 months (range 10–26 months). It is important to be aware of the possibility of thymic hyperplasia after chemotherapy to avoid misdiagnosis or over-staging of disease, as well as unnecessary biopsies, especially when the presenting anterior mediastinal mass was originally located near the thymus on CT scan. Mild FDG PET uptake was sufficient for the diagnosis of benign disease in the cases in this study.     

12例肾上腺淋巴瘤的影像学表现分析

目的探讨肾上腺淋巴瘤的影像学特点。方法回顾性分析12例初诊未治、有完整影像学资料及病理结果的肾上腺淋巴瘤患者的临床表现、病理类型及影像学表现。结果 12例均为非霍奇金淋巴瘤（2例原发性,10例继发性）。10例继发性病例中8例为双侧肾上腺受侵,2例为单侧受侵;8例表现为肾上腺肿物,2例为肾上腺增厚。8例边界清楚。4例伴有坏死或囊变。无伴有出血、钙化、脂肪者。增强扫描强化程度低于静脉期肝实质。8例伴多脏器受侵。9例伴淋巴结肿大,受侵淋巴结主要分布于腹腔及腹膜后。其中3例行PET-CT检查,肾上腺病变均伴有明显摄取增高,中位SUVmax为24.5。2例原发病例均为双侧肾上腺受侵,肿物密度混杂,内见囊变、坏死,增强扫描静脉期强化程度均低于肝实质。结论肾上腺淋巴瘤CT表现具有一定特征,以双侧受侵、边界清楚的低血供肿物为多见。继发病例常伴有多脏器、多组淋巴结受累。PET-CT有助于肿瘤定性诊断和观察有无淋巴结及其他脏器受累。     

18F-脱氧葡萄糖正电子发射计算机断层显像对淋巴瘤分期和预后评估的作用

 【摘要】　目的　探讨18F-脱氧葡萄糖正电子发射计算机断层显像（FDG-PET）对淋巴瘤患者分期及预后评估的作用。 方法 对初诊的41例淋巴瘤患者,化疗前和化疗4个疗程后行FDG-PET,中位随访30个月,比较化疗前FDG-PET分期和化疗4个疗程后FDG-PET结果对预后的影响。 结果 41例患者治疗前结内、外病灶的最大标准摄取值（SUVmax）分别为9.7±6.9和8.4±6.8。侵袭性非霍奇金淋巴瘤（NHL）和惰性NHL比较,结内、外病灶的SUVmax值差异有统计学意义（侵袭性NHL分别为10.3±7.5和9.1±6.5,惰性NHL分别为4.7±2.1和2.4±0.6,均P<0.05）。NHL和霍奇金淋巴瘤（HL）、B细胞和T细胞NHL、活化B与生发中心来源弥漫大B细胞淋巴瘤治疗前FDG-PET的SUVmax差异无统计学意义（P>0.05）。化疗前 22例（54 ％）患者FDG-PET检出结外器官病变;6例（15 ％）因FDG-PET发现CT等其他检查未显示的淋巴结或结外病变而提高临床分期。治疗前经FDG-PET分期为Ⅰ、Ⅱ期的患者15例（37 ％）,Ⅲ、Ⅳ期的患者26例（63 ％）。随访期间,FDG-PET分期Ⅰ、Ⅱ期的患者中1例（7 ％）因疾病进展死亡,Ⅲ、Ⅳ期的患者中6例（23 ％）因疾病进展死亡。41例患者化疗4个疗程后行FDG-PET检查,FDG-PET阴性的患者17例（41 ％）中,随访期间1例（6 ％）因疾病复发死亡,FDG-PET阳性的患者24例（59 ％）中,随访期间6例（25 ％）因疾病进展死亡。 结论　化疗前FDG-PET检查有助于对淋巴瘤患者进行准确的临床分期,化疗4个疗程后FDG-PET检查有助于评估淋巴瘤患者的预后,指导进一步治疗。     

18FDG PET - CT中SUV值对胰腺肿瘤鉴别诊断的作用

目的 回顾性分析胰腺良恶性病变在PET -CT双时相显像中摄取18FDG的变化,寻找PET显像中最大SUV的诊断界值,以探讨其对胰腺良恶性病变诊断与鉴别诊断的临床应用价值.方法 2006年9至2010年9月118例胰腺良恶性病变患者.①胰腺癌患者65例,24例有病理或细胞学诊断,41例仅有影像学和临床诊断,并经临床和影...     

Diagnostic Performance of Diffusion - Weighted Imaging for Multiple Hilar and Mediastinal Lymph Nodes with FDG Accumulation

Background: It is sometimes difficult to assess patients who have multiple hilar and mediastinal lymph nodes(MHMLN) with FDG accumulation in PET-CT. Since it is uncertain whether diffusion-weighted magneticresonance imaging (DWI) is useful in the assessment of such patients, its diagnostic performance was assessed.Materials and Methods: Twenty-three patients who had three or more stations of hilar and mediastinal lymphnodes with SUVmax of 3 or more in PET-CT were included in this study. Results: For diagnosis of disease, therewere 20 malignancies (lung cancers 17, malignant lymphomas 2 and metastatic lung tumor 1), and 3 benigncases (sarcoidosis 2 and benign disease 1). For diagnosis of lymph nodes, there were 7 malignancies (metastasisof lung cancer 7 and malignant lymphoma 1) and 16 benign lymphadenopathies (pneumoconiosis/silicosis 7,sarcoidosis 4, benign disease 4, and atypical lymphocyte infiltration 1). The ADC value (1.57±0.29 ×10-3mm2/sec) of malignant MHMLN was significantly lower than that (1.99±0.24 ×10-3mm2/sec) of benign MHMLN(P=0.0437). However, the SUVmax was not significantly higher (10.0±7.34 as compared to 6.38±4.31) (P=0.15).The sensitivity (86%) by PET-CT was not significantly higher than that (71%) by DWI for malignant MHMLN(P=1.0). The specificity (100%) by DWI was significantly higher than that (31%) for benign MHMLN (P=0.0098).Furthermore, the accuracy (91%) with DWI was significantly higher than that (48%) with PET-CT for MHMLN(P=0.0129). Conclusions: Evaluation by DWI for patients with MHMLN with FDG accumulation is useful fordistinguishing benign from malignant conditions.     

误诊为周围型肺癌的肺结核18F-FDG PET-CT表现

目的分析误诊为周围型肺癌的肺结核18F-FDG PET-CT表现,提高对肺结核PET-CT表现的认识。方法回顾性分析31例在我院行18F-FDG PET-CT检查并误诊为周围型肺癌的肺结核的PET-CT表现。27例行双时像显像。所有患者均行胸部屏气螺旋CT扫描。所有病例通过组织学或诊断性治疗证实。结果 31例肺结核(均径≤4.0cm)均为周围型肺结节,23例有分叶,27例有毛刺,27例有胸膜牵拉,13例有小卫星灶。肺结核病灶的SUVmax常规为3.87±3.20,SUVmax延迟为4.10±2.94,△SUVmax为0.97±1.02,RI为28.92%±32.11%。肺结核病灶的SUVmax与其均径呈正相关(r=0.816,P<0.01),且在不同大小病变组中的分布差异有统计学意义(P<0.05)。5例患者有肺门和/或纵隔淋巴结肿大,最大淋巴结的平均短径为(1.52±0.41)cm,肿大淋巴结的SUVmax明显高于非肿大淋巴结(P<0.01)。15例患者的淋巴结为高密度,淋巴结的SUVmax在高密度淋巴结组与非高密度淋巴结组的差异没有统计学意义(P>0.05)。结论误诊为周围型肺癌的肺结核病灶,形态学表现和摄取程度可与周围型肺癌相似,但较少伴有淋巴结肿大,当病灶中央出现摄取分布稀疏区以及病灶周围有小卫星灶时,对诊断有帮助。     

^18F-FDG PET-CT与肿瘤标志检测对肺癌诊断价值的分析

目的：分析^18F-FDG PET-CT和肿瘤标志对肺癌的诊断价值及SUVmax与临床病理参数的关系。方法：选取152例可疑肺癌的初治患者,治疗前分别行^18F-FDG PET-CT及神经元特异性烯醇化酶（NSE）、癌胚抗原（CEA）和细胞角蛋白片段（CYFRA21—1）检查,以细胞学或病理学结果为金标准分析^18F-FDG PET-CT和肿瘤标志的诊断价值。结果：152例患者中,肺癌患者134例。^18F-FDG PET-CT诊断肺癌的敏感性、特异性和准确性分别为96．27％、61．11％和92．11％;肿瘤标志的敏感性、特异性和准确性分别为87．31％、55．56％和81．41％,两者比较P值分别为0．008、1．000和0．024。在134例肺癌患者中,初步统计显示SUVmax与原发肿瘤大小有相关性（r=0．548,P=0．000）,SUVmax在不同病理类型之间差异无统计学意义,P=0．085,SUVmax与各肿瘤标志值无相关性。结论：SUVmax在一定程度上反映原发病灶大小,^18F-FDG PET-CT检查对肺癌诊断是一种灵敏可靠的方法,联合肿瘤标志综合分析能提高肺癌诊断的准确性,减少漏诊或误诊率。     

Radiotherapy for Post-Chemotherapy Residual Mass in Advanced Seminoma: A Fluorodeoxyglucose Positron Emission Tomography-Computed Tomography-Based Risk-adapted Approach

AimsThere is a lack of consensus regarding the management of post-chemotherapy residual mass in classical seminoma. The use of fluorodeoxyglucose positron emission tomography-computed tomography (FDG PET-CT) may aid the detection of residual masses harbouring viable disease and help to tailor therapy. The aim of this study was to evaluate if PET-CT could identify patients who will benefit from locoregional radiotherapy.Materials and MethodsThis ethics-approved study included patients with advanced classical seminoma primarily treated with standard platinum-based first-line chemotherapy. Patients were either observed or given adjuvant radiotherapy based on the clinician's preference and followed up. For this study, patients were stratified into two groups based on FDG PET-CT residual nodal maximum standardised uptake value (SUVmax): low risk (SUVmax <3) and high risk (SUVmax ≥3). Further subgroup analysis was carried out for patients with residual nodal size ≥3 cm and SUVmax ≥3, and this was considered as the very high risk group. The diagnostic accuracy of FDG PET-CT was assessed and survival was compared between the different groups.ResultsSixty-nine patients were included in the study: 48 patients were observed and 21 received radiotherapy. The low and high risk groups contained 50.7% and 49.3% of the patients, respectively. The very high risk subgroup had 24 patients. At a median follow-up of 44 months, locoregional failures in the radiotherapy and observation cohorts were 0% and 30% (P = 0.059) in the very high risk subgroup and 5.8% and 29.4% (P = 0.078) in the high risk group. The positive predictive value for the very high risk and high risk groups was 30% and 17.1%, respectively. The benefit of locoregional control failed to translate into overall survival benefit.ConclusionA tailored, FDG PET-based risk-adapted treatment approach can refine the management of post-chemotherapy residual masses in seminoma. In this study, with the largest cohort of advanced seminoma patients treated with radiotherapy reported to date, radiotherapy seems to benefit patients with post-chemotherapy residual mass SUVmax ≥3.     

Standardized uptake value based evaluation of lymphoma by FDG and FLT PET/CT

Although ¹⁸F‐FDG PET/CT imaging is the conventional method for evaluating lymphoma, PET/CT imaging with radiopharmaceuticals other than FDG is being investigated. We evaluated the utility of different standardized uptake value (SUV) measurements in ¹⁸F‐FLT PET/CT scans compared with PET/CT scans performed with FDG. Two scans, each using one of the radiopharmaceuticals, were performed on each of 114 patients with histologically proven lymphoma. Maximum and mean SUV (SUVmax) and (SUVmean) of all visualized lesions, with backgrounds of mediastinal blood pool, liver, spleen and vertebra were calculated. The ratios of the SUVs of the lesions to those of each reference region were statistically analyzed. Using receiver operating characteristic curves, we analyzed the differences in uptake of the two agents in aggressive and indolent B‐cell non‐Hodgkin lymphoma. We found that the SUVmax measurements of FDG were significantly different between aggressive and indolent B‐cell non‐Hodgkin lymphoma. The receiver operating characteristic curve of SUVmax of tumour/liver for FDG studies resulted in the most area under the curve. The SUVmax of the tumour/mediastinum ratio for FLT studies resulted in the most area under the curve (0.781). There was no significant correlation between FDG and FLT uptake in most types of lymphoma we studied. Further studies of the characteristics of ¹⁸F‐FLT should employ the tumour/mediastinum SUVmax ratio for accurate uptake measurement. Copyright © 2013 John Wiley & Sons, Ltd.