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.

Reply to comments by Laffon et al.: Liver SUV versus stage in Hodgkin’s lymphoma: the total amount of uptake may play a role in the inverse relationship

“…In particular, in our study cohort, the SUV max in the mediastinum is significantly related to the extension of HL according to Ann Arbor criteria with a lower SUV max in the mediastinum being related to a higher stage of the disease (p= 0.0385, Fig. 1) [2]. In agreement with Laffon et al, we can conclude that when a tissue shows an intense tracer uptake, the amount of tracer available to another tissue is reduced (to be specific, the circulating 18 F-FDG in the blood as detectable by means of mediastinum SUV max ) [4].…”

“…Laffon et al suggest that the total amount of uptake in malignant tissues of cancer patients may play a role in the reduction of 18 F-FDG uptake in the liver at staging in HL (as shown in the report previously cited) [2,3]. For this reason, the authors suggest that the measurement of the total 18 F-FDG that is irreversibly trapped in a pathological tissue (as measured by a formula suggested by Laffon et al [3]) could help in the explanation of this phenomenon and could be useful when evaluating positron emission tomography/computed tomography (PET/CT) scans of patients with cancer.…”

“…We performed a further analysis of the data already published [2], and here we report a graphical representation of the relationship between the maximum standardized uptake value (SUV max ) in the mediastinum and the stage of the disease (Fig. 1) that led to results similar to those observed in the liver [2].…”

“…Dear Sir, We read with great interest the letter from Laffon et al [1] in which the authors refer to a recently published paper of our group that evaluates the factors affecting 2-deoxy-2-( 18 F)-fluoro-D-glucose ( 18 F-FDG) uptake in the liver and mediastinum during chemotherapy (CHT) in Hodgkin's lymphoma (HL) [2]. Laffon et al suggest that the total amount of uptake in malignant tissues of cancer patients may play a role in the reduction of 18 F-FDG uptake in the liver at staging in HL (as shown in the report previously cited) [2,3].…”

“…We performed a further analysis of the data already published [2], and here we report a graphical representation of the relationship between the maximum standardized uptake value (SUV max ) in the mediastinum and the stage of the disease (Fig. 1) that led to results similar to those observed in the liver [2]. In particular, in our study cohort, the SUV max in the mediastinum is significantly related to the extension of HL according to Ann Arbor criteria with a lower SUV max in the mediastinum being related to a higher stage of the disease (p= 0.0385, Fig.…”