Value of F-18 Fluorodeoxyglucose Positron Emission Tomography for Predicting the Clinical Outcome of Patients With Aggressive Lymphoma Prior to and After Autologous Stem-Cell Transplantation*

Filmont, Jean-Emmanuel; Czernin, Johannes; Yap, Cecelia S; Silverman, Daniel; Quon, Andrew; Phelps, Michael E.; Emmanouilides, Christos

doi:10.1378/chest.124.2.608

Cited by 68 publications

(45 citation statements)

References 28 publications

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“…More recently, some studies indicated that 18 FDG-FDG-PET also provides useful information about disease status before ASCT and even allogeneic stem cell transplantation in relapsed or refractory HL and non-Hodgkin's lymphoma, with a significant correlation between pretransplant PET status and prognosis [20][21][22][23][24][25][26]. CT scan is the most used in restaging lymphoma; however, some authors reported that history and physical examination could be the standard approach to follow-up because in most cases early recurrence is first suspected by the patient himself or by the physician, even with routine screening including CT scans [27,28].…”

Section: Discussionmentioning

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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Section: Discussionmentioning

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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“…Chemosensitivity to salvage therapy was defined as a reduction greater than 50% in all measurable disease for at least 1 month. 3,10 Functional imaging with 18 F-fluoro-deoxyglucose-positron emission tomography (FDG-PET) scan provides additional information to conventional anatomic imaging by CT scan. It is superior in characterization of residual masses that are a common finding after treatment of lymphoma.…”

Section: And Sj Schustermentioning

confidence: 99%

Prognostic value of FDG-PET scan imaging in lymphoma patients undergoing autologous stem cell transplantation

Svoboda

Andreadis

Elstrom

et al. 2006

Bone Marrow Transplant

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We conducted a retrospective analysis of 50 lymphoma patients (Hodgkin's disease and non-Hodgkin's lymphoma) who had an 18 F-fluoro-deoxyglucose positron emission tomography (FDG-PET) scan after at least two cycles of salvage chemotherapy and before autologous stem cell transplantation (ASCT) at our institution. The patients were categorized into FDG-PET negative (N ¼ 32) and positive (N ¼ 18) groups. The median follow-up after ASCT was 19 months (range: 3-59). In the FDG-PET-negative group, the median progressionfree survival (PFS) was 19 months (range: 2-59) with 15 (54%) patients without progression at 12 months after ASCT. The median overall survival (OS) for this group was not reached. In the FDG-PET-positive group, the median PFS was 5 months (range: 1-19) with only one (7%) patient without progression at 12 months after ASCT. The median OS was 19 months (range: 1-34). In the FDG-PET-negative group, chemotherapy-resistant patients by CT-based criteria had a comparable outcome to those with chemotherapy-sensitive disease. A positive FDG-PET scan after salvage chemotherapy and prior ASCT indicates an extremely poor chance of durable response after ASCT.

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“…[19][20][21] In those patients with lymphoma who have a poor prognosis, FDG-PET/CT is important for pretransplantation evaluations and decision-making. 22 However whether it is important for post-transplantation evaluation, because it strengthens chemosensitivity and indicates the chances of a durable response, is not known. Therefore, the objective of the current study was to determine the impact of pretransplantation and post-transplantation FDG-PET/CT on patient outcomes, which we evaluated 1 year after ASCT.…”

mentioning

confidence: 99%

The impact of pre‐ and post‐transplantation positron emission tomography using 18‐fluorodeoxyglucose on poor‐prognosis lymphoma patients undergoing autologous stem cell transplantation

Filmont¹,

Gisselbrecht²,

Cuenca³

et al. 2007

Cancer

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BACKGROUND. In patients with lymphoma who had a poor prognosis, pretransplantation 18‐fluorodeoxyglucose (FDG)‐positron‐emission tomography (PET) was important for the evaluation of response and outcome. However, little is known about the correlation of FDG‐PET with post‐transplantation PET. The current study was designed to ascertain whether positive pretransplantation PET images are modified by the conditioning regimen. METHODS. Sixty consecutive patients who had achieved remission and underwent consolidation by autologous stem cell transplantation (ASCT) had PET images obtained before ASCT (after 3 or 4 chemotherapy cycles) and 100 days after ASCT. The correlation was explored between the presence of abnormal 18‐FDG uptake (PET positive) or its absence (PET negative) and patient outcomes. RESULTS. Before ASCT, 31 patients achieved complete remission (CR), and 23 patients achieved uncertain CR. Before ASCT, 44 patients (75%) were had negative PET images; and, after ASCT, 48 patients (80%) had negative PET images. One year after ASCT, the estimated event‐free survival (EFS) rate was 80% in patients who had negative pre‐ASCT PET images compared with 43% in patients who had positive pre‐ASCT PET images (P = .0002). The EFS rate was 81% in patients who had negative post‐ASCT PET images compared with 25% in patients who had negative post‐ASCT PET images (P < .0001). In multivariate analysis, only the results for pre‐ and post‐ASCT PET images retained prognostic value, with relative risks of failure estimated at 4.9 and 11.9, respectively. CONCLUSIONS. A positive pre‐ASCT PET image indicated a high risk of ASCT failure, which was increased by a positive post‐ASCT PET image. For patients with lymphoma who have positive pre‐ASCT PET images, more investigations using new treatment approaches will be required. For patients who have negative pre‐ASCT PET images, obtaining post‐ASCT PET images does not seem to be mandatory. Cancer 2007. © 2007 American Cancer Society.

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Value of F-18 Fluorodeoxyglucose Positron Emission Tomography for Predicting the Clinical Outcome of Patients With Aggressive Lymphoma Prior to and After Autologous Stem-Cell Transplantation*

Cited by 68 publications

References 28 publications

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

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

Prognostic value of FDG-PET scan imaging in lymphoma patients undergoing autologous stem cell transplantation

The impact of pre‐ and post‐transplantation positron emission tomography using 18‐fluorodeoxyglucose on poor‐prognosis lymphoma patients undergoing autologous stem cell transplantation

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