Fluorine-18 fluorodeoxyglucose PET-CT for extranodal staging of non-Hodgkin and Hodgkin lymphoma

Abstract

NUCLEAR MEDICINE AND MOLECULAR IMAGINGF-FDG PET-CT imaging, following a diagnostic contrast-enhanced CT (CE-CT) performed within the last month, were included in our study. A total of 129 PET-CT images, and all radiologic, clinical, and pathological records of these patients were retrospectively reviewed. RESULTSIn total, 137 hypermetabolic extranodal infiltration sites were detected by 18 F-FDG PET-CT in 62 of 110 patients. There were no positive findings by CE-CT that reflected organ involvement in 40 of 137 18 F-FDG-positive sites. The κ statistics revealed fair agreement between PET-CT and CE-CT for the detection of extranodal involvement (κ=0.60). The organs showing a disagreement between the two modalities were the spleen, bone marrow, bone, and thyroid and prostate glands. In all lesions that were negative at CE-CT, there was a diffuse 18 F-FDG uptake pattern in the PET-CT images. The frequency of extranodal involvement was 51% and 58% in Hodgkin and non-Hodgkin lymphoma patients, respectively. There was a high positive correlation between the maximum standardized uptake values of the highest 18 F-FDG-accumulating lymph nodes and extranodal sites (r=0.67) in patients with nodal and extranodal involvement. CONCLUSION 18 F-FDG PET-CT is a more effective technique than CE-CT for the evaluation of extranodal involvement in Hodgkin and non-Hodgkin lymphoma patients. PET-CT has a significant advantage for the diagnosis of diffusely infiltrating organs without mass lesions or contrast enhancement compared to CE-CT.

Expert consensus statements for Waldeyer's ring involvement in pediatric Hodgkin lymphoma: The staging, evaluation, and response criteria harmonization (SEARCH) for childhood, adolescent, and young adult Hodgkin lymphoma (CAYAHL) group

“…The use of FDG‐PET has been well established as a modality in the staging and response assessment of HL in general 50‐52 . While only five cases were identified that specifically utilized FDG‐PET with CT or MRI for WR characterization in HL, the use of FDG‐PET imaging for the evaluation of WR in NHL has been well established 13,14 .…”

Uterine presentation of an intravascular large B-cell lymphoma diagnosed by PET/CT and histology

“…In the present case, hysterectomy was performed because of the rapid worsening of the patient's neurological symptoms and the findings of the pelvic radiological examinations (PET/CT and MRI). PET/CT with Fluorine-18 fluorodeoxyglucose is now used in the diagnosis and staging of lymphoma [4] . It provides informations about lymphomatous extranodal involvement [4] .…”

“…PET/CT with Fluorine-18 fluorodeoxyglucose is now used in the diagnosis and staging of lymphoma [4] . It provides informations about lymphomatous extranodal involvement [4] . Maximum standard uptake value (SUVmax) increases with aggressiveness of the lymphoma [5] ; for high-grade Non Hodgkin Lymphoma (NHL), median SUVmax is about 20.6+/-14.2 [4] .…”

“…It provides informations about lymphomatous extranodal involvement [4] . Maximum standard uptake value (SUVmax) increases with aggressiveness of the lymphoma [5] ; for high-grade Non Hodgkin Lymphoma (NHL), median SUVmax is about 20.6+/-14.2 [4] . IVLBCL is an aggressive sub-type of DLBCL, but the role of PET/CT in the diagnosis is not well established [6] .…”

Bone Marrow Involvement in Hodgkin and Non-Hodgkin Lymphomas: The Role of Fluorine-18-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography

“…Performance of FDG PET/CT in detecting bone marrow involvement was compared to contrast enhanced CT scan (CE-CT) in a prospective study by Omür et al [13], on a cohort of 110 patients with lymphoma (35 Hodgkin; 75 non-Hodgkin): they showed that CE-CT was falsely negative in 6 Hodgkin and 11 non-Hodgkin patients with bone marrow involvement on FDG PET/CT. All 17 cases were confirmed on BMB and successfully treated, with evidence of complete metabolic response on post-treatment PET/CT scans.…”