18F-FDG PET/CT代谢参数在移植后淋巴增生性疾病诊断中的应用

IF 2.5 4区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Annals of Nuclear Medicine Pub Date : 2025-01-18 DOI:10.1007/s12149-025-02016-9

Guoying Zhang, Jie Shen, Tianpeng Hu, Wei Zheng, Qiang Jia, Jian Tan, Zhaowei Meng

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引用次数: 0

摘要

目的：利用18F-FDG PET/CT代谢参数鉴别移植后淋巴增生性疾病（PTLD）和反应性淋巴样增生（RLH）及其亚型。方法：回顾性收集63例PTLD和19例RLH的18F-FDG PET/CT及临床资料。根据2017年世界卫生组织的分类，PTLD分为四种亚型：非破坏性（ND-PTLD）、多态（P-PTLD）、单态（M-PTLD）和经典霍奇金淋巴瘤。代谢参数包括最大标准化摄取值（SUVmax）、平均标准化摄取值（SUVmean）、代谢肿瘤体积（MTV）、病变总糖酵解（TLG）和SUVmax不同阈值（2.5%和41%），以及总肿瘤体积（GTV）。采用非参数检验和受试者工作特征（ROC）曲线进行统计。结果：ND-PTLD 42例，P-PTLD 7例，M-PTLD 14例。Ki-67与所有代谢参数(P)均有显著相关性，所有18F-FDG PET/CT代谢参数对PTLD和RLH均有中等诊断效能，曲线下面积（AUC）范围为0.682 ~ 0.747。P-PTLD + M-PTLD的诊断效能表现优异（RLH + ND-PTLD vs P-PTLD + M-PTLD的AUC为SUVmax 0.848, SUVmean41% 0.846, SUVmean2.5 0.834, GTV 0.819）。MTV41%、tlg41%、MTV2.5、TLG2.5的AUC分别为0.676、0.761、0.761、0.787。结论：不同SUVmax阈值（2.5%和41%）下18F-FDG PET/CT代谢参数对PTLD及其亚型的诊断效果相当。所有代谢参数在鉴别PTLD和RLH方面均表现出中等的诊断效能。SUVmax、SUVmean41%、SUVmean2.5和GTV对P-PTLD + M-PTLD的诊断效果较好。

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Utility of ¹⁸F-FDG PET/CT metabolic parameters on post-transplant lymphoproliferative disorder diagnosis.

Objective: Using ¹⁸F-FDG PET/CT metabolic parameters to differentiate post-transplant lymphoproliferative disorder (PTLD) and reactive lymphoid hyperplasia (RLH), and PTLD subtypes.

Methods: ¹⁸F-FDG PET/CT and clinical data from 63 PTLD cases and 19 RLH cases were retrospectively collected. According to the 2017 WHO classification, PTLD was categorized into four subtypes: nondestructive (ND-PTLD), polymorphic (P-PTLD), monomorphic (M-PTLD), and classic Hodgkin. Metabolic parameters included maximum standardized uptake value (SUVmax), mean standardized uptake value (SUVmean), metabolic tumor volume (MTV), total lesion glycolysis (TLG) and at different thresholds of SUVmax (2.5 and 41%), as well as gross tumor volume (GTV) was also collected. Nonparametric test and receiver operating characteristic (ROC) curves were used for statistics.

Results: There were 42 ND-PTLD patients, 7 P-PTLD patients, and 14 M-PTLD patients. Ki-67 was significantly correlated with all metabolic parameters (P all < 0.01). SUVmean, SUVmax, MTV, TLG and GTV were all highest in M-PTLD, followed by P-PTLD, ND-PTLD, and RLH. ROC curves showed ¹⁸F-FDG PET/CT metabolic parameters all had moderate diagnostic efficacy in differentiating between PTLD and RLH, the area under the curves (AUC) range from 0.682 to 0.747. Diagnostic efficacy for P-PTLD + M-PTLD showed excellent performance (AUC for RLH + ND-PTLD vs P-PTLD + M-PTLD was 0.848 for SUVmax, 0.846 for SUVmean_41%, 0.834 for SUVmean_2.5, and 0.819 for GTV). For MTV_41%, TLG _41%, MTV_2.5, TLG_2.5, the AUC was 0.676, 0.761, 0.761, 0.787, respectively.

Conclusion: ¹⁸F-FDG PET/CT metabolic parameters at different thresholds of SUVmax (2.5 and 41%) exhibited comparable diagnostic efficacy for PTLD and its subtypes. All metabolic parameters demonstrated moderate diagnostic efficacy in distinguishing PTLD and RLH. SUVmax, SUVmean_41%, SUVmean_2.5 and GTV showed excellent performance in diagnosing P-PTLD + M-PTLD.

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来源期刊

Annals of Nuclear Medicine 医学-核医学

CiteScore

4.90

自引率

7.70%

发文量

111

审稿时长

4-8 weeks

期刊介绍： Annals of Nuclear Medicine is an official journal of the Japanese Society of Nuclear Medicine. It develops the appropriate application of radioactive substances and stable nuclides in the field of medicine. The journal promotes the exchange of ideas and information and research in nuclear medicine and includes the medical application of radionuclides and related subjects. It presents original articles, short communications, reviews and letters to the editor.