The Korean Journal of Nuclear Medicine (대한핵의학회지)

The Korean Society of Nuclear Medicine (대한핵의학회)
권호 표지

Positron Emission Tomography with $^{18}F-FDG$ Fluorodeoxyglucose for Primary Lymphoma of Bone

뼈에 발생한 악성 림프종 환자의 치료 효과 판정에서 $^{18}F-FDG$ Positron Emission Tomography의 유용성

  • Kim, Nam-Don (Department of Interual Medicine, Korea Cancer Center Hospital) ;
  • Park, Yeon-Hee (Department of Interual Medicine, Korea Cancer Center Hospital) ;
  • Ki, Seung-Seog (Department of Interual Medicine, Korea Cancer Center Hospital) ;
  • Park, Yong-Jin (Department of Interual Medicine, Korea Cancer Center Hospital) ;
  • Kim, Heoyng-Joon (Department of Interual Medicine, Korea Cancer Center Hospital) ;
  • Ryoo, Baek-Yeol (Department of Interual Medicine, Korea Cancer Center Hospital) ;
  • Kim, Heung-Tae (Department of Interual Medicine, Korea Cancer Center Hospital) ;
  • Kim, Sung-Eun (Department of Nuclear Medicine, Korea Cancer Center Hospital) ;
  • Cheon, Gi-Jeong (Department of Nuclear Medicine, Korea Cancer Center Hospital) ;
  • Choi, Chang-Woon (Department of Nuclear Medicine, Korea Cancer Center Hospital) ;
  • Lim, Sang-Moo (Department of Nuclear Medicine, Korea Cancer Center Hospital)
  • Published : 2003.10.30
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: Accurate assessment of the lesion after treatment of patients with bone lymphoma is difficult. In this patient who demonstrated complete remission after chemotherapy, the regions of fluorine-18 fluorodeoxyglucose $(^{18}FFDG)PET$ uptake diminished more rapidly fellowing therapy, indicating a complete response at much earlier stage than did Magnetic Resonance Imaging (MRI) or CT based findings. With the conventional methods, such as MRI and CT, It was difficult to assess whether the residual tumor tissue was viable or not. Decision to complete response is very important in patients with lymphoma to plan the further treatment. We experienced a patient with primary lymphoma of bone who revealed complete response to chemotherapy on $^{18}FFDGPET$ while CT showed persistent destructive bone lesion. Thus, $^{18}FFDGPET$ study after therapy may be superior to CT in the evaluation of response to treatment in primary lymphoma of bone.

원발성골림프종은 매우 드문 질환이기는 하나, 복합항암요법이나 방사선 치료등에 높은 반응율을 보이며, 좋은 예후를 가지는 림프절외 비호지킨 림프종의 일종이다. 그러나, 치료 효과 판정에 있어 골병변의 특이성에 의한 모호한 방사선학적 특징으로 어려움이 있어 왔다. 본 증례는 위와 같은 원발성골림프종 환자에서 PET 스캔을 사용하여 민감하게 완전 반응을 평가할 수 있었던 예로 앞으로 다른 고식적인 방법과 함께 이 질환의 진단과 치료 평가 있어 유용하게 사용 될 수 있을 것으로 전망할 수 있었다.

Keywords

References

  1. Parker F, Jackson H Jr. Primary reticulum cell sarcoma of bone. Surg Gynecol Obstet 1939;68:43-5
  2. Huvos AG. Primary non-Hodgkin's lymphoma of bone. In: Huvos AG. Bone tumor diagnosis, treatment, and prognosis. 2nd ed. Philadelphia: Saunders Co;1991, p. 625-37
  3. Barr J, Burkes RL, Bell R, Blackstein ME, Fernandes B, Langer F. Primary non-Hodgkin's lymphoma of bone. Cancer 1994;73: 1194-9 https://doi.org/10.1002/1097-0142(19940215)73:4<1194::AID-CNCR2820730412>3.0.CO;2-R
  4. Mulligan ME, McRae GA, Murphey MD. Imaging features of primary lymphoma of bone. AJR 1999;173: 1691-7 https://doi.org/10.2214/ajr.173.6.10584821
  5. Leeson MC, Makely JT, Carter JR, Krupco T. The use of radioisotope scans in the evaluation of primary lymphoma of bone. Orthop Rev 1989;18:410-6
  6. Hicks DG, Gokan T, O'Keefe RJ, Totterman SM, Fultz PJ, Judkins AR, et al. Primary lymphoma of bone. Cancer 1995;75: 973-80 https://doi.org/10.1002/1097-0142(19950215)75:4<973::AID-CNCR2820750412>3.0.CO;2-8
  7. Daldrup-Link HE, Franzius C, Link TM, Laukamp D, Sciuk J, Jurgens H, et al. Whole-body MR imaging for detection of bone metastases in children and young adults: comparison with skeletal scintigraphy and FDG PET. AJR 2001: 177:229-36
  8. Durr HR, Muller PE, Hiller E, Maier M, Baur A, Jansson V, et al. Malignant lymphoma of bone. Arch Orthop Trauma Surg 2002;122: 10-6 https://doi.org/10.1007/s004020100316
  9. Heyning FH, Hogendoorn PCW, Kramer MHH, Hermans J, Kluin-Nelemans JC, Noordijk EM, et al. Primary non-Hodgkin's lymphoma of bone: a clinicopathological investigation of 60 cases. Leukemia 1999;13: 2094-8 https://doi.org/10.1038/sj/leu/2401582
  10. Dubey P, Ha CS, Besa PC, Fuller L, Cabanillas F, Murray J, et al. Localized primary malignant lymphoma of bone. Int J Radia Oncol Biol Phys 1997;37: 1087-93 https://doi.org/10.1016/S0360-3016(97)00106-5
  11. Jerusalem G, Beguin Y, Fassotte MF, Najjar F, Paulus P, Rigo P, et al. Whole-body positron emission tomography using 18F-fluorodeoxyglucose for posttreatment evaluation in Hodgkin's disease and non-Hodgkin's lymphoma has higher diagnostic value than classical computed tomography scan imaging. Blood 1999;94: 429-33
  12. Moog F, Kotzerke J, Reske SN. FDG PET can replace scintigraphy in primary staging of malignant lymphoma. J Nucl Med 1999;40:1407-13
  13. Romer W, Hanauske AR, Ziegler S, Thodtmann R, Weber W, Fuchs C, et al. Positron emission tomography in non-Hodgkin's lymphoma: Assessment of chemotherapy with fluorodeoxyglucose.Blood 1998;91: 4464-71
  14. Naumann R, Vaic A, Beuthien-Baumann B, Bredow J, Kropp J, Kittner T et al. Prognostic value of positron emission tomography in the evaluation of post-treatment residual mass in patients with Hodgkin's disease and non-Hodgkin's lymphoma. Br J Haematol 2001;115: 793-800 https://doi.org/10.1046/j.1365-2141.2001.03147.x
  15. Spaepen K, Stroobants S, Dupont P, Vandenberghe P, Thomas J, de Groot T, et al. Early restaging positron emission tomography with 18F-fluorodeoxyglucose predicts outcome in patients with aggressive non-Hodgkin's lymphoma. Ann Onco 2002;13: 1356-63 https://doi.org/10.1093/annonc/mdf256