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淋巴瘤化疗后行受侵区域PET—CT扫描评价疗效的可行性研究

Minimizing radiation dose with PET-CT limited to involved sites in the assessment ofpostchemotherapy lymphoma
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摘要 目的 为降低辐射剂量,探讨淋巴瘤化疗后采用受侵区域PET-CT扫描评价疗效的可行性.方法 回顾性分析53例化疗前、后均行全身PET-CT扫描的淋巴瘤初诊患者.将化疗前PET-CT所示的淋巴瘤侵犯范围定义为受侵区域,化疗后假设采用受侵区域PET-CT扫描,比较其与全身PET-CT扫描在疗效评价方面的差异.对全身和受侵区域PET-CT扫描疗效评价结果一致者,比较其有效剂量和扫描时间的差异.结果 在评价淋巴瘤化疗后疗效方面,全身PET-CT扫描示37例达到完全缓解(CR)、13例部分缓解(PR)、3例进展(PD),受侵区域PET-CT示37例达到CR、14例PR、2例PD.37例CR者全身和受侵区域PET-CT扫描的有效剂量分别为(15.0±1.7)和(12.0±2.5)mSv(Z=-5.307,P<0.05)、扫描时间分别为(19.5±2.6)与(11.3±4.4)s(Z=-5.324,P<0.05).结论 化疗后达到CR者行受侵区域PET-CT扫描,其疗效与全身PET-CT扫描相同,减少了PET-CT扫描的有效剂量和时间.化疗后PR或PD者受侵区域PET-CT扫描的疗效评价结果与全身扫描不同,应行全身PET-CT扫描评价化疗后疗效. Objective To assess PET-CT scanning limited to involved sites in postchemotherapy lymphoma and explore possible radiation dose reductions.Methods Fifty-three lymphoma patients with prechemotherapy and postchemotherapy whole-body PET-CT were analyzed retrospectively.The involved sites were determined on prechemotherapy PET-CT scanning.Whole-body PET-CT scanning and hypothetical PET-CT limited to involved sites were compared in assessing clinical response to chemotherapy.The potential reductions in effective dose and total acquisition time achieved with PET-CT scanning limited to involved sites were calculated.Results Whole-body PET-CT scanning revealed CR in 37 cases,PR in 13 cases and PD in 3 cases in postchemotherapy lymphoma patients,while PET-CT scanning limited to involved sites revealed CR in 37 cases,PR in 14 cases and PD in 2 cases.The mean effective dose was(15.0 ± 1.7)mSv for per patients of CR with whole-body PET-CT scanning,and was (12.0 ± 2.5)mSv for per patients of CR with PET-CT scanning limited in involved sites(Z=-5.307,P〈0.05).The mean acquisition time was(19.5 ±2.6)s for per patients of CR with whole-body PET-CT scanning,and(11.3 ± 4.4)s for per patient of CR with PET-CT scanning limited in involved sites(Z=-5.324,P〈0.05).Conclusions Response assessment with PET-CT scanning limited in involved sites has good agreement with whole-body PET-CT scanning in postchemotherapy lymphoma patients with CR.Lymphoma patients with CR may benefit from reduced radiation dose and total acquisition time.PET-CT scanning limited in involved sites is not advisable in patients with PR or PD for poor agreement with whole-body PET-CT scanning in response assessment.
出处 《中华放射医学与防护杂志》 CAS CSCD 北大核心 2013年第5期536-539,共4页 Chinese Journal of Radiological Medicine and Protection
关键词 淋巴瘤 PET-CT扫描 疗效评价 有效剂量 Lymphoma PET-CT scanning Response assessment Effective dose
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