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Predic.ive Potential of FDG-PET/c. for Histologic.l Transform.tion in Patients with Indolent Lym.hom.

Advanc.s in m.lec.lar Im.ging 2014年第1期4卷 1-10页

作者： Peter E. Blase pieternel c. m. pasker-de jong Anton Hagenbeek Rob Fijnheer m.rie J. de Haas John m. H. de Klerk departm.nt of Haem.tology Academical Medical Centre Amsterdam The Netherlands departm.nt of Internal m.dic.ne Meander Medical Centre Amersfoort The Netherlands departm.nt of m.ander Ac.dem. Meander Medical Centre Amersfoort The Netherlands departm.nt of Nuc.ear m.dic.ne Meander Medical Centre Amersfoort The Netherlands

Bac.grounds and Purpose—In indolent non-Hodgkin lym.hom., histologic.l transform.tion is a dram.tic.event whic. reduc.s the prognosis signific.ntly. SUVm.x values from.FDG-PET/c. help differentiate between aggressive and indolent lym.hom.s, and transform.d indolent lym.hom.s also show an inc.eased FDG uptake. Possibly FDG uptake inc.eases early in the c.inic.l c.urse and c.uld predic. histologic.l transform.tion. Our objec.ive was to predic. histologic.l transform.tion in indolent lym.hom.s from.initial staging FDG-PET/c.. Patients and m.thods—A retrospec.ive study was perform.d. Patients with biopsy-proven indolent lym.hom. who had had initial staging FDG-PET/c. were inc.uded. Qualitative (foc. c.m.ared with FDG uptake liver) and sem.quantitative (SUVm.x-value per foc.s) analyses were perform.d of all abnorm.l foc.. Patient c.arac.eristic. and outc.m. were evaluated. Results—We inc.uded 88 patients, 5 of whom.developed a histologic.l transform.tion. Sem.quantitative analysis showed a relation between m.xim.m.standardized uptake value and histologic.l transform.tion (odds ratio 1.25, 95% c. 1.024 - 1.513). Qualitative analysis showed a negative predic.ive relation of FDG uptake less than or equal to liver in the oc.urrenc. of histologic.l transform.tion. Transform.tion-free survival was 100% over 30 m.nths in those with FDG uptake lower than or equal to liver. m.re FDG uptake than liver showed transform.tion-free survival of 88% over 30 m.nths. c.nc.usion—Qualitative analysis of staging FDG-PET/c. in indolent lym.hom.s c.uld be useful to rule out transform.tion in the next 30 m.nths. In our study, sem.quantitative analysis was statistic.lly signific.ntly assoc.ated with histologic.l transform.tion and m.xim.m.standardized uptake value. However, bec.use of the sm.ll num.er of patients, c.utious interpretation of the results is warranted. m.re studies are needed to investigate the role of staging PET/c. in patient with indolent non-Hodkin lym.hom. in the predic.ion of

关键词： Indolent Lym.hom. Transform.tion PET/c. Predic.ive Value

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c.n I-124 PET/c. Predic. Pathologic.l Uptake of Therapeutic.Dosages of Radioiodine (I-131) in Differentiated Thyroid c.rc.nom.?

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Advanc.s in m.lec.lar Im.ging 2014年第3期4卷 27-34页

作者： Gauke K. Lam.ers Jan Paul Esser pieternel c. m. pasker m.rina E. Sanson-van Praag John m. H. de Klerk departm.nt of Epidem.ology and Researc. Meander Medical Centre Amersfoort The Netherlands departm.nt of Internal m.dic.ne Meander Medical Centre Amersfoort The Netherlands departm.nt of Nuc.ear m.dic.ne Meander Medical Centre Amersfoort The Netherlands

Introduc.ion: The aim.of the study was to assess the role of I-124 PET/c. in the predic.ion of uptake of a therapeutic.dosage I-131 during follow-up of patients with differentiated thyroid c.nc.r (DTc.. m.thods: The results of 34 I-124 PET/c. sc.ns perform.d in our hospital between 2007 and 2012 were retrospec.ively evaluated. All sc.ns were m.de in patients under follow up, replac.ng the diagnostic.I-131 or I-123 sc.ntigraphy. In all c.ses thyroglobulin (Tg) was stim.lated (by rec.m.inant thyroid stim.lating horm.ne (rhTSH) or thyroid horm.ne withdrawal). A dosage of 40 m.q I-124 was used, with sc.ns at 24 hours and 96 hours after adm.nistration. Results were c.m.ared to subsequent I-131 post-treatm.nt sc.ns (6 c.ses) and a c.m.ination of follow up, stim.lated Tg and other im.ging tools results available to assess presenc. of rec.rrenc.. Results: Rec.rrenc. of DTc.was found in 14/34 c.ses. I-124 PET/c. c.rrec.ly detec.ed rec.rrenc. in 2 c.ses, with false negative results in 12 c.ses. In 1 c.se a false positive I-124 PET/c. result was rec.rded. 19 true negative results were found. For I-124 PET/c. this m.ant a sensitivity of 14% and a spec.fic.ty of 95%. Positive predic.ive value was 67%, negative predic.ive value 61%. Post-treatm.nt I-131 uptake (6 c.ses) was c.rrec.ly predic.ed in 1 c.se, with false negative results in 4 c.ses and 1 true negative result. c.nc.usions: In this study I-124 PET/c. did not reliably detec. rec.rrent differentiated thyroid c.rc.nom.. m.re im.ortantly it failed to predic. I-131 uptake on post-treatm.nt sc.ntigraphy in a signific.nt num.er of c.ses, whic. would lead to under-treatm.nt.

关键词： I-124 PET I-131 Thyroid c.rc.nom.

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