首页 中华核医学与分子影像杂志 2025年45卷02期 淋巴瘤PET/CT及PET/MR显像临床应用指南(2025版)
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淋巴瘤PET/CT及PET/MR显像临床应用指南(2025版)
中华医学会核医学分会
作者及单位信息
·
DOI： 10.3760/cma.j.cn321828-20240924-00333
Clinical practice guideline of PET/CT and PET/MR in lymphoma (2025 edition)
Chinese Society of Nuclear Medicine
Wang Jing
Zhao Jinhua
Authors Info & Affiliations
Chinese Society of Nuclear Medicine
Wang Jing
Department of Nuclear Medicine, the First Affiliated Hospital of the Air Force Medical University, Xi′an 710032, China
Zhao Jinhua
Department of Nuclear Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200080, China
·
DOI： 10.3760/cma.j.cn321828-20240924-00333
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摘要
淋巴瘤是一组起源于淋巴造血系统的恶性肿瘤，具有高度异质性，病理分为霍奇金淋巴瘤(Hodgkin lymphoma, HL)和非霍奇金淋巴瘤(non-Hodgkin lymphoma, NHL)两大类。我国淋巴瘤的发病率为5.56/10万，呈逐年上升趋势，病死率为2.47/10万 [1]。 18F-FDG PET/CT显像已经用于淋巴瘤患者的初始分期、再分期、早期治疗反应及疗效评估、预后预测及随访。本指南在《淋巴瘤 18F-FDG PET/CT及PET/MR显像临床应用指南(2021版)》 [2]的基础上，结合近年来该领域的发展、文献证据与专家共识，对推荐内容、推荐水平以及证据水平做出相应的修改，并增加了相关内容。修订要点如下：(1)淋巴瘤的诊断和初始分期中，修改了滤泡性淋巴瘤(follicular lymphoma, FL)、自然杀伤(natural killer, NK)/T细胞淋巴瘤等的推荐水平，新增原发性皮肤细胞淋巴瘤等；(2)淋巴瘤中期再次分期和疗效评估中，新增原发纵隔大B细胞淋巴瘤(primary mediastinal large B-cell lymphoma, PMBL)、淋巴母细胞淋巴瘤、FL等；(3)指导淋巴瘤放疗策略中，新增结外鼻型NK/T细胞淋巴瘤(extranodal NK/T-cell lymphoma nasal type, ENKTCL-NT)治疗前及中期评估、Ⅲ～Ⅳ期HL的化疗中期评估；(4)预后评价中，新增ENKTCL-NT的化疗中期预后评估，新增FL的化疗中期、结束后预后评估，新增肿瘤代谢体积(metabolic tumor volume, MTV)、病灶糖酵解总量(total lesion glycolysis, TLG)、病变之间的最大距离(the largest distance between two lesions, D max)等参数的预测预后作用；(5)免疫治疗疗效评估中，新增嵌合抗原受体T细胞免疫疗法(chimeric antigen receptor T-cell immunotherapy, CAR-T)的疗效评价和预后评估；(6)新增儿童淋巴瘤、其他显像剂的应用、人工智能(artificial intelligence, AI)的应用等。
引用本文
中华医学会核医学分会. 淋巴瘤PET/CT及PET/MR显像临床应用指南(2025版)[J]. 中华核医学与分子影像杂志,2025,45(02)：94-104.
DOI:10.3760/cma.j.cn321828-20240924-00333PERMISSIONS
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一、概述
淋巴瘤是一组起源于淋巴造血系统的恶性肿瘤，具有高度异质性，病理分为霍奇金淋巴瘤(Hodgkin lymphoma, HL)和非霍奇金淋巴瘤(non-Hodgkin lymphoma, NHL)两大类。我国淋巴瘤的发病率为5.56/10万，呈逐年上升趋势，病死率为2.47/10万
[
1
]。
18F-FDG PET/CT显像已经用于淋巴瘤患者的初始分期、再分期、早期治疗反应及疗效评估、预后预测及随访。本指南在《淋巴瘤
18F-FDG PET/CT及PET/MR显像临床应用指南(2021版)》
[
2
]的基础上，结合近年来该领域的发展、文献证据与专家共识，对推荐内容、推荐水平以及证据水平做出相应的修改，并增加了相关内容。修订要点如下：(1)淋巴瘤的诊断和初始分期中，修改了滤泡性淋巴瘤(follicular lymphoma, FL)、自然杀伤(natural killer, NK)/T细胞淋巴瘤等的推荐水平，新增原发性皮肤细胞淋巴瘤等；(2)淋巴瘤中期再次分期和疗效评估中，新增原发纵隔大B细胞淋巴瘤(primary mediastinal large B-cell lymphoma, PMBL)、淋巴母细胞淋巴瘤、FL等；(3)指导淋巴瘤放疗策略中，新增结外鼻型NK/T细胞淋巴瘤(extranodal NK/T-cell lymphoma nasal type, ENKTCL-NT)治疗前及中期评估、Ⅲ～Ⅳ期HL的化疗中期评估；(4)预后评价中，新增ENKTCL-NT的化疗中期预后评估，新增FL的化疗中期、结束后预后评估，新增肿瘤代谢体积(metabolic tumor volume, MTV)、病灶糖酵解总量(total lesion glycolysis, TLG)、病变之间的最大距离(the largest distance between two lesions,
D
max)等参数的预测预后作用；(5)免疫治疗疗效评估中，新增嵌合抗原受体T细胞免疫疗法(chimeric antigen receptor T-cell immunotherapy, CAR-T)的疗效评价和预后评估；(6)新增儿童淋巴瘤、其他显像剂的应用、人工智能(artificial intelligence, AI)的应用等。
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备注信息
A
汪静，空军军医大学第一附属医院核医学科，西安 710032, Email:
nc.defudabe.ummfgnijgnaw；
B
赵晋华，上海交通大学医学院附属第一人民医院核医学科，上海 200080, Email:
mocdef.6ab213691auhnijoahz
C
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