Comparison between 2-deoxy-2-[F]fluoro-D-Glucose positron emission tomography and positron emission tomography/computed tomography hardware fusion for staging of patients with lymphoma

Allen-Auerbach, Martin; Quon, Andrew; Weber, Wolfgang; Obrzut, Sebastian; Crawford, Tyler L.; Silverman, Daniel; Ratib, Osman; Phelps, Michael E.; Czernin, Johannes

doi:10.1016/j.mibio.2004.08.004

Cited by 109 publications

(56 citation statements)

References 19 publications

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“…23 Combining FDG-PET with a CT scan (PET/ CT) improves the interpretation of PET scans, and PET/CT has become the standard. 24 It has been suggested that the addition of contrast-enhanced CT may further increase the benefit. 25 Other authors have challenged this view by reporting that a diagnostic CT scan with intravenous contrast does not add useful information regarding extent of lymphoma in patients undergoing PET/CT for staging if the low-dose CT scan is interpreted individually.…”

Section: Current Use Of Pet Scans In Managing Lymphoma Stagingmentioning

confidence: 99%

Positron Emission Tomographic Scans in Lymphoma: Convention and Controversy

Ansell

Armitage

2012

Mayo Clinic Proceedings

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The use of sensitive and specific imaging techniques for accurate initial staging and evaluation of response to therapy in patients with lymphoma is essential for their optimal management. Fluorine 18 fluorodeoxyglucose (FDG) positron emission tomography (PET) integrated with computed tomography (CT) has emerged as a powerful imaging tool and is being routinely used in staging, response evaluation, and posttreatment surveillance in patients with non-Hodgkin lymphoma and Hodgkin lymphoma. PET/CT is currently widely used in clinical practice, but the established clinical benefit is currently restricted to the posttreatment evaluation of Hodgkin lymphoma, diffuse large B-cell lymphoma, and follicular lymphoma. Although used in other histologic subtypes and in other clinical situations including response assessment, its impact on patient outcome remains to be demonstrated. We performed a literature search of PubMed from 1999 to 2011 using the following keywords: PET scan, FDG-PET, PET/CT, lymphoma. This review addresses the challenges and controversies in the use of PET/CT scans in the management of patients with lymphoma. I n most patients with lymphoma, positron emission tomographic (PET) scans show abnormalities at diagnosis. Normal findings on the scan after therapy is highly predictive of a good prognosis, particularly in patients with diffuse large B-cell lymphoma (DLBCL), follicular lymphoma, and Hodgkin lymphoma. However, the optimal application of PET scans to the management of all patients with lymphoma remains problematic. The major controversies include the optimal timing of PET scans (for staging, during therapy, after completion of therapy, surveillance in remission), standardization of PET scan interpretation (visual interpretation compared with standard uptake value [SUV] calculation), what constitutes a positive PET scan result, and whether PET scans should be used to direct management (eg, does changing therapy in patients with positive findings on PET change outcome, should biopsies of sites with positive PET results be done routinely before a management change). Although a large body of literature addressing these topics exists, the studies are often difficult to compare, making definitive conclusions on all these issues difficult. The previously published studies often used different designs and variable reporting, making interpretation and comparison of the results difficult. In the early studies particularly, heterogeneous populations with different stages of disease and different histologic subtypes were included, making the clinical applicability of the studies' results difficult. More recent studies focusing on efforts to standardize the conduct and interpretation of PET scans and on riskadapted therapies based on interim PET scan results will, it is hoped, improve the management and outcome of patients with lymphoma. A literature search of PubMed from 1999 to 2011 was performed using the following keywords: PET scan, FDG-PET, PET/CT, lymphoma. We highlight the current standard use ...

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Section: Current Use Of Pet Scans In Managing Lymphoma Stagingmentioning

confidence: 99%

Positron Emission Tomographic Scans in Lymphoma: Convention and Controversy

Ansell

Armitage

2012

Mayo Clinic Proceedings

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“…The images are fused to provide precise localization of abnormal lesions. PET/CT provides more sensitive and specific imaging than either modality alone, [20][21][22][23][24][25] and is considerably faster than the combination of emission and transmission PET scans required to obtain attenuation-corrected PET images. PET/CT is essentially replacing stand-alone PET scanners.…”

Section: Fdg-petmentioning

confidence: 99%

The role of FDG-PET scans in patients with lymphoma

Seam

Juweid

Cheson

2007

Blood

273

172

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“…14 This problem has been partly overcome by integrating PET and the anatomic details of CT in a single procedure (PET/CT). 15,16 At present, PET/CT is widely used in the pre-therapy staging and response evaluation of HL, but its role during post-therapy disease surveillance has not been established. 17 The aim of this retrospective study was to investigate the value of PET/CT surveillance during the follow-up of HL patients in first remission.…”

Section: Introductionmentioning

confidence: 99%

Positron emission tomography/computed tomography surveillance in patients with Hodgkin lymphoma in first remission has a low positive predictive value and high costs

El‐Galaly

Mylam²,

Brown³

et al. 2011

Haematologica

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BackgroundThe value of performing post-therapy routine surveillance imaging in patients with Hodgkin lymphoma is controversial. This study evaluates the utility of positron emission tomography/computed tomography using 2-[18F]fluoro-2-deoxyglucose for this purpose and in situations with suspected lymphoma relapse. Design and MethodsWe conducted a multicenter retrospective study. Patients with newly diagnosed Hodgkin lymphoma achieving at least a partial remission on first-line therapy were eligible if they received positron emission tomography/computed tomography surveillance during follow-up. Two types of imaging surveillance were analyzed: "routine" when patients showed no signs of relapse at referral to positron emission tomography/computed tomography, and "clinically indicated" when recurrence was suspected. ResultsA total of 211 routine and 88 clinically indicated positron emission tomography/computed tomography studies were performed in 161 patients. In ten of 22 patients with recurrence of Hodgkin lymphoma, routine imaging surveillance was the primary tool for the diagnosis of the relapse. Extranodal disease, interim positron emission tomography-positive lesions and positron emission tomography activity at response evaluation were all associated with a positron emission tomography/computed tomography-diagnosed preclinical relapse. The true positive rates of routine and clinically indicated imaging were 5% and 13%, respectively (P=0.02). The overall positive predictive value and negative predictive value of positron emission tomography/computed tomography were 28% and 100%, respectively. The estimated cost per routine imaging diagnosed relapse was US$ 50,778. ConclusionsNegative positron emission tomography/computed tomography reliably rules out a relapse. The high false positive rate is, however, an important limitation and a confirmatory biopsy is mandatory for the diagnosis of a relapse. With no proven survival benefit for patients with a pre-clinically diagnosed relapse, the high costs and low positive predictive value make positron emission tomography/computed tomography unsuitable for routine surveillance of patients with Hodgkin lymphoma.Key words: Hodgkin lymphoma, follow-up, PET/CT, positron emission tomography, relapse, health care costs.Citation: El-Galaly TC, Mylam KJ, Brown P, Specht L, Christiansen I, Munksgaard L, Johnsen HE, Loft A, Bukh A, Iyer V, Nielsen AL and Hutchings M. Positron emission tomography/computed tomography surveillance in patients with Hodgkin lymphoma in first remission has a low positive predictive value and high costs. Haematologica 2012;97(6):931-936.

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Comparison between 2-deoxy-2-[F]fluoro-D-Glucose positron emission tomography and positron emission tomography/computed tomography hardware fusion for staging of patients with lymphoma

Cited by 109 publications

References 19 publications

Positron Emission Tomographic Scans in Lymphoma: Convention and Controversy

Positron Emission Tomographic Scans in Lymphoma: Convention and Controversy

The role of FDG-PET scans in patients with lymphoma

Positron emission tomography/computed tomography surveillance in patients with Hodgkin lymphoma in first remission has a low positive predictive value and high costs

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