18F-FDG符合探测正电子显像对淋巴瘤的临床应用研究

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。

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

Objective To investigate clinical value of 18 F-fluorodeoxyglucose ( 18 F-FDG) coincidence imaging (SPECT/PET)in diagnosis and treatment of lymphoma. Methods 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. Results 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). Conclusion SPECT/PET 18 F-FDG metabolic imaging plays an important role in clinical diagnosis and treatment of NHL.