Factors affecting intrapatient liver and mediastinal blood pool 18F-FDG standardized uptake value changes during ABVD chemotherapy in Hodgkin’s lymphoma

Abstract

The results of our study suggest that liver (18)F-FDG uptake is variable in patients with HL during the CHT treatment and the disease course and should be considered carefully when used to define the response to therapy in the interim PET in HL.

Fluorine-18 fluorodeoxyglucose uptake change in liver, mediastinal blood pool, and lymphoid cell–rich organs during programmed cell death-1 immunotherapy in lymphoma

“…In patients with DLBCL, treated with different protocols, Ceriani et al [9] found a significant increase in liver uptake at the interim scan which could be correlated to reversible metabolism or morphological change induced by chemotherapy. Similar findings were also reported by Finnish and Italian researchers that liver uptake increased significantly at the early or interim scan in comparison with baseline scan in DLBCL patients receiving rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP) therapy or patients with Hodgkin lymphoma receiving doxorubicin, bleomycin, vinblastine, dacarbazine strategy, respectively [11,12]. They demonstrated that this phenomenon might be contributed to more distribution of FDG to healthy tissues rather than tumor after effective chemotherapy as well as other mechanisms [11,17,18].…”

“…Similar findings were also reported by Finnish and Italian researchers that liver uptake increased significantly at the early or interim scan in comparison with baseline scan in DLBCL patients receiving rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP) therapy or patients with Hodgkin lymphoma receiving doxorubicin, bleomycin, vinblastine, dacarbazine strategy, respectively [11,12]. They demonstrated that this phenomenon might be contributed to more distribution of FDG to healthy tissues rather than tumor after effective chemotherapy as well as other mechanisms [11,17,18]. Contrary to the above results, Kim et al [10] and Kaya et al [19] clarified that liver SUV value of DLBCL did not change significantly during the R-CHOP therapy.…”

Fluorine-18 fluorodeoxyglucose uptake change in liver, mediastinal blood pool, and lymphoid cell–rich organs during programmed cell death-1 immunotherapy in lymphoma

“…In patients with DLBCL, treated with different protocols, Ceriani et al [9] found a significant increase in liver uptake at the interim scan which could be correlated to reversible metabolism or morphological change induced by chemotherapy. Similar findings were also reported by Finnish and Italian researchers that liver uptake increased significantly at the early or interim scan in comparison with baseline scan in DLBCL patients receiving rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP) therapy or patients with Hodgkin lymphoma receiving doxorubicin, bleomycin, vinblastine, dacarbazine strategy, respectively [11,12]. They demonstrated that this phenomenon might be contributed to more distribution of FDG to healthy tissues rather than tumor after effective chemotherapy as well as other mechanisms [11,17,18].…”

“…Similar findings were also reported by Finnish and Italian researchers that liver uptake increased significantly at the early or interim scan in comparison with baseline scan in DLBCL patients receiving rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP) therapy or patients with Hodgkin lymphoma receiving doxorubicin, bleomycin, vinblastine, dacarbazine strategy, respectively [11,12]. They demonstrated that this phenomenon might be contributed to more distribution of FDG to healthy tissues rather than tumor after effective chemotherapy as well as other mechanisms [11,17,18]. Contrary to the above results, Kim et al [10] and Kaya et al [19] clarified that liver SUV value of DLBCL did not change significantly during the R-CHOP therapy.…”

Liver SUV versus stage in Hodgkin’s lymphoma: the total amount of uptake may play a role in the inverse relationship

“…The former may be consistent with the role of the total amount of uptake at staging (PET0: reduced liver SUV), which would be expected to be significantly reduced on PET2 as a result of ABVD treatment (leading then to increased liver SUV). The latter strongly supports the suggestion of Chiaravalloti et al that metabolic changes in the liver in HL patients undergoing ABVD chemotherapy should indeed be taken into consideration [1].…”

Assessment of alteration in liver 18F–FDG uptake due to steatosis in lymphoma patients and its impact on the Deauville score

“…The study showing a positive relationship between steatosis and SUV max did not actually take into account patients BMI, and; therefore, these results were certainly biased [ 15 ]. In our study, BMI and BGL appeared to be statistically different between steatotic and non-steatotic groups of patients whereas other parameters described as potentially affecting hepatic uptake {age, sex, treatment, time course of treatment [ 14 , 19 – 21 ]} were not. Concerning BGL, a proportional relationship with 18 F–FDG liver uptake has been shown, even for blood glucose in line with EANM recommendations [ 22 ].…”

Fluorine-18 fluorodeoxyglucose uptake change in liver, mediastinal blood pool, and lymphoid cell–rich organs during programmed cell death-1 immunotherapy in lymphoma

“…In patients with DLBCL, treated with different protocols, Ceriani et al [9] found a significant increase in liver uptake at the interim scan which could be correlated to reversible metabolism or morphological change induced by chemotherapy. Similar findings were also reported by Finnish and Italian researchers that liver uptake increased significantly at the early or interim scan in comparison with baseline scan in DLBCL patients receiving rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP) therapy or patients with Hodgkin lymphoma receiving doxorubicin, bleomycin, vinblastine, dacarbazine strategy, respectively [11,12]. They demonstrated that this phenomenon might be contributed to more distribution of FDG to healthy tissues rather than tumor after effective chemotherapy as well as other mechanisms [11,17,18].…”

“…Similar findings were also reported by Finnish and Italian researchers that liver uptake increased significantly at the early or interim scan in comparison with baseline scan in DLBCL patients receiving rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP) therapy or patients with Hodgkin lymphoma receiving doxorubicin, bleomycin, vinblastine, dacarbazine strategy, respectively [11,12]. They demonstrated that this phenomenon might be contributed to more distribution of FDG to healthy tissues rather than tumor after effective chemotherapy as well as other mechanisms [11,17,18]. Contrary to the above results, Kim et al [10] and Kaya et al [19] clarified that liver SUV value of DLBCL did not change significantly during the R-CHOP therapy.…”

Liver SUV versus stage in Hodgkin’s lymphoma: the total amount of uptake may play a role in the inverse relationship

“…The former may be consistent with the role of the total amount of uptake at staging (PET0: reduced liver SUV), which would be expected to be significantly reduced on PET2 as a result of ABVD treatment (leading then to increased liver SUV). The latter strongly supports the suggestion of Chiaravalloti et al that metabolic changes in the liver in HL patients undergoing ABVD chemotherapy should indeed be taken into consideration [1].…”

Assessment of alteration in liver 18F–FDG uptake due to steatosis in lymphoma patients and its impact on the Deauville score

“…The study showing a positive relationship between steatosis and SUV max did not actually take into account patients BMI, and; therefore, these results were certainly biased [ 15 ]. In our study, BMI and BGL appeared to be statistically different between steatotic and non-steatotic groups of patients whereas other parameters described as potentially affecting hepatic uptake {age, sex, treatment, time course of treatment [ 14 , 19 – 21 ]} were not. Concerning BGL, a proportional relationship with 18 F–FDG liver uptake has been shown, even for blood glucose in line with EANM recommendations [ 22 ].…”

Fluorine-18 fluorodeoxyglucose uptake change in liver, mediastinal blood pool, and lymphoid cell–rich organs during programmed cell death-1 immunotherapy in lymphoma

“…In patients with DLBCL, treated with different protocols, Ceriani et al [9] found a significant increase in liver uptake at the interim scan which could be correlated to reversible metabolism or morphological change induced by chemotherapy. Similar findings were also reported by Finnish and Italian researchers that liver uptake increased significantly at the early or interim scan in comparison with baseline scan in DLBCL patients receiving rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP) therapy or patients with Hodgkin lymphoma receiving doxorubicin, bleomycin, vinblastine, dacarbazine strategy, respectively [11,12]. They demonstrated that this phenomenon might be contributed to more distribution of FDG to healthy tissues rather than tumor after effective chemotherapy as well as other mechanisms [11,17,18].…”

“…Similar findings were also reported by Finnish and Italian researchers that liver uptake increased significantly at the early or interim scan in comparison with baseline scan in DLBCL patients receiving rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP) therapy or patients with Hodgkin lymphoma receiving doxorubicin, bleomycin, vinblastine, dacarbazine strategy, respectively [11,12]. They demonstrated that this phenomenon might be contributed to more distribution of FDG to healthy tissues rather than tumor after effective chemotherapy as well as other mechanisms [11,17,18]. Contrary to the above results, Kim et al [10] and Kaya et al [19] clarified that liver SUV value of DLBCL did not change significantly during the R-CHOP therapy.…”

Liver SUV versus stage in Hodgkin’s lymphoma: the total amount of uptake may play a role in the inverse relationship

“…The former may be consistent with the role of the total amount of uptake at staging (PET0: reduced liver SUV), which would be expected to be significantly reduced on PET2 as a result of ABVD treatment (leading then to increased liver SUV). The latter strongly supports the suggestion of Chiaravalloti et al that metabolic changes in the liver in HL patients undergoing ABVD chemotherapy should indeed be taken into consideration [1].…”

Assessment of alteration in liver 18F–FDG uptake due to steatosis in lymphoma patients and its impact on the Deauville score

“…The study showing a positive relationship between steatosis and SUV max did not actually take into account patients BMI, and; therefore, these results were certainly biased [ 15 ]. In our study, BMI and BGL appeared to be statistically different between steatotic and non-steatotic groups of patients whereas other parameters described as potentially affecting hepatic uptake {age, sex, treatment, time course of treatment [ 14 , 19 – 21 ]} were not. Concerning BGL, a proportional relationship with 18 F–FDG liver uptake has been shown, even for blood glucose in line with EANM recommendations [ 22 ].…”