F-18 FDG PET-CT versus contrast enhanced ct in detection of extra nodal involvement in patients with lymphoma

Predicting early clinical failure in patients with untreated follicular lymphoma (FL) is important but difficult. This study aimed to determine the incidence and patterns of extranodal (EN) and spleen disease using PET/CT, and assess their utility in predicting early clinical failure. PET/CT images from 613 cases of untreated FL (2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015)(2016) were reviewed. The location and number of EN sites, patterns of bone involvement, and splenic involvement were recorded. Outcomes were assessed using event-free survival (EFS), overall survival (OS), and early clinical failure at 24 months (EFS24). So, 49% (301/613) of patients had PET/CT-detected EN involvement, and 28% (171/613) had spleen involvement. The presence of ≥2 EN sites, spleen, bone or soft tissue involvement all predicted failure to achieve EFS24. Presence of ≥2 EN sites and bone involvement pattern were also predictive of OS in a univariate analysis. In a multivariate analysis with FLIPI-2 factors, spleen involvement, pattern of bone involvement, and soft tissue involvement independently predicted a lower EFS (HR 1.49 (1.11-2.00), P = .007; HR 1.71 (1.10-2.65), P = .017; and HR 1.67(1.06-2.62), P = .026, respectively). When the multivariate analysis was performed using PRIMA-PI factors (marrow and B2M), the number of EN sites was an independent prognostic factor for inferior OS (HR 2.28; P = .05). Baseline PET/CT identifies EN involvement in nearly half of patients with untreated FL. The presence of ≥2 EN sites, bone, soft tissue, or splenic involvement predicts early clinical failure. These results, when combined with other factors, may better identify high-risk patients and guide therapy.

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Detection of extranodal and spleen involvement by FDG‐PET imaging predicts adverse survival in untreated follicular lymphoma

St‐Pierre

Broski

LaPlant

et al. 2019

American J Hematol

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Radiogenomics and Its Role in Lymphoma

Khan

Naim

Bilwani

et al. 2020

Curr Hematol Malig Rep

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Comparison of clinicopathological features and treatment outcomes in aggressive primary intestinal B- and T/NK-cell lymphomas

Yeh

Yao

et al. 2021

Journal of the Formosan Medical Association

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F-18 FDG PET-CT versus contrast enhanced ct in detection of extra nodal involvement in patients with lymphoma

Cited by 8 publications

References 18 publications

Detection of extranodal and spleen involvement by FDG‐PET imaging predicts adverse survival in untreated follicular lymphoma

Detection of extranodal and spleen involvement by FDG‐PET imaging predicts adverse survival in untreated follicular lymphoma

Radiogenomics and Its Role in Lymphoma

Comparison of clinicopathological features and treatment outcomes in aggressive primary intestinal B- and T/NK-cell lymphomas

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