rentradВестник рентгенологии и радиологииJournal of radiology and nuclear medicine0042-46762619-0478Limited Liability Company "LUCHEVAYA DIAGNOSTIKA", Russian Association of Radiologists10.20862/0042-4676-2015-0-1-16-21rentrad-2Research ArticleСтатьиПозитронная эмиссионная томография с 18F-фтордезоксиглюкозой в диагностике и стадировании неходжкинских лимфом маргинальной зоны18F-FDG positron emission tomography in the diagnosis and staging of marginal zone non-Hodgkin lymphomasХоджибековаМ. М.KhodzhibekovaM. M.

к. м. н., врач-радиолог

MD, PhD, Radiologist

ТютинЛ. А.TyutinL. A.

д. м. н., профессор, заместитель директора по научной работе

MD, PhD, DSc, Professor, Deputy Director of Research

КостениковН. А.KostenikovN. A.

д. м. н., заведующий отделением радиоизотопной позитронной эмиссионной томографии

MD, PhD, DSc, Head of Department of Radioisotope Positron Emission Tomography

ИльинН. В.Il’inN. V.

д. м. н., профессор, руководитель отделения лучевой терапии системных заболеваний

MD, PhD, DSc, Professor, Head of the Radiotherapy Department of Systemic Diseases

ВиноградоваЮ. Н.VinogradovaYu. N.

к. м. н., ст. науч. сотр. отделения лучевой терапии системных заболеваний

MD, PhD, Senior Researcher of Radiotherapy Department of Systemic Diseases

ФГБУ «Российский научный центр радиологии и хирургических технологий» Министерства здравоохранения РФРоссияRussian Research Center of Radiology and Surgical Technologies, Ministry of Health of the RFRussian Federation201527022016011621Copyright © Ходжибекова М.М., Тютин Л.А., Костеников Н.А., Ильин Н.В., Виноградова Ю.Н., 20162016Ходжибекова М.М., Тютин Л.А., Костеников Н.А., Ильин Н.В., Виноградова Ю.Н.Khodzhibekova M.M., Tyutin L.A., Kostenikov N.A., Il’in N.V., Vinogradova Y.N.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.russianradiology.ru/jour/article/view/2

Цель исследования – изучение диагностической значимости позитронной эмиссионной томографии (ПЭТ) с 18F-фтордезоксиглюкозой (ФДГ) в диагностике и стадированиинеходжкинских лимфом маргинальной зоны.Материал и методы. Обследованы 24 пациента с впервые выявленными лимфомами маргинальной зоны (ЛМЗ). У 18 больных была диагностирована экстранодальная MALT-лимфома, у 3 пациентов – маргинальная лимфома селезенки и еще у 3 больных – нодальная ЛМЗ. ПЭТ с 18F-ФДГ выполнялась по стандартному протоколу в режиме обследования всего тела с оценкой интенсивности стандартизованного уровня захва-та радиофармпрепарата (РФП) (SUVmax) в патологических очагах.Результаты. У большей части обследованных больных (83,3%) были выявлены очаги патологической гиперфиксации РФП. Среднее значение SUVmax составило 5,05±0,9. Корреляционной зависимости между уровнем SUVmax в опухолевых очагах и их метаболическими размерами выявлено не было (r=0,1, p=0,7). Значимых отличий между средними значениями SUVmax у больных с различными гистологическими вариантами ЛМЗ не обнаружено (p>0,05). При оценке стадии заболевания были получены противоречивые данные ПЭТ и других методов диагностики у 3 пациентов. Окончательный анализ показал, что у всех 3 больных стадия была корректно  определена по данным ПЭТ.Заключение. Результаты ПЭТ с 18F-ФДГ свидетельствуют о высокой диагностической ценности метода в визуализации неходжкинских лимфом маргинальной зоны. Основным преимуществом ПЭТ является возможность точного стадированиязаболевания, что позволяет обосновать оптимальную тактику лечения.

Objective

Objective: to investigate the diagnostic value of 18F-FDG positron  emission tomography (PET) in the diagnosis and staging of marginal zone non-Hodgkin lymphomas (NHLs).

Objective

Objective: to investigate the diagnostic value of 18F-FDG positron  emission tomography (PET) in the diagnosis and staging of marginal zone non-Hodgkin lymphomas (NHLs).

Material and methods

Material and methods. Twenty-four patients with new-onset NHLs were examined. Extranodal MALT lymphoma, splenic marginal zone  lymphoma (MZL), and nodal MZL lymphoma were diagnosed in 18, 3, and 3 patients, respectively. 18F-FDG PЕT was carried out by the standard protocol via whole-body examination, by estimating the  standardized tracer uptake value (SUVmax) in the abnormal foci.

Results

Results. Most (83.3%) of the examinees were found to have abnormal tracer hyperfixation foci. The mean SUVmax was 5.05±0.9. There was no correlation between SUVmax in the tumor foci and their metabolic sizes (r = 0.1; p = 0.7). No significant differences between the mean SUVmax were found in patients with different histological types of MZL (p > 0.05). Disease staging by PET and other diagnostic methods yielded  contradictory results in three patients. The final analysis suggested that the stage had been correctly determined in all the 3 patients from PET findings.

Conclusion

Conclusion. The results of 18F-FDG PET suggest that it is of high diagnostic value in imaging marginal zone NHLs. The major advantage of PET is that it can accurately stage the disease, which can provide a rationale for optimal treatment policy.

 

 

позитронная эмиссионная томография18F-фтордезоксиглюкозалимфомы маргинальной зоныстандартизованный уровень захватаpositron emission tomography18F-FDGmarginal zone lymphomasSUVmaxReferencesFerreri A.J., Zucca E. Marginal-zone lymphoma. Crit. Rev. Oncol. Hematol.2007; 63 (3): 245–56.Ferreri A.J., Zucca E. Marginal-zone lymphoma. Crit. Rev. Oncol. Hematol.2007; 63 (3): 245–56.Bertoni F., Zucca E. State-of-the-art therapeutics: marginal-zone lymphoma. J. Clin. Oncol. 2005; 23 (26): 6415–20.Bertoni F., Zucca E. State-of-the-art therapeutics: marginal-zone lymphoma. J. Clin. Oncol. 2005; 23 (26): 6415–20.Copie-Bergman C., Wotherspoon A. MALT lymphoma pathology, initial diagnosis, and posttreatmentev aluation. In: Cavalli F., Stein H., Zucca E. (eds). Extranodal lymphomas pathology and management. London: Informa Health Care; 2008: 114–23.Copie-Bergman C., Wotherspoon A. MALT lymphoma pathology, initial diagnosis, and posttreatmentev aluation. In: Cavalli F., Stein H., Zucca E. (eds). Extranodal lymphomas pathology and management. London: Informa Health Care; 2008: 114–23.Ferrucci P.F., Zucca E. Primary gastric lymphoma pathogenesis and treatment: what has changed over the past 10 years? Br. J. Haematol. 2007; 136 (4): 521–38.Ferrucci P.F., Zucca E. Primary gastric lymphoma pathogenesis and treatment: what has changed over the past 10 years? Br. J. Haematol. 2007; 136 (4): 521–38.Raderer M., Vorbeck F., Formanek M., Osterreicher C., Valencak J., Penz M. et al. Importance of extensive staging in patients with mucosaassociated lymphoid tissue (MALT)- type lymphoma. Br. J. Cancer. 2000; 83 (4): 454–7.Raderer M., Vorbeck F., Formanek M., Osterreicher C., Valencak J., Penz M. et al. Importance of extensive staging in patients with mucosaassociated lymphoid tissue (MALT)- type lymphoma. Br. J. Cancer. 2000; 83 (4): 454–7.O’Doherty M.J., Hoskin P.J. Positron emission tomography in the management of lymphomas: a summary. Eur. J. Nucl. Med. Mol. Imag. 2003; 30 (1, Suppl): 128–30.O’Doherty M.J., Hoskin P.J. Positron emission tomography in the management of lymphomas: a summary. Eur. J. Nucl. Med. Mol. Imag. 2003; 30 (1, Suppl): 128–30.Hoskin P.J. PET in lymphoma: what are the oncologist’s need. Eur. J. Nucl. Med. Mol. Imag. 2003; 30 (1, Suppl): 37–41.Hoskin P.J. PET in lymphoma: what are the oncologist’s need. Eur. J. Nucl. Med. Mol. Imag. 2003; 30 (1, Suppl): 37–41.Wohrer S., Jaeger U., Kletter K., Becherer A., Hauswirth A., Turetschek K. et al. 18F-fluoro-deoxy-glucose positron emission tomography (18F-FDG-PET) visualizes follicular lymphoma irrespective of grading. Ann. Oncol. 2006; 17 (5): 780–4.Wohrer S., Jaeger U., Kletter K., Becherer A., Hauswirth A., Turetschek K. et al. 18F-fluoro-deoxy-glucose positron emission tomography (18F-FDG-PET) visualizes follicular lymphoma irrespective of grading. Ann. Oncol. 2006; 17 (5): 780–4.Gill S., Wolf M., Prince H.M., Januszewicz H., Ritchie D., Hicks R.J. et al. [18F] Fluorodeoxyglucose positron emission tomography scanning for staging, response assessment, and disease surveillance in patients with mantle cell lymphoma. Clini. Lymph. Myel. 2008; 8 (3): 159–65.Gill S., Wolf M., Prince H.M., Januszewicz H., Ritchie D., Hicks R.J. et al. [18F] Fluorodeoxyglucose positron emission tomography scanning for staging, response assessment, and disease surveillance in patients with mantle cell lymphoma. Clini. Lymph. Myel. 2008; 8 (3): 159–65.Michallet A.S., Trotman J., TychyjPinel C. Role of early PET in the management of diffuse large B-cell lymphoma. Curr. Opin. Oncol. 2010; 22 (5): 414–8.Michallet A.S., Trotman J., TychyjPinel C. Role of early PET in the management of diffuse large B-cell lymphoma. Curr. Opin. Oncol. 2010; 22 (5): 414–8.Hoffmann M., Kletter K., Diemling M., Becherer A., Pfeffel F., Petkov V. et al. Positron emission tomography with fluorine-18-2-fluoro-2-deoxy-D-glucose (F18-FDG) does not visualize extranodal B-cell lymphoma of the mucosa-associated lymphoid tissue (MALT)-type. Ann. Oncol. 1999; 10 (10): 1185–9.Hoffmann M., Kletter K., Diemling M., Becherer A., Pfeffel F., Petkov V. et al. Positron emission tomography with fluorine-18-2-fluoro-2-deoxy-D-glucose (F18-FDG) does not visualize extranodal B-cell lymphoma of the mucosa-associated lymphoid tissue (MALT)-type. Ann. Oncol. 1999; 10 (10): 1185–9.Hoffmann M., Kletter K., Becherer A., Jдger U., Chott A., Raderer M. et al. 18F-fluorodeoxyglucose positron emission tomography (18F-FDGPET) for staging and follow-up of marginal zone B-cell lymphoma. Oncology. 2003; 64 (4): 336–40.Hoffmann M., Kletter K., Becherer A., Jдger U., Chott A., Raderer M. et al. 18F-fluorodeoxyglucose positron emission tomography (18F-FDGPET) for staging and follow-up of marginal zone B-cell lymphoma. Oncology. 2003; 64 (4): 336–40.Schoder H., Noy A., Gonen M., Weng L., Green D., Erdi Yu.E. et al. Intensity of 18fluorodeoxyglucose uptake in positron emission tomography distinguishes between indolent and aggressive non-Hodgkin’s lymphoma. J. Clin. Oncol. 2005; 23 (21): 4643–51.Schoder H., Noy A., Gonen M., Weng L., Green D., Erdi Yu.E. et al. Intensity of 18fluorodeoxyglucose uptake in positron emission tomography distinguishes between indolent and aggressive non-Hodgkin’s lymphoma. J. Clin. Oncol. 2005; 23 (21): 4643–51.Khodzhibekova M.M. Role of positron emission tomography with 18F-FDG in predicting malignancy grade of non-Hodgkin’s Lymphoma. Radiologiya-praktika. 2014; 1: 31–7 (in Russian).Khodzhibekova M.M. Role of positron emission tomography with 18F-FDG in predicting malignancy grade of non-Hodgkin’s Lymphoma. Radiologiya-praktika. 2014; 1: 31–7 (in Russian).Beal K.P., Yeung H.W., Yahalom J. FDG-PET scanning for detection and staging of extranodal marginal zone lymphomas of the MALT type: a report of 42 cases. Ann. Oncol. 2005; 16 (3): 473–80.Beal K.P., Yeung H.W., Yahalom J. FDG-PET scanning for detection and staging of extranodal marginal zone lymphomas of the MALT type: a report of 42 cases. Ann. Oncol. 2005; 16 (3): 473–80.Elstrom R., Guan L., Baker G., Nakhoda Kh., Vergilio J.A., Zhuang H. et al. Utility of FDG-PET scanning in lymphoma by WHO classification. Blood. 2003; 101 (10): 3875–6.Elstrom R., Guan L., Baker G., Nakhoda Kh., Vergilio J.A., Zhuang H. et al. Utility of FDG-PET scanning in lymphoma by WHO classification. Blood. 2003; 101 (10): 3875–6.

The authors declare that there are no conflicts of interest present.