Characteristics of primary mediastinal large B-cell lymphoma in 18F-FDG PET/CT imaging

中华核医学与分子影像杂志 Pub Date : 2020-01-25 DOI:10.3760/CMA.J.ISSN.2095-2848.2020.01.001

Yangyang Li, Zhe Guo, Tiannyu Li, Li-jun Tang, L. Fan, C. Ding

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Abstract

Objective To investigate the characteristics of primary mediastinal large B-cell lymphoma (PMBL) in 18F-fluorodeoxyglucose (FDG) PET/CT imaging. Methods From July 2010 to April 2019, 18F-FDG PET/CT images of 27 patients (10 males, 17 females, median age 31 (19-57) years) with pathologically confirmed PMBL from the First Affiliated Hospital of Nanjing Medical University were retrospectively analyzed. The location, shape, density, presence of necrosis and calcification, and invasion around or beyond the lesions were observed. The maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV) and total lesion glycolysis (TLG) were measured by automatic segmentation algorithm method. Spearman correlation analysis was used to evaluate the correlation between SUVmax or MTV or TLG and the maximum diameter or Ann Arbor staging. Results The lesions appeared as anterior mediastinal huge masses in 27 patients, and grew in the anterior mediastinal cross-regionally in 25 patients, lobulated at the edge in 24 patients. Low-density necrosis lesions were found in 18 patients. The lesions were surrounded by large blood vessels in 15 patients and tracheae were compressed in 12 patients. Lung tissues were invaded in 3 patients, abdominal lymph nodes and bone marrow were invaded in 1 patient, and no splenomegaly was found in 27 patients. The maximum diameter, SUVmax, MTV and TLG were (11.6±3.7) cm, 21.07 (15.78, 25.09), 190.43 (130.14, 350.75) cm3 and 2 165.54 (1 465.86, 4 185.21) g, respectively. There was no correlation between SUVmax and the maximum diameter of lesions (rs=-0.305, P=0.122), while MTV and TLG were positively correlated with the maximum diameter (rs values: 0.741, 0.532, both P 0.05). Conclusions PMBL mostly presents as large anterior mediastinal mass with the high 18F-FDG uptake in 18F-FDG PET/CT imaging, and the focal necrosis is common, while abdominal lymph nodes, spleen and bone marrow invasion are rare. MTV and TLG of lesions positively correlate with Ann Arbor staging. Key words: Lymphoma, large B-cell, diffuse; Mediastinum; Positron-emission tomography; Tomography, X-ray computed; Deoxyglucose

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原发性纵隔大b细胞淋巴瘤的18F-FDG PET/CT影像特征

目的探讨原发性纵隔大B细胞淋巴瘤（PMBL）的18F-氟脱氧葡萄糖（FDG）PET/CT显像特点。方法回顾性分析2010年7月至2019年4月南京医科大学附属第一医院27例经病理证实的PMBL患者（男10例，女17例，中位年龄31（19-57）岁）的18F-FDG PET/CT图像。观察病变的位置、形状、密度、坏死和钙化的存在，以及病变周围或以外的侵袭。采用自动分割算法测量最大标准化摄取值（SUVmax）、代谢肿瘤体积（MTV）和总病变糖酵解（TLG）。Spearman相关分析用于评估SUVmax、MTV或TLG与最大直径或Ann Arbor分期之间的相关性。结果27例患者病变表现为前纵隔巨大肿块，25例患者病变在前纵隔跨区域生长，24例患者病变边缘分叶。18例患者出现低密度坏死灶。病变被大血管包围15例，气管受压12例。肺组织侵犯3例，腹腔淋巴结和骨髓侵犯1例，27例未发现脾肿大。最大直径、SUVmax、MTV和TLG分别为（11.6±3.7）cm、21.07（15.78,25.09）、190.43（130.14350.75）cm3和2165.54（1465.86,4185.21）g。SUVmax与病变最大直径无相关性（rs=0.305，P=0.122），而MTV和TLG与最大直径呈正相关（rs值：0.741，0.532，均P 0.05），脾脏和骨髓侵犯是罕见的。病变的MTV和TLG与Ann Arbor分期呈正相关。关键词：淋巴瘤，大B细胞，弥漫性；纵隔；正电子发射断层扫描；层析成像，X射线计算机；脱氧葡萄糖

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来源期刊

中华核医学与分子影像杂志核医学，分子影像

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5088

期刊介绍： Chinese Journal of Nuclear Medicine and Molecular Imaging (CJNMMI) was established in 1981, with the name of Chinese Journal of Nuclear Medicine, and renamed in 2012. As the specialized periodical in the domain of nuclear medicine in China, the aim of Chinese Journal of Nuclear Medicine and Molecular Imaging is to develop nuclear medicine sciences, push forward nuclear medicine education and basic construction, foster qualified personnel training and academic exchanges, and popularize related knowledge and raising public awareness. Topics of interest for Chinese Journal of Nuclear Medicine and Molecular Imaging include: -Research and commentary on nuclear medicine and molecular imaging with significant implications for disease diagnosis and treatment -Investigative studies of heart, brain imaging and tumor positioning -Perspectives and reviews on research topics that discuss the implications of findings from the basic science and clinical practice of nuclear medicine and molecular imaging - Nuclear medicine education and personnel training - Topics of interest for nuclear medicine and molecular imaging include subject coverage diseases such as cardiovascular diseases, cancer, Alzheimer’s disease, and Parkinson’s disease, and also radionuclide therapy, radiomics, molecular probes and related translational research.