18F-FDG PET in Non-Hodgkin's Lymphoma: Qualitative or Quantitative?

Prognostic Value of Interim 18F-FDG PET in Patients with Diffuse Large B-Cell Lymphoma: SUV-Based Assessment at 4 Cycles of Chemotherapy

“…Nevertheless, a relatively large number of patients with false-positive findings persisted. By using an SUVmax cutoff of 5.0 or an SUVmax reduction of approximately two thirds (65.7%), we were able to strongly reduce the number of false-positive interpretations (13,14). Interestingly, in the study by Gallamini et al (17) including 260 patients with Hodgkin disease, semiquantification was helpful in defining the minimal residual uptake category-that is, an SUVmax of between 2.0 and 3.5.…”

“…In a recent study, we showed that semiquantification of 18 F-FDG uptake, using standardized uptake value (SUV), was helpful in reducing false-positive interpretations after 2 cycles of first-line chemotherapy (13,14). By computing the percentage of maximal SUV (SUVmax) reduction between baseline and 2 cycles, we found that an optimal cutoff of 65.7% SUVmax reduction better separated patients with favorable outcomes (reduction .…”

Midtreatment 18F‐fluorodeoxyglucose positron‐emission tomography in aggressive non‐Hodgkin lymphoma

“…9,11,38 All of these variables, which are often taken into consideration in the same report, can modify and alter the results significantly; consequently, data obtained from interim PET evaluations performed at different observation periods should not be pooled. Furthermore, the potential different response related to the inclusion or exclusion of rituximab in the treatment regimen must be considered.…”

Diffuse Large B-Cell Lymphoma: Prospective Multicenter Comparison of Early Interim FLT PET/CT versus FDG PET/CT with IHP, EORTC, Deauville, and PERCIST Criteria for Early Therapeutic Monitoring

“…Although FDG PET/CT has been used for interim restaging or therapy monitoring after one to four cycles of therapy for prognostication and/or to tailor further management according to the scan findings (2,3,5,(6)(7)(8)(9)(10)(11)(32)(33)(34)(35)(36)(37)(38), more recent data suggest that this approach offers only a moderate PPV (25%-70%) but a high NPV (2,3,(6)(7)(8)(9)(10)(11)(32)(33)(34)(35)(36).…”

“…luorine 18 fluorodeoxyglucose (FDG) positron emission tomography (PET) with integrated computed tomography (CT) is a noninvasive imaging technique that is used for staging, restaging, monitoring therapy, and predicting the prognosis of diffuse large B-cell lymphoma (DLBCL) and Hodgkin lymphoma (1-4). Interim FDG PET/CT in malignant lymphoma has been reported to have an excellent negative predictive value (NPV) of 80% or more but a modest and variable positive predictive value (PPV) of 25%-70%, depending on tumor bulk, timing of PET after chemotherapy, the outcome methodology, and, possibly, the type of treatment used (3,(5)(6)(7)(8)(9)(10)(11)(12)). An important factor for the suboptimal PPV is that residual FDG accumulation may occur because of posttherapy inflammatory changes after initiation of chemotherapy, particularly during interim treatment monitoring (13).…”