международные рекомендации

Современные аспекты применения позитронно-эмиссионной томографии при лимфомах

ОБЗОРЫ , , ,

Асланиди И.П., Мухортова О.В., Катунина Т.А., Екаева И.В., Шавман М.Г.

ФГБНУ «Научный центр сердечно-сосудистой хирургии им. А.Н. Бакулева», Рублевское ш., д. 135, Москва, Российская Федерация, 121552

Для переписки: Ольга Валентиновна Мухортова, д-р мед. наук, Рублевское ш., д. 135, Москва, Российская Федерация, 121552; тел.: +7(495)414-77-31; e-mail: olgamukhortova@yandex.ru

Для цитирования: Асланиди И.П., Мухортова О.В., Катунина Т.А. и др. Современные аспекты применения позитронно-эмиссионной томографии при лимфомах. Клиническая онкогематология. 2015;8(1):13–25.

РЕФЕРАТ

Цель. Определить наиболее эффективные направления использования позитронно-эмиссионной томографии (ПЭТ) со фтордезоксиглюкозой, меченной 18-фтором (18F-ФДГ), у больных лимфомами.

Методы. Изучено 56 научных источников, опубликованных в 2005–2014 гг., в которых анализируются результаты последних крупных исследований по применению ПЭТ у больных лимфомами.

Результаты. ПЭТ с 18F-ФДГ стала неотъемлемой частью диагностического алгоритма у больных лимфомами, которые характеризуются активным накоплением 18F-ФДГ. Высокая точность ПЭТ у пациентов с некоторыми типами лимфом позволяет эффективно использовать метод в клинической практике для определения стадии заболевания, оценки эффективности лечения, уточнения распространенности рецидива, результатов противорецидивного лечения, а также при подозрении на трансформацию лимфомы. Применение ПЭТ на других этапах лечения больных лимфомами находится в процессе научных разработок. При индолентных лимфомах с известной низкой гликолитической активностью или лимфомах редких гистологических типов ПЭТ для оценки эффективности лечения используется только при наличии исходных (до начала лечения) результатов исследования. Для оценки результатов лечения рекомендуется использовать 5-балльную шкалу Deauville. Соблюдение сроков обследования в процессе противоопухолевой терапии позволяет существенно повысить точность ПЭТ-диагностики. Одиночные очаги, выявленные при ПЭТ и имеющие принципиальное значение для выбора лечения, должны быть верифицированы другими методами диагностики. Выполнение ПЭТ при наблюдении за больными в состоянии ремиссии признается нецелесообразным.

Выводы. ПЭТ является «золотым стандартом» стадирования и оценки эффективности лечения больных лимфомами, которые характеризуются активным накоплением 18F-ФДГ.

Ключевые слова: ПЭТ, лимфомы, международные рекомендации, 5-балльная шкала Deauville.

Получено: 14 ноября 2014 г.

Принято в печать: 18 ноября 2014 г.

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