Preliminary Clinical Application Of ¹⁸F-FDG PET/CT In Tumor Disease Of Hematologic And Lymphatic Systems

Part 1:Preliminary clinical application of ¹⁸F-FDG PET/CT in lymphomaObjective To evaluate the clinical application value of ¹⁸F-FDG PET/CT in diagnosing, staging and evaluating the therapeutic effect of lesions of lymphoma.Methods ¹⁸F-FDG PET/CT imaging was performed in 77 patients with lymphoma. The results were compared with traditional image, and also extranodal lesions was analyzed.Results 1.Prior-treat group: PET/CT correctly diagnosed all 48 positive lesions ( including 33 lymph nodes and 15 extranodal lesions),but found 2 false positive extranodal lesions. Traditional image correctly diagnosed 33 positive lesions(including 27 lymph nodes and 6 extranodal lesions),1 false positive extranodal lesions. PET/CT diagnosing sensitivity is ( lymph nodes 100%, extranodal lesions 100%, in all 100%), specificity is (lymph nodes 100%, extranodal lesions 98.2%, in all 98.7%),accuracy is ( lymph nodes 100%, extranodal lesions 98.4%, in all 99.0%). While traditional image diagnosing sensitivity is ( lymph nodes 81.8%, extranodal lesions 40%, in all 68.8%), specificity is ( lymph nodes 100%, extranodal lesions 99.1%, in all 99.3%), accuracy is ( lymph nodes 86.1%, extranodal lesions 92.0%, in all 91.9%). The two methods have statistic meanings in sensitivity and accuracy differences in finding lesions(especially extranodal lesions), specificity difference have no statistic meanings.8 cases have coincident stage(44.4%), PET/CT correctly upstaged 9 cases compared with traditional image(50%); no finding of downstage. 2.Post-treat group: 31 cases have no lesions,not compared .34 lesions in 28 cases, PET/CT correctly diagnosed all(including 21 lymph nodes and 12 extranodal lesions),but found 3 false positive extranodal lesions.Traditional image correctly diagnosed 20(including 14 lymph nodes and 6 extranodal lesions), but found 5 false positive lesions. PET/CT diagnosing sensitivity is ( lymph nodes 100%, extranodal lesions 100%, in all 100%), specificity is ( lymph nodes 100%, extranodal lesions 98.4%, in all 98.9%),accuracy is ( lymph nodes 100%, extranodal lesions 98.5%, in all 99.0%). While traditional image diagnosing sensitivity is ( lymph nodes 66.7%, extranodal lesions 46.2%, in all 58.8%), specificity is ( lymph nodes 95.6%, extranodal lesions 99.5%, in all 98.2%),accuracy is ( lymph nodes 91.2%, extranodal lesions 95.9%, in all 93.8%). the two methods have statistic meanings in sensitivity differences in finding lesions(especially extranodal lesions), specificity difference have statistic meanings in lymph node lesions. 9 cases have coincident stage(32.1%),PET/CT correctly upstaged 12 cases(42.9%), downstaged 4 cases(14.3%). 3.extranodal lesions group: Compared with tradition image, in 21 cases PET/CT found and confirmed 28 positive extranodal lesions ( many bones and bone marrow counted as one organ),traditional image only definitely diagnosed 14 lesions in them, missed 8 lesions because their affection area was small or had no significant density contrast, and could not ascertainment 6 lesions. Compare the two ways in staging, PET/CT upstaged 9 cases.Conclusions ¹⁸F-FDG PET/CT gain an advantage over traditional image in detecting lesions and staging the lymphoma before and after treatment, having significant superiority especially in examine extranodal lesions.Part 2 Preliminary clinical application of ¹⁸F-FDG PET/CT in detecting the leukemia with multi-organs infiltrationObjective Retrospectively analyze and discuss the value and image features of ¹⁸F -FDG PET/CT in diagnosing and monitoring the treatment of leukemia with multi-organs infiltration. Methods 8 cases doing whole-body ¹⁸F-FDG PET/CT display include 5 acute lymphoblastic leukemia cases, 2 chronic leukemia cases and 1 granular cell tumor cameus.Results Among all the 8 cases, 6 cases have skeleton and bone marrow infiltration, 4 cases have spleen infiltration, 3 cases have liver infiltration, 3 cases have lymph nodes infiltration. All the cases have multi-organs infiltration. PET imaging detected 22 organs positive while CT imaging detected 14 positive. The 6 cases with skeleton infiltration appeared whole body's skeleton and bone marrow diffuse raising up of radioactive uptake, the 4 spleen affected individuals had greatly intumesced spleens with diffuse or focal raising up of radioactive uptake. The 3 liver affected individuals manifested their livers diffuse raising up of radioactive uptake. The 3 cases having lymph nodes infiltration were found many places of 5mm³0mm lymph nodes raising up of radioactive uptake.Conclusions PET/CT can display image of whole body's metabolism and morphous at the same time, so it can sensitively and all-roundly discover the focus of infection in leukemia with multi-organs infiltration. It can be used in detecting the delitescene infiltrated focus of infection in leukemia and monitoring the treatment.Part 3 The value of ¹⁸F-FDG PET/CT in diagnosing the splenic secondary malignant lesionObjective To evaluate the value of ¹⁸F-FDG PET/CT in diagnosing the splenic secondary malignant lesion.Methods Retrospectively analyze all the 13 cases with splenic secondary malignant lesion diagnosed by PET/CT(Among all the patients, there are 4 splenic metastases, 6 lymphoma spleen infiltration, 3 leukemia infiltration), and compare the diagnostic result of PET, CT, and the fused imaging of PET/CT with the diagnostic results confirmed by pathological and clinical follow-up.Results Of all the 13 cases of splenic secondary malignant lesion diagnosed by PET/CT, PET revealed 13, CT revealed 6, PET detected larger affected area than CT.PET/CT gave more definite information to decide the qualitation, quantitation and location of the lesion.Conclusions PET/CT has great advantage and potential in detecting and diagnosing splenic secondary malignant lesion and monitory the therapy.