Characteristics of T-cell non-Hodgkin Lymphomas by FDG PET/CT

Ngô Văn Tấn, Nguyễn Xuân Cảnh

Main Article Content

Abstract

Objective: T-cell non-Hodgkin lymphomas (NHL) is a group of uncommon lymphomas, accounting for about 12% of all cases of non-Hodgkin lymphoma. The purpose of this study is to investigate the sites and metabolic activity of lesions in T-cell NHL on FDG PET/CT images, and to determine the correlation between metabolic activity and Ki67.
Patients and methods: A retrospective study of patients with T-cell NHL who underwent FDG PET/CT examination for initial disease staging from 2009 to 2019.


Results: A total of 62 patients (37 men and 25 women) with mean age of 44.8 were included in this study. There were 30/62 patients with histopathological subtypes, in which the highest frequency was peripheral T-cell lymphoma, not otherwise specified, and extranodal NK/T-cell lymphoma, nasal type with 8 cases (26.7%) each. PET/CT images showed the frequency of lesions in the lymph node regions in descending order of neck (67.7%), axillary (41.9%),
mediastinum (40.3%), abdomen (40.3), inguinal area (37.1%). There were 32 extranodal sites/organs involved in T-cell NHL, most commonly in the spleen
(27.4%), nasal cavity (24.2%), bone marrow (22.6%), nasopharynx (21%) with a frequency greater than 20%. The mean SUVmax of lymph nodes in descending order was 9.9 (in the abdominal lymph nodes), 7.7 (in the cervical lymph nodes), 7.7 (in the axillary lymph nodes), 6.2 (in the mediastinal lymph nodes), 5.9 (in the inguinal lymph nodes). The majority (81%) of lesions in extranodal sites/organs had a mean SUVmax ≥5. Sites/organs with high frequency of lesions having the highest mean SUVmax were skeletal muscle (17.3), nasal cavity (12.3), skin/subcutaneous tissue (11.7), nasopharynx (10.2), lung (6.9), pleura (6.8), bone marrow (5.3), liver (5.0) and spleen (5.0). Analysis of the linear correlation between SUVmax of the lesion at the biopsy site and the percentage of Ki67 was performed in 24 patients, and the results showed no correlation (r=0.03).
Conclusion: In patients with T-cell NHL, FDG PET/CT is useful for detecting lesions in many sites/organs in the body. The metabolic activity of the lesions was high, but there was no correlation between SUVmax and Ki67.

Article Details

References

1. Feeney J, Horwitz S, Gönen M, Schöder H. Characterization of T-cell lymphomas by FDG PET/CT. AJR. American journal of roentgenology. Aug 2010;195(2):333-340.
2. Storto G, Di Giorgio E, De Renzo A, et al. Assessment of metabolic activity by PET-CT with F-18-FDG in patients with T-cell lymphoma. British journal of haematology. Oct 2010;151(2):195-197.
3. Mai Trọng Khoa, Trần Đình Hà, Trần Hải Bình, et al. Giá trị của PET/CT trong chẩn đoán bệnh u lymphoma ác tính không Hodgkin. 2011; http://ungthubachmai.com.vn/ao-to/item/1573. Accessed Aug 20, 2019.
4. Phạm Cẩm Phương, Mai Trọng Khoa, Võ Thị Huyền Trang. Nhận xét đặc điểm hình ảnh PET/CT với 18F-FDG ở bệnh nhân u lympho ác tính không Hodgkin. Tạp chí Y - Dược học Quân sự 2016(3):122-127.
5. Lại Thị Thanh Thảo, Suzanne MCB Thanh Thanh, Trần Thanh Tùng, et al. Ứng dụng hình ảnh PET/CT trong phân chia giai đoạn U lympho không Hodgkin tế bào B lớn lan tỏa. Tạp chí Ung thư học Việt Nam 2015(5):124- 129.
6. Paes FM, Kalkanis DG, Sideras PA, Serafini AN. FDG PET/CT of extranodal involvement in non-Hodgkin lymphoma and Hodgkin disease. Radiographics : a review publication of the Radiological Society of North America, Inc. Jan 2010;30(1):269-291.
7. AlShemmari SH, Ameen RM, Sajnani KP. Extranodal lymphoma: a comparative study. Hematology (Amsterdam, Netherlands). Jun 2008;13(3):163-169.
8. Liu YM, Zhai XM, Wu YW. Biological correlation between glucose transporters, Ki-67 and 2-deoxy-2-[18F]- fluoro-D-glucose uptake in diffuse large B-cell lymphoma and natural killer/T-cell lymphoma. Genetics and molecular research : GMR. May 9 2016;15(2).
9. Lucignani G, Paganelli G, Bombardieri E. The use of standardized uptake values for assessing FDG uptake with PET in oncology: a clinical perspective. Nuclear medicine communications. Jul 2004;25(7):651-656.
10. He X, Chen Z, Fu T, et al. Ki-67 is a valuable prognostic predictor of lymphoma but its utility varies in lymphoma subtypes: evidence from a systematic meta-analysis. BMC cancer. Mar 5 2014;14:153.
11. Abd-Elhamid Omar G, Hassan H, Guirguis M. Immunohistochemical study of microvessel density in Non-Hodgkin lymphoma. Egyptian Journal of Pathology. July 1, 2019 2019;39(2):336-340.
12. Ishii Y, Tomita N, Sakata S, et al. Maximum standard uptake value at the biopsy site during (18) F-fluorodeoxyglucose positron emission tomography does not predict the proliferation potential of tumor cells in extranodal natural killer/t cell lymphoma, nasal type. Acta haematologica. 2012;128(2):110-112.
13. Shou Y, Lu J, Chen T, Ma D, Tong L. Correlation of fluorodeoxyglucose uptake and tumor-proliferating antigen Ki-67 in lymphomas. Journal of cancer research and therapeutics. Jan-Mar 2012;8(1):96-102.