rentradВестник рентгенологии и радиологииJournal of radiology and nuclear medicine0042-46762619-0478Limited Liability Company "LUCHEVAYA DIAGNOSTIKA", Russian Association of Radiologists10.20862/0042-4676-2014-0-4-38-41rentrad-40Research ArticleСтатьиПРОГНОСТИЧЕСКОЕ ЗНАЧЕНИЕ ПОЗИТРОННОЙ ЭМИССИОННОЙ ТОМОГРАФИИ С 18F-ФДГ В РАННЕЙ ОЦЕНКЕ ЭФФЕКТИВНОСТИ ЛЕЧЕНИЯ БОЛЬНЫХ НЕХОДЖКИНСКИМИ ЛИМФОМАМИPROGNOSTIC VALUE OF 18F-FDG POSITRON EMISSION TOMOGRAPHY IN THE EARLY EVALUATION OF THE EFFICIENCY OF TREATMENT IN PATIENTS WITH NON-HODGKIN LYMPHOMASХоджибековаМ. М.KhodzhibekovaM. M.

к. м. н., врач-радиолог

пос. Песочный, ул. Ленинградская, 70, Санкт-Петербург, 197758

MD, PhD, Radiologist

poselok Pesochnyy, ul. Leningradskaya, 70, St. Petersburg, 197758

malika_25@mail.ruТютинЛ. А.TyutinL. A.

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

пос. Песочный, ул. Ленинградская, 70, Санкт-Петербург, 197758

MD, PhD, DSc, Professor, Deputy Director for Science

poselok Pesochnyy, ul. Leningradskaya, 70, St. Petersburg, 197758

КостениковН. А.KostenikovN. A.

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

пос. Песочный, ул. Ленинградская, 70, Санкт-Петербург, 197758

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

poselok Pesochnyy, ul. Leningradskaya, 70, St. Petersburg, 197758

ИльинН. В.Il’inN. V.

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

пос. Песочный, ул. Ленинградская, 70, Санкт-Петербург, 197758

MD, PhD, DSc, Professor, Head of Department of Radiation Therapy of Systemic Diseases

poselok Pesochnyy, ul. Leningradskaya, 70, St. Petersburg, 197758

ВиноградоваЮ. Н.VinogradovaYu. N.

к. м. н., с. н. с. 

пос. Песочный, ул. Ленинградская, 70, Санкт-Петербург, 197758

MD, PhD, Senior Research Associate 

poselok Pesochnyy, ul. Leningradskaya, 70, St. Petersburg, 197758

ФГБУ «Российский научный центр радиологии и хирургических технологий» Министерства здравоохранения РФРоссияRussian Research Center of Radiology and Surgical Technologies, Ministry of Health of the Russian FederationRussian Federation201427022016043841Copyright © 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/40

Цель исследования – определение роли позитронной эмиссионной томографии (ПЭТ) с 18F-ФДГ, выполненной после 2–3 циклов химиотерапевтического лечения, в прогнозировании течения заболевания и определении группы больных, требующих более интенсивного лечения.

Материал и методы

Материал и методы. Обследован 71 пациент с неходжкинскими лимфомами различных гистологических типов. Позитронная эмиссионная томография проводилась на различных этапах диагностики и первичного лечения больных.

Результаты

Результаты. После 2–3 циклов полихимиотерапии (ПХТ) у 36 (50,7%) пациентов сохранялись признаки метаболической активности лимфопролиферативного заболевания (ПЭТ-позитивная группа), у 35 (49,3%) больных очаги патологического накопления радиофармпрепарата (РФП) не определялись (ПЭТ-негативная группа). На протяжении всего периода наблюдения (медиана 405 дней) 29 (82,9%) больных ПЭТ-негативной группы продолжали оставаться в стадии полной ремиссии. У 6 (17,1%) пациентов на отдаленных этапах были выявлены очаги патологической гиперфиксации РФП, свидетельствующие о рецидиве заболевания. Только у 8 больных ПЭТ-позитивной группы отмечался полный метаболический ответ на полученное лечение в конце 1-й линии ПХТ. У остальных больных сохранялась метаболическая активность заболевания. Результаты ПЭТ, проведенной на отдаленных этапах наблюдения, показали, что у 20 (55,6%) пациентов продолжали визуализироваться метаболически активные опухолевые очаги, у 16 (44,4%) больных дальнейшее лечение привело к полной ремиссии.

Заключение

Заключение. Данные ПЭТ позволили на ранних этапах химиотерапевтического лечения прогнозировать дальнейшее течение заболевания и дифференцировать пациентов, требующих более интенсивного лечения. 

Objective

Objective: to define the role of 18F-FDG positron emission tomography (PЕT) performed after 2–3 chemotherapy cycles in the prediction of disease prognosis and to identify a group of patients requiring more intensive treatment.

Material and methods

Material and methods. Seventy-one patients with nonHodgkin lymphoma of different histological types were examined. PET was carried out at different stages of diagnosis and primary treatment in the patients.

Results

Results. The examinations made after 2–3 polychemotherapy (PCT) cycles indicated that 36 (50.7%) patients continued to have signs of metabolic activity of lymphoproliferative disease (a PET-positive group) and 35 (49.3%) patients were found to have no abnormal tracer accumulation foci (a PET-negative group). Twenty-nine (82.9%) patients from the PET-negative group continued to remain in complete remission throughout the follow-up (the median follow-up was 405 days). At late stages, 6 (17.1%) patients were identified to have abnormal tracer hyperfixation foci that were indicative of disease recurrence. Only 8 patients from the PET-positive group were observed to show a complete metabolic response to treatment at the end of first-line PCT. The metabolic activity of the disease was maintained in the remaining patients. The results of PET conducted at the late stages of the follow-up indicated that metabolically active tumor foci continued to be visualized in 20 (55.6%) patients and further treatment resulted in complete remission in 16 (44.4%) patients.

Conclusion

Conclusion. PET findings could predict the further course of the disease and differentiate more intensive treatment-requiring patients at the early stages of chemotherapy.

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