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Diagnostic role of 18F-fluorodeoxyglucose positron emission tomography for follicular lymphoma with gastrointestinal involvement

查看全文 作　　者：Masaya [1]Iwamuro;Hiroyuki [2]Okada;Katsuyoshi [3]Takata;Katsuji [4]Shinagawa;Shigeatsu [5]Fujiki;Junji [6]Shiode;Atsushi [7]Imagawa;Masashi [8]Araki;Toshiaki [9]Morito;Mamoru [10]Nishimura;Motowo [11]Mizuno;Tomoki [12]Inaba;Seiyu [13]Suzuki;Yoshinari [14]Kawai;Tadashi [3]Yoshino;Yoshiro [2]Kawahara;Akinobu [1]Takaki;Kazuhide [1]Yamamoto 高影响力作者 机构地区：[1]Department of Gastroenterology and Hepatology,Okayama University Graduate School of Medicine,Dentistry,and Pharmaceutical Sciences,Okayama 700-8558,Japan;[2]Department of Endoscopy,Okayama University Hospital,Okayama 700-8558,Japan;[3]Department of Pathology,Okayama University Graduate School of Medicine,Dentistry,and Pharmaceutical Sciences,Okayama 700-8558,Japan;[4]Department of Hematology and Oncology,Okayama University Graduate School of Medicine,Dentistry,and Pharmaceutical Sciences,Okayama 700-8558,Japan;[5]Department of Internal Medicine,Tsuyama Central Hospital,Tsuyama 708-0841,Japan;[6]Department of Internal Medicine,Okayama Saiseikai General Hospital,Okayama 700-8511,Japan;[7]Department of Gastroenterology,Mitoyo General Hospital,Kanonji 769-1695,Japan;[8]Department of Internal Medicine,Kagawa Rosai Hospital,Marugame 763-8502,Japan;[9]Department of Anatomic Pathology,Kagawa Rosai Hospital,Marugame 763-8502,Japan;[10]Department of Internal Medicine,Okayama Citizens' Hospital,Okayama 700-8557,Japan;[11]Department of Internal Medicine,Hiroshima City Hospital,Hiroshima 730-8518,Japan;[12]Department of Gastroenterology,Kagawa Prefectural Central Hospital,Takamatsu 760-8557,Japan;[13]Department of Internal Medicine,Sumitomo Besshi Hospital,Niihama 792-8543,Japan;[14]Department of Gastroenterology,Onomichi Municipal Hospital,Onomichi 722-8503,Japan高影响力机构 出　　处：《World Journal of Gastroenterology》索引2012年第18卷第44期,共10页高影响力期刊 摘　　要：AIM:To investigate the capacity for 18F-fluorodeoxyglucose(18F-FDG) positron emission tomography(PET) to evaluate patients with gastrointestinal lesions of follicular lymphoma.METHODS:This retrospective case series consisted of 41 patients with follicular lymphoma and gastrointestinal involvement who underwent 18F-FDG-PET and endoscopic evaluations at ten different institutions between November 1996 and October 2011.Data for endoscopic,radiological,and biological examinations performed were retrospectively reviewed from clinical records.A semi-quantitative analysis of 18F-FDG uptake was performed for each involved area by calculating the maximum standardized uptake value(SUVmax).Based on the positivity of 18F-FDG uptake in the gastrointestinal lesions analyzed,patients were subdivided into two groups.To identify potential predictive factors for 18F-FDG positivity,these two groups were compared with respect to gender,age at diagnosis of lymphoma,histopathological grade,pattern of follicular dendritic cells,mitotic rate,clinical stage,soluble interleukin-2 receptor levels detected by 18F-FDG-PET,lactate dehydrogenase(LDH) levels,hemoglobin levels,bone marrow involvement,detectability of gastrointestinal lesions by computed tomography(CT) scanning,and follicular lymphoma international prognostic index(FLIPI) risk.RESULTS:Involvement of follicular lymphoma in the stomach,duodenum,jejunum,ileum,cecum,colon,and rectum was identified in 1,34,6,3,2,3,and 6 patients,respectively.No patient had esophageal involvement.In total,19/41(46.3%) patients exhibited true-positive 18F-FDG uptake in the lesions present in their gastrointestinal tract.In contrast,false-negative 18F-FDG uptake was detected in 24 patients(58.5%),while false-positive 18F-FDG uptake was detected in 5 patients(12.2%).In the former case,2/19 patients had both 18F-FDG-positive lesions and 18F-FDGnegative lesions in the gastrointestinal tract.In patients with 18F-FDG avidity,the SUVmax value of the involved gastrointestinal tract ranged from 2.6 to 17.4(median:4.7).For the 18F-FDG-negative(n = 22) and-positive(n = 19) groups,there were no differences in the male to female ratios(10/12 vs 4/15,P = 0.186),patient age(63.6 ± 2.4 years vs 60.1 ± 2.6 years,P = 0.323),presence of histopathological grade 1 vs 2(20/2 and 17/2,P = 1.000),follicular dendritic cell pattern(duodenal/nodal:13/5 vs 10/3,P = 1.000),mitotic rate(low/partly high,14/1 vs 10/3,P = 0.311),clinical stage according to the Ann Arbor system(stages ⅠE and ⅡE/other,15/7 vs 15/4,P = 0.499),clinical stage according to the Lugano system(stages Ⅰ and Ⅱ-1/other,14/8 vs 14/5,P = 0.489),soluble interleukin-2 receptor levels(495 ± 78 vs 402 ± 83,P = 0.884),LDH levels(188 ± 7 vs 183 ± 8,P = 0.749),hemoglobin levels(13.5 ± 0.3 vs 12.8 ± 0.4,P = 0.197),bone marrow involvement(positive/negative,1/8 vs 1/10,P = 1.000),detectability by CT scanning(positive/negative,1/16 vs 4/13,P = 0.335),and FLIPI risk(low risk/other,16/6 vs 13/6,P = 0.763),respectively in each case.CONCLUSION:These findings indicate that it is not feasible to predict 18F-FDG-avidity.Therefore,18FFDG-PET scans represent a complementary modality for the detection of gastrointestinal involvements in follicular lymphoma patients,and surveillance of the entire gastrointestinal tract by endoscopic examinations is required. 关 键 词：正电子发射断层扫描 脱氧葡萄糖 胃肠道 淋巴瘤 滤泡 诊断 白细胞介素2 计算机断层扫描
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