Study Of ¹⁸F-FDG PET/CT In The Diagnosis Of Diffuse Large B Cell Lymphoma Chemotherapy Interim And Curative Effect Evaluation

Objective: Application of 18 fluorinemArkers of glucose(18FDG) positron emission computed tomography(CT) imaging and conventional CT imaging in diffuse large B cell lymphoma(DLBCL) chemotherapy treatment before mid stages and 2~4 curative effect evaluation after the treatment, application of new evaluation system of tumor PERCIST draft standard(PERCIST), the cases of image to assess the curative effect after normalization and standardization. Methods: Retrospective analysis of our hospital in 2011-2015 at the end of August, September in undergraduate course examination by pathological diagnosis of diffuse large B cell lymphoma(DLBCL) in 66 cases, both for new patients.66 patients were performed international prognostic index grading and staging, new patient evaluation stage and clinical stage.Before treatment and 2~4 cycles of chemotherapy after 18F-FDG PET/CT imaging and CT imaging, according to China’s diagnosis and treatment of DLBCL guide(2013 edition), all patients according to the line of immune chemotherapy(R-CHOP) treatment, according to the curative effect is divided into effective and ineffective group. Compared with the traditional CT image sensitivity, specificity, accuracy, positive predictive value and negative predictive value and the largest lesion standardized values(SUVmax) taken before and after chemotherapy. Application PERCIST standard evaluation system of the tumor, 66 cases of patients in 21 of image processing, fully metabolic relief(CMR) and metabolic degradation(PMD), etc. To evaluate the curative effect. Results: 1) this study 18F-FDG PET/CT and CT in the sensitivity, accuracy, positive predictive value and negative predictive value, PET/CT than CT increased by 17.77%, 73.28%, 5.6% and 73.28% respectively, the differences were statistically significant(chi-square=36.43, P=0.00; chi-square=45.62, P=0.00; chi-square=6.25, P=0.01; chi-square=30.78, P=0.00); 2) 66 patients with DLBCL after chemotherapy; 19 in the evaluation of CT PR patients, 10 patients in the therapeutic effect evaluation standard of PET/CT is a toughening is CR; CT evaluation in 27 patients with CR, eight patients with PET/CT found new lesions; 3) DLBCL patients before chemotherapy, two to four courses of chemotherapy after lesion SUVmax differences between statistically significant(t=3.58, P<0.05), treatment group effective SUVmax is on the decline, invalid group is on the rise; period patientsⅣ, 2 to 4 patients with valid for curative effect evaluation after the treatment, patients at high risk of IPI score SUV2~4mAx significantly higher, and the difference was statistically significant; 4) Application PERCIST standard evaluation system of tumor curative effect evaluation, can better metabolism changes from the level of quantitative observation of pathological changes, tumor activity, mid-term efficacy evaluation. Conclusion: In the middle of chemotherapy for patients with DLBCL 18F-FDG PET/CT imaging in clinical diagnosis, staging and efficacy evaluation has great clinical value.