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目前,PET/CT显像对恶性淋巴瘤的临床应用价值已得到广泛认可[1]。SUVmax为勾画病灶ROI的最大SUV,可以反映肿瘤组织中的最大活性代谢程度,是评价肿瘤生物学活性的有效指标[2]。然而,其只能代表病变部位一个像素点的SUVmax,不能反映出整个病灶的代谢活性情况。特别是对于低摄取的病灶,其背景噪声摄取值往往被高估[3]。PET体积计算机辅助判读(volume computed assisted reading,VCAR)软件采用边界框自动轮廓绘制和分割肿瘤感兴趣体积(volumes of interest,VOI),采用迭代自适应分段算法自动计算病灶瘦体标准化摄取值峰值(peak SUV normalized by lean body mass,SULpeak)、肿瘤代谢体积(metabolic tumor volume,MTV)、病灶糖酵解总量(total lesion glycolysis,TLG)等代谢评估参数[4],对多种病理亚型淋巴瘤的诊疗效率进行评估,这有利于个性化精准诊疗方案的制定,我们现对其最新进展进行综述。
基于18F-FDG PET VCAR有效预测淋巴瘤诊疗效能的最新进展
Recent advances of effective prediction of lymphoma diagnosis and therapeutic based on 18F-FDG PET VCAR
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摘要: 淋巴瘤是起源于身体不同部位以及具有多种病理亚型的血液系统恶性肿瘤。传统使用的评价指标为最大标准化摄取值,其反映肿瘤组织中的最大活性代谢程度,是目前临床研究应用最多的代谢参数。PET体积计算机辅助判读(VCAR)软件可对淋巴瘤病灶进行测量分析,自动计算病灶的代谢评估指标,包括瘦体标准化摄取值峰值、肿瘤代谢体积和病灶糖酵解总量等。但淋巴瘤病理亚型分类繁多,上述代谢评估参数对不同亚型淋巴瘤的诊断和疗效评估效率各不相同。因此,笔者对基于18F-氟脱氧葡萄糖PET VCAR软件有效预测淋巴瘤诊疗效能的最新进展进行综述。Abstract: Lymphoma is a malignant tumor of the hematological system that originates from different sites of the body and has a variety of pathological types. Maximum standardized uptake value, a traditionally used evaluation index, can reflect the maximum metabolic activity in tumor tissues, and which is the most widely studied metabolic parameter in clinical research at present. PET volume computed assisted reading (VCAR) software can measure and analyze the lymphoma lesions and automatically calculate the metabolic evaluation indexes of the lesions, including the peak SUV normalized by lean body mass, metabolic tumor volume, total lesion glycolysis, etc. There are many pathological subtypes of lymphoma, and the above metabolic evaluation parameters have different diagnosis and efficacy evaluation efficiency for different types of lymphoma. Therefore, the author intends to review recent advances in the effective prediction of the diagnostic and therapeutic effect of lymphoma based on the metabolic assessment of 18F-fluorodeoxyglucose PET VCAR software.
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