诊断学理论与实践 ›› 2024, Vol. 23 ›› Issue (04): 439-444.doi: 10.16150/j.1671-2870.2024.04.013

• 综述 • 上一篇    下一篇

18F-FDG PET/CT在滤泡性淋巴瘤诊断和预后评估中的研究进展

李卓含1,2, 黄新韵2, 郭睿2, 李彪2()   

  1. 1.山西医科大学医学科学院,山西 太原 030001
    2.上海交通大学医学院附属瑞金医院核医学科,上海 200025
  • 收稿日期:2023-07-19 接受日期:2023-10-12 出版日期:2024-08-25 发布日期:2024-08-25
  • 通讯作者: 李彪 E-mail: lb10363@rjh.com.cn
  • 基金资助:
    上海申康医院发展中心临床科技创新项目(SHDC22023201)

18F-FDG PET/CT in the diagnosis and prognosis evaluation of follicular lymphoma

LI Zhuohan1,2, HUANG Xinyun2, GUO Rui2, LI Biao2()   

  1. 1. Academy of Medical Sciences, Shanxi Medical University, Taiyuan 030001, China
    2. Department of Nuclear Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
  • Received:2023-07-19 Accepted:2023-10-12 Published:2024-08-25 Online:2024-08-25

摘要:

滤泡性淋巴瘤(follicular lymphoma, FL)是一种生物学性质复杂、临床表现异质性大的非霍奇金淋巴瘤,多累及全身淋巴结。我国约有7%的FL患者会发生组织学转化。转化为其他侵袭性淋巴瘤,因此不同FL患者的治疗策略及预后均存在较大差异。随着分子影像学技术的发展,PET/CT融合分子影像检查既能更精确识别体内微小病变又能提供病灶代谢信息。多项研究和指南均肯定了18氟-氟代脱氧葡萄糖-正电子发射断层扫描 (18F-fluorodeoxyglucose-positron emission computed tomography, 18F-FDG PET/CT)图像特征在FL识别诊断、分级分期、评价疗效和预测生存结局等过程中的重要价值。但由于尚无统一的图像扫描和阈值界定标准,目前在不同研究中PET/CT参数对FL患者具体的预后效能尚存在争议。本文综述了近年来国内外基于PET/CT图像特征,在早期识别高危FL患者及预测FL患者预后中的最新研究进展,进一步肯定了18F-FDG PET/CT检查在判断FL患者发生组织学转化的可能性以及评估其生存结局中的价值,旨在辅助临床优化诊疗决策,提高和改善患者的治疗效率和预后结局。

关键词: 滤泡性淋巴瘤, 正电子发射断层扫描, 预后, 诊断, 人工智能

Abstract:

Follicular lymphoma (FL) is a non-Hodgkin lymphoma with complex biological properties and heterogeneous clinical manifestations. FL mainly involves lymph nodes throughout the body, and about 7% of patients in China will histologically transform into other aggressive lymphoma. Therefore, there are great differences in the treatment strategies and prognosis of patients with FL. With the development of molecular imaging technology, PET/CT fusion molecular ima-ging can not only identify small lesions in vivo more accurately, but also provide metabolic information of lesions. A number of studies and guidelines have affirmed the important value of 18F-fluorodeoxyglucose-positron emission computed tomography (18F-FDG PET/CT) image features in the whole process of FL disease diagnosis, grading and staging, evaluation of efficacy and prediction of survival outcomes. However, due to the lack of uniform standards for image scanning and threshold definition, the specific prognostic efficacy of PET/CT parameters in FL patients in different studies is still controversial. This article reviews the recent progress in early identification of high-risk follicular lymphoma patients and prognosis prediction of FL patients based on PET/CT image features at home and abroad, further affirms the value of 18F-FDG PET/CT in judging the possibility of histological transformation of FL and evaluating the survival outcome of FL patients. To assist to optimize the clinical diagnosis and treatment decisions, improve the treatment efficiency and prognosis of FL patients.

Key words: Follicular lymphoma, Positron emission computed tomography, Prognosis, Diagnosis, Artificial intelligence

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