首页|Diagnostic role of 18F-fluorodeoxyglucose positron emission tomography for follicular lymphoma with gastrointestinal involvement

Diagnostic role of 18F-fluorodeoxyglucose positron emission tomography for follicular lymphoma with gastrointestinal involvement

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AIM:To investigate the capacity for 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)to evaluate patients with gastrointestinal lesions of follicular lymphoma.METHODS:This retrospective case series consisted of 41 patients with follicular lymphoma and gastrointestinal involvement who underwent 18F-FDG-PET and endoscopic evaluations at ten different institutions between November 1996 and October 2011.Data for endoscopic,radiological,and biological examinations performed were retrospectively reviewed from clinical records.A semi-quantitative analysis of 18F-FDG uptake was performed for each involved area by calculating the maximum standardized uptake value (SUVmax).Based on the positivity of 18F-FDG uptake in the gastrointestinal lesions analyzed,patients were subdivided into two groups.To identify potential predictive factors for 18F-FDG positivity,these two groups were compared with respect to gender,age at diagnosis of lymphoma,histopathological grade,pattern of follicular dendritic cells,mitotic rate,clinical stage,soluble interleukin-2 receptor levels detected by 18F-FDG-PET,lactate dehydrogenase (LDH) levels,hemoglobin levelsbone marrow involvement,detectability of gastrointestinal lesions by computed tomography (CT) scanningand follicular lymphoma international prognostic index (FLIPI) risk.RESULTS:Involvement of follicular lymphoma in the stomach,duodenum,jejunum,ileum,cecum,colon,and rectum was identified in 1,34,6,3,2,3,and 6patients,respectively.No patient had esophageal involvement.In total,19/41 (46.3%) patients exhibited true-positive 18F-FDG uptake in the lesions present in their gastrointestinal tract.In contrast,false-negative 18F-FDG uptake was detected in 24 patients (58.5%),while false-positive 18F-FDG uptake was detected in 5 patients (12.2%).In the former case,2/19 patients had both 18F-FDG-positive lesions and 18F-FDG-negative lesions in the gastrointestinal tract.In patients with 18F-FDG avidity,the SUVmax value of the involved gastrointestinal tract ranged from 2.6 to 17.4 (median:4.7).For the 18F-FDG-negative (n =22) and-positive (n =19) groups,there were no differences in the male to female ratios (10/12 vs 4/15,P =0.186),patient age (63.6 ± 2.4 years vs 60.1 ± 2.6 years,P =0.323),presence of histopathological grade 1 vs 2 (20/2 and 17/2,P =1.000),follicular dendritic cell pattern (duodenal/nodal:13/5 vs10/3,P =1.000),mitotic rate (low/partly high,14/1 vs 10/3,P =0.311),clinical stage according to the Ann Arbor system (stages Ⅰ E and Ⅱ E/other,15/7 vs 15/4,P =0.499),clinical stage according to the Lugano system (stages Ⅰ and Ⅱ-1/other,14/8 vs 14/5,P =0.489),soluble interleukin-2 receptor levels (495 ± 78 vs 402 ± 83,P =0.884),LDH levels (188 ±7 vs 183 ± 8,P =0.749),hemoglobin levels (13.5 ± 0.3vs 12.8 ± 0.4,P =0.197),bone marrow involvement (positive/negative,1/8 vs 1/10,P =1.000),detectability by CT scanning (positive/negative,1/16 vs 4/13,P =0.335),and FLIPI risk (low risk/other,16/6 vs13/6,P =0.763),respectively in each case.CONCLUSION:These findings indicate that it is not feasible to predict 18F-FDG-avidity.Therefore,18F-FDG-PET scans represent a complementary modality for the detection of gastrointestinal involvements in follicular lymphoma patients,and surveillance of the entire gastrointestinal tract by endoscopic examinations is required.

Follicular lymphomaGastrointestinal endoscopy18F-fluorodeoxyglucose positron emission tomographyGastrointestinal lymphomaDuodenal neoplasm

Masaya Iwamuro、Hiroyuki Okada、Katsuyoshi Takata、Katsuji Shinagawa、Shigeatsu Fujiki、Junji Shiode、Atsushi Imagawa

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Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama 700-8558, Japan

Department of Endoscopy,Okayama University Hospital, Okayama 700-8558, Japan

Department of Pathology,Okayama University Graduate School of Medicine, Dentistry,and Pharmaceutical Sciences, Okayama 700-8558, Japan

Department of Hematology and Oncology,Okayama University Graduate School of Medicine, Dentistry,and Pharmaceutical Sciences, Okayama 700-8558, Japan

Department of Internal Medicine, Tsuyama Central Hospital, Tsuyama 708-0841, Japan

Department of Internal Medicine, Okayama Saiseikai General Hospital, Okayama 700-8511, Japan

Department of Gastroenterology, Mitoyo General Hospital, Kanonji 769-1695, Japan

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2012

世界胃肠病学杂志(英文版)
太原消化病研治中心

世界胃肠病学杂志(英文版)

SCI
影响因子:1.001
ISSN:1007-9327
年,卷(期):2012.18(44)
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