18F-FDG PET/CT在儿童及青少年淋巴瘤诊治中的应用价值

Value of 18F-FDG PET/CT for diagnosing and treating childhood and adolescent lymphoma

  • 摘要: 儿童及青少年淋巴瘤占所有儿科恶性肿瘤的10%~15%,其多为高度侵袭性肿瘤,较成人更易侵犯结外组织。准确的分期以及早期疗效评价对儿童及青少年淋巴瘤患者具有重要价值。传统影像学方法(超声、CT、MRI及67Ga成像)在其诊治过程中存在一定的局限性,18F-FDG PET/CT是将PET的功能代谢显像与CT的解剖结构显像相融合的一种新型成像技术。笔者通过对18F-FDG PET/CT检查在儿童及青少年淋巴瘤中的分期、疗效评级、随访中的作用作一综述,发现18F-FDG PET/CT在淋巴结、脾脏监测方面具有更高的灵敏度,可通过一次显像发现更多的病灶,在分期方面的准确性优于传统影像学方法。同时,因其代谢改变早于解剖形态的改变,能更早期、准确地评估疗效,对残留病灶的性质进行判断。由于其较低的复发率,需权衡在随访过程中监测复发及辐射暴露之间的利弊关系。

     

    Abstract: Childhood and adolescent lymphomas account for 10%-15% of all pediatric cancers. Most cases of pediatric lymphoma involve highly aggressive tumors and extranodal sites. As such, accurate staging and early assessment of therapeutic response are of great value for lymphoma in children and adolescents. Conventional imaging modalities (e.g., ultrasound, CT, MRI, and 67Ga) present some limitations in their diagnosis and treatment. 18F-FDG PET/CT is a new imaging technique that combines the functional data of PET with the morphological information of CT. This article reviews the current role of 18F-FDG PET/CT in the staging, efficacy evaluation, and follow-up of childhood and adolescent lymphoma and finds that 18F-FDG PET/CT is more sensitive than other imaging techniques in monitoring lymph nodes and the spleen. By imaging more lesions, the accuracy of 18F-FDG PET/CT for staging is better than that achieved by traditional imaging methods. At the same time, because of its metabolic changes earlier than the anatomical changes, assessing treatment efficacy promptly and accurately, as well as determining the nature of residual lesions, may be possible. Because of its lower recurrence rate, the trade-offs between monitoring recurrence and radiation exposure during the follow-up period must be weighed.

     

/

返回文章
返回