2-[18F]-FDG PET/CT Role in Detecting Richter Transformation of Chronic Lymphocytic Leukemia and Predicting Overall Survival

The Role of 2-[18F]-FDG PET/CT in Detecting Richter Transformation in Chronic Lymphocytic Leukemia: A Systematic Review

“…In the other 6 studies [18][19][20]22,24,25], an SUVmax of 5 was used to detect RT with an average overall sensitivity of 87% (range 71-96%), an average overall specificity of 49% (range 4-80%), an average overall PPV of 41% (range 16-53%) and an average overall NPV of 84% (range 33-97%). Albano et al [26] and Michallet et al [21] proposed a different SUVmax threshold as the best predictor for RT: an SUVmax of 9 and of 10, respectively, with a sensitivity, specificity, PPV and NPV of 67%, 90%, 67% and 90%, respectively, in the first case [26], and 91%, 95%, 29% and 99%, respectively, in the second one [21]. In two studies [22,24], different SUVmax cutoff values were directly compared in the same population.…”

“…After the revision of the titles and abstracts, 90 records were eliminated because they were not within the field of interest of the research of this review and 44 records were eliminated because they were editorials, comments, case reports, small case series, reviews or conference proceedings. Finally, 13 studies (for a total of 1336 patients affected by CLL who performed 2-[ 18 F]-FDG PET or PET/CT) were screened in their full-text version and included in this systematic review [14][15][16][17][18][19][20][21][22][23][24][25][26] (Figure 1). No additional manuscripts were discovered while checking the references of the selected articles.…”

“…Tables 1-3 contain the main characteristics and results of the studies included. Of the 13 studies, 10 were of retrospective nature [14][15][16][19][20][21][23][24][25][26] and only 3 were prospective [17,18,22]. In two papers the scanner utilized was PET only [15,24], while in the other 10 cases the scanner used was hybrid PET/CT [14,[16][17][18][20][21][22][23]25,26]; only in one manuscript both techniques were considered [19].…”

“…Of the 13 studies, 10 were of retrospective nature [14][15][16][19][20][21][23][24][25][26] and only 3 were prospective [17,18,22]. In two papers the scanner utilized was PET only [15,24], while in the other 10 cases the scanner used was hybrid PET/CT [14,[16][17][18][20][21][22][23]25,26]; only in one manuscript both techniques were considered [19]. In all the included studies, PET or PET/CT images were analyzed visually and semi-quantitatively.…”

“…Regarding the semi-quantitative analysis, the maximum standardized uptake value (SUVmax) was the most frequent metabolic parameter investigated. Metabolic tumor volume (MTV) and total lesion glycolysis (TLG) were analyzed only in two articles [23,26]. All 13 studies were evaluated qualitatively using the QUADAS-2 tool (Figure 2).…”