Role of 18F-FDG SPECT / CT imaging in the diagnosis and initial staging of lymphoma

• Main Authors: Liang-Qian Tong, Sheng-Nan Jiang
• Format: Article
• Language: English
• Published: Editorial Board of Journal of Hainan Medical University 2020-09-01
• Series: Journal of Hainan Medical University
• Subjects: lymphoma; staging; tomography emission-computed; single-photon; fluorodeoxyglucose
• Online Access: http://www.hnykdxxb.com/PDF/202017/11.pdf
• ISSN: 1007-1237; 1007-1237

Objective: To investigate the role of 18F-FDG SPECT/PET in the diagnosis and initial staging of lymphoma. Methods: A retrospective analysis was carried out on 48 patients in Haikou Hospital from January 2015 to June 2018, who were eventually pathologically diagnosed with lymphoma and had undergone 18F-FDG SPECT/PET before definite diagnosis. (1) Patients were divided into Hodgkin's lymphoma group, diffuse large B cell lymphoma group and other non-Hodgkin's lymphoma group according to Pathological classification; and were divided into nodal lymphoma group and extranodal lymphoma group according to the presence of invasion to the tissues beyond lymph node; and were divided into stage I+II group and stage III+IV group according to clinical Ann Arbor staging. The diagnostic consistencies of 18FFDG SPECT/PET and conventional imaging (CI) in each group were calculated, the T/N ratios of the lymphoma lesion were analyzed as well. (2) Clinical Ann Arbor staging, SPECT/ PET staging and CI staging were performed in 48 patients, respectively. Then the efficacy of SPECT/PET staging and CI staging was compared, and the consistency of SPECT/PET staging and clinical Ann Arbor staging was compared as well. Results: (1) In this study, the diagnostic consistent rates of 18F-FDG SPECT/PET and CI were 45.8% (22/48) and 16.6% (8/48), respectively (χ2=9.503, P=0.002＜0.01). (2) The diagnostic consistent rate of 18FFDG SPECT/PET in diffuse large B cell lymphoma group and other non-Hodgkin's lymphoma group was higher than that of CI (P < 0.05). There was no statistical significance between the diagnostic consistent rates of 18F-FDG SPECT/PET in the Hodgkin's lymphoma group, diffuse large B cell lymphoma group and other non-Hodgkin's lymphoma group (χ2=1.067, P=0.448＞0.05). (3) The diagnostic consistent rates of 18F-FDG SPECT/PET in nodal group and extranodal group were 100.0% (19/19) and 21.1% (4/19) (χ2=24.783, P=0.000＜0.01) , respectively. (4) The diagnostic consistent rates of 18F-FDG SPECT/PET and CI were 25% (2/8) and 0 (0/8) in lymphoma with early stage(stage I+II group) (χ2=2.268, P=0.131＞ 0.05), and 50% (20/40) and 20% (8/40) in lymphoma with late stage (stage III+IV group) (χ2=7.912, P=0.002＜0.01), respectively. (5) There was no statistical significance in T/N ratios of lymphoma lesions between different pathological groups, between nodal group and extranodal group, or between the stage I+II group and the stage III+IV group (P > 0.05). (6) The total consistent rates of 18F-FDG SPECT/PET and CI for initial lymphoma staging were 79.2% (38/45) and 64.4% (31/48) (χ2=18.774, P=0.000＜0.01). SPECT/PET staging was well consistent with clinical Ann Arbor staging in initial lymphoma staging (Kappa=0.696, P=0.000＜0.01). Conclusion: The research has showed that the consistent rates of 18F-FDG SPECT/PET in the diagnosis and initial staging of lymphoma are relatively high, and 18F-FDG SPECT/PET plays an important role in the diagnosis and initial staging of lymphoma.