18Flourodeoxyglucose Positron Emission Tomography/Computer Tomography (18F-FDG PET/CT) for extranodal non Hodgkin lymphoma in staging and treatment response assessment

Dr Mai Hong Son1, Dr Le Ngoc Ha1
1 Department of Nuclear Medicine, 108 Central Military Hospital

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Abstract

Background: the aim of our study to investigate the role of 18F-FDG PET/CT for extranodal lymphoma non Hodgkin in
staging and treatment response’s assessment.
Methods: In our center, a total of 38 consecutive B-cell non- Hodgkin extranodal lymphoma patients were newly diagnosed
between December 2013 to January 2016. All these patients were undergone 18F-FDG PET/CT scan before treatment, after
3- cycle and 6-cycle chemotherapy. The assessment criteria were followed by modified Ann Aborr for staging and Lugano 2015 for treatment response.
Results: there were 13.2% of patients in stage IE, 7.9% in stage II3, 21.1% in stage IIIE and 47.9% ín stage IV. According to
PET/CT staging, 56.2% of patients were upstaging in comparision to CT and 26.3% of patients have been changed in treatment’s
stratergies. Kappa statistics revealed that CT and PET/CT showed fair agreement for the detection of extranodal lymphoma.
After 6-cycle chemotherapy, 26/38 patients had no evidence of residuals or relapse and 7/38 patients showed partial response
and 5/38 patients was in advanced diseases on PET/CT imaging. The positive and negative PET/CT after 3 cylces chemotherapy
may predicted the treatment’s response after 6 cylces (p=0.4).
Conclusions: 18F-FDG PET/CT has higher value than CT for staging and important role in assessment of treatment’s
response of extranodal lymphoma non Hodgkin patients.

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References

1. Boellaard R. et al. (2010), “FDG PET and PET/CT: EANM procedure guidelines for tumour PET imaging: version 1.0”, Eur J Nucl Med Mol Imaging. 37 (1), pp. 181-200.
2. Cronin C. G. et al. (2010), “Clinical utility of PET/ CT in lymphoma”, AJR Am J Roentgenol. 194 (1), pp. W91-W103.
3. Haioun C. et al. (2005), “[18F]fluoro-2-deoxy- D-glucose positron emission tomography (FDG-PET) in aggressive lymphoma: an early prognostic tool for predicting patient outcome”, Blood. 106 (4), pp. 1376-1381.
4. Wahl R. L. et al. (2009), “From RECIST to PERCIST: Evolving Considerations for PET response criteria in solid tumors”, J Nucl Med. 50 Suppl 1, pp. 122s-150s.
5. Cheson B. D. (2015), “Staging and response assessment in lymphomas: the new Lugano classification”, Chin Clin Oncol. 4 (1), pp. 5.
6. Omur O. et al. (2014), “Fluorine-18 fluorodeoxyglucose PET-CT for extranodal staging of non-Hodgkin and Hodgkin lymphoma”, Diagn Interv Radiol. 20 (2), pp. 185-192.
7. Pregno P. et al. (2012), “Interim 18-FDGPET/CT failed to predict the outcome in diffuse large B-cell lymphoma patients treated at the diagnosis with rituximab-CHOP”, Blood. 119 (9), pp. 2066-2073.
8. Schaefer N. G. et al. (2004), “Non-Hodgkin Lymphoma and Hodgkin Disease: Coregistered FDG PET and CT at Staging and Restaging—Do We Need Contrastenhanced CT?”, Radiology. 232 (3), pp. 823-829.
9. Society. A. C. (2009), “Cancer Facts & Figures”, 008. Available at: http://www.cancer.org/downloads/STT/2008CAFFfinalsecured.pdf. Accessed March 11, 2009.