Thoracic positron emission tomography using18F-fluorodeoxyglucose for the evaluation of residual mediastinal Hodgkin disease

Weihrauch, Martin R.; Ré, Daniel; Scheidhauer, Klemens; Ansén, Sascha; Dietlein, Markus; Bischoff, Stefanie; Bohlen, Heribert; Wolf, Jürgen; Schicha, H.; Diehl, Volker; Tesch, Hans

doi:10.1182/blood.v98.10.2930

Cited by 207 publications

(80 citation statements)

References 24 publications

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“…HL is associated with a high rate of residual masses at the end of therapy, which are difficult to characterize as residual disease or not on conventional imaging. Therefore, a major milestone was the finding that end-of-treatment FDG-PET offers excellent prediction of progression-free-survival (PFS), even in the presence of a residual mass [8][9][10][11]. This finding led to the introduction of FDG-PET imaging in response criteria for HL [12].…”

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confidence: 99%

Advanced Hodgkin’s lymphoma: End-of-treatment FDG-PET should be maintained

Hindié

Mesguich

Bouabdallah

et al. 2017

Eur J Nucl Med Mol Imaging

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confidence: 99%

Advanced Hodgkin’s lymphoma: End-of-treatment FDG-PET should be maintained

Hindié

Mesguich

Bouabdallah

et al. 2017

Eur J Nucl Med Mol Imaging

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“…In particular, its role in managing lymphoma patients has grown progressively and its use is now often recommended in disease staging [2][3][4][5], monitoring during therapy [6][7][8][9][10], posttreatment restaging [11][12][13][14][15], and modeling radiotherapy field [16]. Less is known about the role of 18 FDG-PET during follow-up, especially its capability to detect relapse earlier with respect to CT or ultrasound imaging.…”

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confidence: 99%

Role of 18FDG-PET/CT in detecting relapse during follow-up of patients with Hodgkin’s lymphoma

et al. 2009

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The role of 18 FDG-PET/CT during follow-up of patients affected by Hodgkin's lymphoma (HL) in complete remission after treatment is not fully elucidated, since a wide use of 18 F fluorodeoxyglucose positron emission tomography/computed tomography ( 18 FDG-PET/CT) in this setting could be limited by a relative high rate of false-positive results. Herein, we summarize a retrospective analysis of 27 patients with Hodgkin's lymphoma in complete remission after the first-line (n=20) or salvage (n=7) therapy receiving serial 18 FDG-PET/CT scans during follow-up. Out of 165 scans, 13 were suspected for relapse, which was confirmed in seven patients. All relapses were correctly identified by 18 FDG-PET/CT positivity, with a 100% sensitivity; false-positive rate was 46% and negative predictive value was 100%. True-positive findings were mostly associated with multiple sites, subdiaphragmatic involvement, and/or previous sites of disease. According to our results, we conclude that performing routine PET/CT scan during follow-up of those patients who are at high risk of relapse would be advisable, although caution must be adopted when interpreting PET/CT results due to the relatively high rate of false-positive findings. If FDG abnormal uptake is present at multiple nodal sites, subdiaphragmatic lymph nodes, or previous sites of disease, histological verification of PET abnormal findings is warranted.

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“…Although 67-Gallium scintigraphy is a metabolic imaging technique to detect active tumour tissue, it has drawbacks such as a low spatial resolution and difficulty in identifying residual abdominal masses (Kostakoglu et al, 1992;Setoain et al, 1997;Zinzani et al, 1999a, b). In recent years, a series of reports have shown that PET is the most helpful noninvasive metabolic imaging technique for patients with either HD or aggressive NHL: it can distinguish between active lymphoma and fibrosis, and it has important prognostic value after completion of front-line therapy (Cremerius et al, 1998(Cremerius et al, , 2001De Wit et al, 2001;Naumann et al, 2001;Spaepen et al, 2001a, b;Weihrauch et al, 2001Weihrauch et al, , 2003Zinzani et al, 2002;Fihnont et al, 2003).…”

Section: Discussionmentioning

confidence: 99%

“…For these purposes, functional imaging with fluorine-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) can reveal decisive metabolic or functional tissue parameters and is more accurate than conventional radiological imaging techniques for restaging after chemotherapy (Jerusalem et al, 1999(Jerusalem et al, , 2001Zinzani et al, 1999a, b;Kostakoglu and Goldsmith, 2000;Dittmann et al, 2001). Several groups, including our own, have evaluated the efficiency of PET for restaging patients after completed therapy (Cremerius et al, 1998(Cremerius et al, , 2001De Wit et al, 2001;Naumann et al, 2001;Spaepen et al, 2001a, b;Weihrauch et al, 2001Weihrauch et al, , 2003Zinzani et al, 2002;Fihnont et al, 2003).…”

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confidence: 99%

Predictive role of positron emission tomography (PET) in the outcome of lymphoma patients

et al. 2004

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An extensive analysis of the reliability of positron emission tomography (PET) after induction treatment in patients with Hodgkin's disease (HD) or aggressive non-Hodgkin's lymphoma (NHL). In all, 75 untreated patients with HD (n ¼ 41) or aggressive NHL (n ¼ 34) were studied with both PET and CT scans following standard chemotherapy induction therapy (ABVD or MACOP-B) with/ without radiotherapy. Histopathological analysis was performed when considered necessary. After treatment, four out of five (80%) patients who were PET þ /CT À relapsed, as compared with zero out of 29 patients in the PET À /CT À subset. Among the 41 CT þ patients, 10 out of 11 (91%) who were PET þ relapsed, as compared with 0 out of 30 who were PET À . The actuarial relapse-free survival (RFS) rates were 9 and 100% in the PET þ and PET À subsets, respectively (P ¼ 0.00001). All five patients who were PET þ / CT À underwent a lymph node biopsy: in four (80%) cases, persistent lymphoma and was confirmed at histopathological examination. Two HD patients who were PET À /CT þ (with large residual masses in the mediastinum or lung) were submitted to biopsy, which in both cases revealed only fibrosis. In HD and aggressive NHL patients, PET positivity after induction treatment is highly predictive for the presence of residual disease, with significant differences being observable in terms of RFS. PET negativity at restaging strongly suggests the absence of active disease; histopathological verification is important in patients who show PET positivity.

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Thoracic positron emission tomography using18F-fluorodeoxyglucose for the evaluation of residual mediastinal Hodgkin disease

Abstract: Residual mediastinal masses are frequently observed in patients with Hodgkin disease (HD) after completed therapy, and the discrimination between active tumor tissue and fibrotic residues remains a clinical challenge. We studied the diagnostic value of metabolic imaging by 18

Cited by 207 publications

References 24 publications

Advanced Hodgkin’s lymphoma: End-of-treatment FDG-PET should be maintained

Advanced Hodgkin’s lymphoma: End-of-treatment FDG-PET should be maintained

Role of 18FDG-PET/CT in detecting relapse during follow-up of patients with Hodgkin’s lymphoma

Predictive role of positron emission tomography (PET) in the outcome of lymphoma patients

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