基线18F-FDG PET/CT显像在滤泡性淋巴瘤分布、分级和分期中的价值

目的:总结滤泡性淋巴瘤（follicular lymphoma，FL）基线18F-FDG PET/CT显像特点并探讨基线18F-FDG PET/CT显像不同代谢参数在FL分布、分级、分期中的价值。方法:回顾性分析2014年01月至2022年12月进行基线18F-FDG PET/CT检查的经病理证实的FL患者56例，对其基线18F-FDG PET/CT显像受累病灶的部位、密度及最大径进行总结分析；应用独立样本t检验比较FL低级别组（1、2级）、高级别组（3a、3b级）与Ki-67、SUVmax、TBR和Dmax间的关系；分析FL局限期组（Ⅰ、Ⅱ期）与播散期组（Ⅲ、Ⅳ期）间SUVmax、TBR的差异。结果:基线18F-FDG PET/CT显像最高代谢病灶最常见的好发部位是腹部和颈部淋巴结，多表现为腹部和颈部多发高代谢肿大淋巴结，密度均匀，较大者融合成团。高、低级别组Ki-67指数间差异有统计学意义（t=4.621,P＜0.05），利用ROC曲线进行分析，Ki-67指数临界值为35%；高、低级别组间SUVmax、TBR差异有统计学意义（t=2.481、t=2.514,P＜0.05），ROC曲线临界值分别为12.3、4.7，Dmax差异无统计学意义（t=1.380,P＞0.05）。局限期组与播散期组的SUVmax、TBR无统计学差异（t=0.534、1.212,P＞0.05）。结论:FL基线18F-FDG PET/CT显像多表现为腹部和颈部多发肿大淋巴结，密度均匀且融合成团，代谢活性不同程度增高，基线18F-FDG PET/CT能有效评估FL患者分级并能够准确分期，代谢参数SUVmax、TBR越高，分级越高，但其与分期间无明显关联。

The value of baseline 18F-FDG PET/CT imaging in the distribution,grading and staging of follicular lymphoma

Objective:To summarize the characteristics of baseline 18F-FDG PET/CT imaging of follicular lymphoma（FL） and to explore the value of different metabolic parameters of baseline 18F-FDG PET/CT imaging in the distribution,grading,and staging of FL.Methods:A retrospective analysis of 56 patients with pathologically confirmed FL who underwent baseline 18F-FDG PET/CT from January 2014 to December 2022 was performed,and the sites,densities,and maximum diameters of the involved lesions on their baseline 18F-FDG PET/CT imaging were summarized and analyzed.The independent samples t-test was applied to compare the relationship between FL low level group (level 1 and 2),high level group (level 3a and 3b) and Ki-67,SUVmax,TBR and Dmax.The differences in SUVmax and TBR between the limited stage group (stage I and II) and the disseminated stage group (stage III and IV) were analyzed.Results:The most common prevalent sites of the highest metabolic lesions on baseline 18F-FDG PET/CT imaging were the abdominal and the neck lymph nodes,which mostly showed multiple hypermetabolic enlarged lymph nodes in the abdomen and the neck with uniform density and some fusion into clusters.The difference in Ki-67 index between high and low level groups was statistically significant (t=4.621,P＜0.05),and the critical value of Ki-67 index was 35% using ROC curve.There were statistically significant differences in SUVmax,TBR between the high and low-level groups (t=2.481,t=2.514,P＜0.05),with ROC curve critical values of 12.3 and 4.7,respectively,and no statistically significant differences in Dmax (t=1.380,P＞0.05).There was no statistically significant difference in SUVmax and TBR between the limited stage group and the disseminated stage group (t=0.534,1.212,P＞0.05).Conclusion:Baseline 18F-FDG PET/CT imaging of FL mostly showed multiple enlarged lymph nodes in the abdomen and neck with homogeneous and fused masses and different degrees of increased metabolic activity.Baseline 18F-FDG PET/CT was effective in assessing the grading of FL patients and accurately stage them,and the higher the metabolic parameters SUVmax and TBR,the higher the grading,but they were not significantly correlated with the staging period.