Applied research on the diagnostic value of 18F-FDG PET/CT in different subtypes mantle cell lymphoma.

Abstract

Objective: To analyze the diagnostic value of fluorine-18-fluoro-deoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT) in mantle cell lymphoma (MCL) and explore its application in distinguishing between the classic and aggressive variants of MCL.

Subjects and methods: Retrospective analysis was performed on the ¹⁸F-FDG PET/CT imaging, clinical, and pathological data of 134 newly diagnosed MCL patients confirmed by pathology.

Results: Among the 134 patients, 97.8% had increased ¹⁸F-FDG uptake in lymph nodes, and 88.8% had increased ¹⁸F-FDG uptake in extranodal tissues or organs. In the diagnosis of bone marrow infiltration in MCL patients, ¹⁸F-FDG PET/CT has demonstrated a high specificity rate of 86.4% and a limited sensitivity rate of 43.9%. Fluorine-18-FDG PET/CT performs well in diagnosing gastric and intestinal infiltration, with high accuracies of 85.0% and 91.7% respectively. The receiver operating characteristic (ROC) curve analysis revealed that a diagnostic threshold of maximum standardized uptake value (SUVmax) at 10.4 effectively distinguished between the classic and aggressive variants of MCL, achieving a sensitivity of 68.0%, a specificity of 80.7%, and an accuracy of 79.1%, with an area under the curve (AUC) value of 0.771.

Conclusion: Fluorine-18-FDG PET/CT has a high positive detection rate in both intra-nodal and extra-nodal lesions of MCL at initial diagnosis. It exhibits high specificity and positive predictive value (PPV) in diagnosing bone marrow infiltration and possesses strong comprehensive diagnostic capabilities in gastrointestinal infiltration. Furthermore, the SUVmax can be used to distinguish between the classic and aggressive variants of MCL, and it is significantly positively correlated with the Ki-67 index, providing valuable clinical reference.