Whole-body positron emission tomography (PET) for diagnosis of residual mass in patients with lymphoma

Wit, Maike de; Bumann, D; Beyer, Wolfgang; Herbst, Kenneth D.; Clausen, M.; Hossfeld, Dieter K.

doi:10.1093/annonc/8.suppl_1.s57

Cited by 99 publications

(25 citation statements)

References 17 publications

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“…Their results showed a one-year progression-free survival (PFS) of 95% for the FDG-PET negative group compared with 40% for the FDG-PET positive group. These and other similar findings are important in making management decisions (De Wit et al, 1997;Jerusalem et al, 1999;Cremerius et al, 2001;Weihrauch et al, 2003). They suggest that any HL patient with a residual mediastinal mass who has a negative FDG-PET scan is unlikely to relapse within 12 months, if ever, and therefore offers reassurance.…”

Section: Hodgkin Lymphomamentioning

confidence: 84%

The role of PET imaging in lymphoma

2004

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SummaryPositron emission tomography using fluorine-18 (FDG-PET) is increasingly used in the staging and follow-up of malignant lymphomas, although its precise role has not yet been determined. This review considers the results reported at the different stages in the disease history and separately considers the major histological subtypes. Attention is given to the situations in which PET scanning is most likely to influence management. Finally, this review discusses ongoing developments in PET scanning with improved resolution and different radiolabelled tracers.Keywords: 2-fluoro-2-deoxy-d-glucose-positron emission tomography, positron emission tomography, lymphoma, nonHodgkin's lymphoma, hodgkin lymphoma/disease.Positron emission tomography using fluorine-18 (FDG-PET) is a functional imaging technique that is now widely used in the management of malignant disease including lymphoma. It is based on the principle that most malignant tumours have increased rates of glucose uptake and metabolism compared with normal tissues. The tumour cells take up the radiolabelled glucose analogue, 2-fluoro-2-deoxy-d-glucose (FDG). This is phosphorylated by hexokinase and then trapped within the cell as FDG-6-PO4, which cannot enter the subsequent glycolytic pathway, and dephosphorylation occurs at a relatively slow rate (Hong et al, 2003). There is little doubt that FDG-PET has a high sensitivity for malignant tissue (Paul, 1987;Kostakoglu & Goldsmith, 2000 and is informative in malignant lymphomas although its precise role in disease management has not been well defined. This is because FDG-PET has been introduced into the clinical environment without randomized trials or the rigorous testing that ideally requires the investigator and patient to be 'blinded' to the results of the new imaging modality. In addition it can be difficult to be sure of the significance of any differences detectable between a new imaging modality and standard staging procedures unless further biopsies are taken, a situation that is often not justified.In lymphomas, FDG-PET imaging can be used in initial staging, response evaluation and follow-up and the issues surrounding these scenarios are different. Furthermore, the different histological types of lymphoma must be considered separately as not only may the efficacy of FDG-PET vary according to the histological type, but the therapeutic implications of any new information obtained may also be different. As with any staging technique, false positive and false negative results can occur. False positive results can be obtained at sites of inflammation and infiltration of necrotic tumour by macrophages is a potential problem (Kubota et al, 1992). Other tissues, such as the brain and non-relaxed muscle (including heart and gut), have high glucose uptake but this is widely recognized and is rarely problematic. Following chemotherapy increased uptake may also be seen in the bone marrow, spleen and thymus (O'Doherty et al, 2002). Staging Hodgkin lymphomaA number of studies have assessed the use of FDG-PET ...

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Section: Hodgkin Lymphomamentioning

confidence: 84%

The role of PET imaging in lymphoma

2004

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“…Fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) has become a standard imaging test in the management of lymphoma in both initial staging [1,2] and response assessment [3][4][5][6]. Response criteria that incorporate FDG-PET can better predict the prognosis than the original International Workshop Criteria [7,8], and revised response criteria for lymphoma using FDG-PET have been published [9].…”

Section: Introductionmentioning

confidence: 99%

Conventional allogeneic hematopoietic stem cell transplantation for lymphoma may overcome the poor prognosis associated with a positive FDG‐PET scan before transplantation

et al. 2008

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A positive scan in pretransplantation fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) has been shown to be associated with a poor prognosis in patients with lymphoma undergoing highdose chemotherapy followed by autologous stem cell transplantation (ASCT). For those with a positive FDG-PET scan, treatment that includes allogeneic stem cell transplantation (allo-SCT) may be an alternative. However, it is uncertain whether allo-SCT can overcome a poor prognosis. Therefore, we conducted a retrospective analysis of 14 patients with lymphoma who had undergone FDG-PET scan within one month before allo-SCT at our institution. Eleven patients were FDG-PET-positive and three were negative. With a median follow-up of 17 months (range: 6-44) after allo-SCT, the cumulative incidence of progression was 29.3% in FDG-PET-positive patients and 0% in the FDG-PET-negative patients. Four of the 11 patients who had post-transplantation FDG-PET showed FDG-avid lesions on the first post-transplantation scan. In two of the four, regression of the lesions was observed during the scheduled reduction of immunosuppressant without donor lymphocyte infusion and remained without progression at the last follow-up (34 and 8 months). Durable responses after allo-SCT, at least with conventional conditioning regimens, can be expected in patients with FDG-PET-positive lesions before transplantation. Thus, conventional allo-SCT could be an attractive modality compared to ASCT for patients with positive FDG-PET after the completion of conventional salvage chemotherapy, and particularly for patients with T and NK-cell lymphomas. Am. J. Hematol. 83:477-481, 2008. V

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“…Biopsy is potentially morbid, and is not standardly used. ͓F-18͔-2-Fluoro-D-glucose positron emission tomography (FDG-PET) has proven useful in the noninvasive diagnosis of pathologic lymphadenopathy in other disease sites, including the mediastinum in non-small cell lung cancer 15,16 and lymphoma, 17 and in staging the axilla in breast cancer. 18,19 To determine the potential utility of FDG-PET in diagnosing IM nodal metastases, we undertook a retrospective review of 28 consecutive patients with locally advanced breast cancer from November 1995 to July 1999 who underwent an FDG-PET scan prior to neoadjuvant chemotherapy.…”

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confidence: 99%

Evaluation of the Internal Mammary Lymph Nodes by FDG-PET in Locally Advanced Breast Cancer (LABC)

Bellon

Livingston

Eubank

et al. 2004

American Journal of Clinical Oncology

100

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The presence of internal mammary (IM) lymph node metastases in breast cancer predicts outcome and may alter treatment. Standard imaging has limited usefulness for evaluation of the IM chain because of low sensitivity. Our preliminary studies suggested that [F-18]-2-fluoro-d-glucose positron emission tomography (FDG-PET) improves the detection of IM and mediastinal metastases. We therefore performed a retrospective review of women who underwent FDG-PET prior to treatment to determine the benefit of PET for imaging IM disease. The records of 28 consecutive patients undergoing FDG-PET prior to neoadjuvant chemotherapy for suspected locally advanced breast cancer (LABC) were reviewed. The presence of abnormal IM uptake on FDG-PET was noted. IM uptake on FDG PET was compared with standard radiographic imaging and was correlated with putative risk factors for IM involvement and with clinical patterns of failure. Patients did not undergo IM biopsy; however, patterns of failure were assessed to validate the FDG-PET findings. Clearly abnormal FDG uptake in the IM nodes was seen in 7 of 28 women (25%). Prospective conventional chest imaging failed to identify IM metastases in any patient. IM uptake on PET was associated with large size of the primary tumor (P = 0.03) and with inflammatory disease (P = 0.04). The presence of IM FDG uptake predicted failure by a pattern consistent with spread from IM lymph node metastasis. FDG-PET appears to be a useful noninvasive modality to detect IM metastases in LABC. Pathologic verification in a prospective study is necessary to confirm these findings.

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Whole-body positron emission tomography (PET) for diagnosis of residual mass in patients with lymphoma

Cited by 99 publications

References 17 publications

The role of PET imaging in lymphoma

The role of PET imaging in lymphoma

Conventional allogeneic hematopoietic stem cell transplantation for lymphoma may overcome the poor prognosis associated with a positive FDG‐PET scan before transplantation

Evaluation of the Internal Mammary Lymph Nodes by FDG-PET in Locally Advanced Breast Cancer (LABC)

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