[The value of positron emission tomography/computed tomography (PET/CT) in the staging of diffuse large B-cell lymphoma].
ABSTRACT The aim of this study was to evaluate the role of positron emission tomography/computed tomography (PET/CT) in improving the staging and changing the management of aggressive lymphoma patients in comparison with the conventional imaging modalities (CT, and 67Ga scintigraphy).
Forty consecutive patients with diffuse large B-cell non Hodgkin lymphoma, were prospectively evaluated. All 40 patients underwent a whole body FDG PET/CT and conventional staging techniques (chest and abdomen CT, 67Ga scintigraphy) were studied before therapy. Sixty minutes after the intravenous administration of 370 MBq FDG, a whole body PET/CT was acquired. We hypothesize that PET/CT improves the diagnostic staging of lymphoma and changes the clinical management of patients.
PET/CT and CT were concordant in 28 patients (65%). However, PET/CT detected more lesions than CT in 11 patients (27.5%). Only in one patient, CT revealed more extensive disease than PET/CT. Additional information of PET/CT had lead to a change in staging (upstaging) in 6 patients (15%), in turn leading to a change in treatment strategy in 1 patient. PET/CT and 67Ga scintigraphy were concordant in 23 patients (60.5%). PET/CT detected more lesions than 67Ga scintigraphy in 14 patients (42%). PET/CT results changed staging (upstaging) in 4 patients (15%), leading to a change of treatment strategy in one patient.
The impression is that PET/CT detected more lesions than conventional examination, but this rarely translates into changes of staging and treatment strategy in aggressive lymphoma.
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ABSTRACT: This study was carried out to evaluate the role of quantitative parameters in staging PET in predicting prognosis in patients with high-grade non-Hodgkin's lymphoma (NHL). A total of 51 histopathologically proven high-grade NHL patients treated with conventional chemotherapy regimens were included in the study. Total lesion glycolysis (TLG) and functional volumes (FVs) were defined as per the PET Response Criteria in Solid Tumors (PERCIST) criteria. All patients were followed up for a minimum period of 1 year or until an event, whichever occurred earlier. Of the four semiquantitative parameters studied, SUV max and SUV mean did not show a statistically significant correlation with progression-free survival or overall survival, whereas TLG and FV showed a weak but statistically significant negative correlation. Using the receiver operating characteristic curve analysis, optimal cut-offs were derived for FV and TLG to predict progression and death. Using the cut-off values of 416 cm3 and 3340 g for FV and TLG, respectively, a statistically significant difference in progression-free survival and overall survival was obtained in the groups with FV and TLG above and below the threshold. On multivariate analysis of all the conventional prognostic factors and TLG more than 3340 and FV more than 416 cm3, only age greater than 60 years (P=0.013) and FV more than 416 cm3 (P=0.012) were found to be independently associated with disease progression. Our results indicate that FV and TLG in staging PET/CT could be useful indices in predicting outcomes in patients with high-grade NHL treated with standard first-line chemotherapy regimens.Nuclear Medicine Communications 07/2012; 33(9):974-81. · 1.38 Impact Factor
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ABSTRACT: Intravascular lymphoma is a rare subtype of extranodal Non-Hodgkin's lymphoma. Its prognosis is poor in a high percentage of cases due to its insidious appearance and low clinical suspicion. Its diagnosis is usually only reached after an autopsy. It may affect different organs as a whole or only one organ. It is extremely rare that the lung is the only damaged organ. Its diagnosis depends of the clinician's suspicion and proper evaluation with imaging studies as well as correct selection of the organ to be biopsied. When detected on time, the treatment of choice is a combination of a series of chemotherapy associated to a monoclonal antibody (anti-CD20). We present the case of a male patient who underwent a positron emission tomography-computed tomography with 2-[F-18]-fluoro-2 deoxy-D-glucose (FDG) due to symptoms suggestive of a lymphoproliferative disease with no clear structural abnormalities. The images led to a diagnosis of pulmonary intravascular large B cell lymphoma.Revista espanola de medicina nuclear e imagen molecular. 01/2013;