Đặc điểm hình ảnh 18F-FDG-PET/CT với một số thể mô bệnh học U lympho ác tính không Hodgkin tại Bệnh viện Bạch Mai giai đoạn 2017-2022

Abstract

Objective: Description of 18F-FDG-PET/CT imaging characteristics and Comment on the correlation of 18F-FDG-PET/CT images with some histopathological types of non-Hodgkin's lymphoma.Subjects and methods: Cross-sectional, retrospective and prospective descriptive study in 286 patients with non-Hodgkin's lymphoma were newly diagnosed and treated at Bach Mai Hospital.Results: Lymph node involvement for 84.3%, extra-nodal lesions for 54.5%. Patients only had lymph node lesions for 45.5%, only extranodal lesions accounted for 15.7% and mixed lymph node and extranodal lesions accounted for 38.8%. Common extranodal lesions are bone (18.4%), tonsils (17.7%), spleen (11.7%), nasopharynx (8.5%), stomach (8.2%), nasal cavity (7.8%), lung (5.3%), adrenal gland (4.3%), colorectal (3.9%), liver (3.7%), soft tissue (2 0.8%), brain (2.1%). Bulky lesions in 22.7% lymph node locations, 19.3% extranodal location. There is a positive linear correlation between lesion size and SUVmax in cervical, axillary, mediastinal, abdominal and inguinal nodes with the corresponding correlation coefficient r: 0.47; 0.51; 0.41; 0.46 and 0.56. There is a positive linear correlation between lesion size and SUVmax in tonsil, nasopharynx, nose, stomach, colorectal, liver, lung and adrenal gland with the corresponding correlation coefficient r: 0.60 ; 0.44; 0.38; 0.64; 0.86; 0.54; 0.44 and 0.78. There was no difference in size and SUVmax of lymph node and extranodal lesions and the proportion of bulky tumors in diffuse large B cells lymphoma’s subtypes GCB and nonGCB. B cells non Hodgkin lymphoma group progressed slowly compared to fast progress: there was a higher difference in the size of abdominal lymph nodes in the rapidly progressing group (p<0.05); There was a difference in SUVmax values ​​of cervical, mediastinal, abdominal, and extra-nodal lesions in group B cells lymphoma that progressed faster with p<0.05. T cells non Hodgkin lymphoma group: Peripheral T, T/NK, aplastic T have differences in size, SUVmax with cervical lymph node damage, extranodal injury, bone (with p<0.05); There was a difference between group T peripheral lower than T anaplastic in size, SUVmax axillary, abdominal, inguinal (p<0.05) and SUVmax mediastinal lymph node (p<0.05). The group with high, medium and low Ki76 index had a difference in SUVmax in cervical, abdominal and extra-nodal lesions (p<0.05) although there was no difference in lesion size (p> 0.05).Conclusions: Study on 286 non Hodgkin lymphoma patients: lymphadenopathy in 84.3%; Extra-nodal lesions in 54.5% (mixed lesions of both lymph nodes and extra-nodals in 38.8%). There is a positive linear correlation between lesion size and SUVmax in lymph nodes and extranodal lesions. There was no difference in size and SUVmax of lymph node and extranodal lesions and the prevalence of bulky tumors, diffuse large B cells lymphoma subtypes GCB and nonGCB. There was a difference in size and maxSUV value of lesions at some sites in the lymph nodes and in extra-nodal nodes in the group with slow progression compared to the fast progression B cell group, the T cells group, the high ki67 group.