Skip to main content
SpringerLink
Log in

18F-FDG PET/CT for Guiding Biopsy in Lymphoma Patients

  • Chapter
  • First Online:
Oncological PET/CT with Histological Confirmation

  • 717 Accesses

Abstract

The term lymphoma refers to a widely heterogeneous group of B-cell and T-cell malignancies with variable biological and histological features, translating into different clinical presentations and prognoses. Imaging has traditionally played an essential role in the staging and restaging of lymphoma, primarily with contrast-enhanced computed tomography (CECT). [18F]Fluoro-2-deoxy-2D-glucose positron emission tomography/computed tomography ([18F]FDG PET/CT) has rapidly become the preferred imaging modality for evaluation of patients with lymphoma, given its high sensitivity and specificity for detection of malignant lesions with high metabolic activity. [18F]FDG PET/CT clinical indications include initial staging, assessment of early metabolic response to treatment, evaluation of prognosis, end-treatment response assessment, and early detection of disease recurrence. Regarding biopsy guiding, [18F]FDG PET/CT can be most useful in two clinical scenarios: (1) histological transformation of indolent lymphoma and (2) detection of bone marrow involvement.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 54.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pileri SA, Stein H, Thiele J, editors. WHO classification of tumours of haematopoietic and lymphoid tissues. Lyon: IARC; 2008.

    Google Scholar 

  2. NCCN Clinical Practice Guidelines in Oncology: Hodgkin Lymphoma Version 2. 2013. http://www.nccn.org.

  3. NCCN Clinical Practice Guidelines in Oncology: Non-Hodgkin Lymphoma Version 2. 2013. http://www.nccn.org.

  4. Engert A, Eichenauer DA, Dreyling M, ESMO Guidelines Working Group. Hodgkin's lymphoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2010;21 Suppl 5:v168–71.

    Article  PubMed  Google Scholar 

  5. Dreyling M, Ghielmini M, Marcus R, Salles G, Vitolo U. Newly diagnosed and relapsed follicular lymphoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2011;22 Suppl 6:vi59–63.

    PubMed  Google Scholar 

  6. Zucca E, Dreyling M, ESMO Guidelines Working Group. Gastric marginal zone lymphoma of MALT type: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2010;21 Suppl 5:v175–6.

    Article  PubMed  Google Scholar 

  7. Tilly H, Dreyling M, ESMO Guidelines Working Group. Diffuse large B-cell non-Hodgkin's lymphoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2010;21 Suppl 5:v172–4.

    Article  PubMed  Google Scholar 

  8. Li JY, Gaillard F, Moreau A, Harousseau JL, Laboisse C, Milpied N, Bataille R, Avet-Loiseau H. Detection of translocation t(11;14)(q13;q32) in mantle cell lymphoma by fluorescence in situ hybridization. Am J Pathol. 1999;154(5):1449–52.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Horn H, Ziepert M, Becher C, Barth TF, Bernd HW, Feller AC, Klapper W, Hummel M, Stein H, Hansmann ML, Schmelter C, Möller P, Cogliatti S, Pfreundschuh M, Schmitz N, Trümper L, Siebert R, Loeffler M, Rosenwald A, Ott G, German High-Grade Non-Hodgkin Lymphoma Study Group. MYC status in concert with BCL2 and BCL6 expression predicts outcome in diffuse large B-cell lymphoma. Blood. 2013;121(12):2253–63.

    Article  CAS  PubMed  Google Scholar 

  10. Sehn LH. Paramount prognostic factors that guide therapeutic strategies in diffuse large B-cell lymphoma. Hematol Am Soc Hematol Educ Program. 2012;2012:402–9.

    Google Scholar 

  11. Alizadeh AA, Eisen MB, Davis RE, Ma C, Lossos IS, Rosenwald A, Boldrick JC, Sabet H, Tran T, Yu X, Powell JI, Yang L, Marti GE, Moore T, Hudson Jr J, Lu L, Lewis DB, Tibshirani R, Sherlock G, Chan WC, Greiner TC, Weisenburger DD, Armitage JO, Warnke R, Levy R, Wilson W, Grever MR, Byrd JC, Botstein D, Brown PO, Staudt LM. Distinct types of diffuse large B-cell lymphoma identified by gene expression profiling. Nature. 2000;403(6769):503–11.

    Article  CAS  PubMed  Google Scholar 

  12. Liu H, Ruskon-Fourmestraux A, Lavergne-Slove A, Ye H, Molina T, Bouhnik Y, Hamoudi RA, Diss TC, Dogan A, Megraud F, Rambaud JC, Du MQ, Isaacson PG. Resistance of t(11;18) positive gastric mucosa-associated lymphoid tissue lymphoma to Helicobacter pylori eradication therapy. Lancet. 2001;357(9249):39–40.

    Article  CAS  PubMed  Google Scholar 

  13. Barrena S, Almeida J, Del Carmen García-Macias M, López A, Rasillo A, Sayagués JM, Rivas RA, Gutiérrez ML, Ciudad J, Flores T, Balanzategui A, Caballero MD, Orfao A. Flow cytometry immunophenotyping of fine-needle aspiration specimens: utility in the diagnosis and classification of non-Hodgkin lymphomas. Histopathology. 2011;58(6):906–18.

    Article  PubMed  Google Scholar 

  14. Paes FM, Kalkanis DG, Sideras PA, Serafini AN. FDG PET/CT of extranodal involvement in non-Hodgkin lymphoma and Hodgkin disease. Radiographics. 2010;30(1):269–91.

    Article  PubMed  Google Scholar 

  15. Kostakoglu L, Cheson BD. State-of-the-art research on "lymphomas: role of molecular imaging for staging, prognostic evaluation, and treatment response". Front Oncol. 2013;3:212. eCollection 2013. Review.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Cheson BD. Role of functional imaging in the management of lymphoma. J Clin Oncol. 2011;29(14):1844–54. doi:10.1200/JCO.2010.32.5225. Epub 2011 Apr 11. Review. Erratum in: J Clin Oncol. 2011;29(19):2739.

    Article  PubMed  Google Scholar 

  17. Le Dortz L, De Guibert S, Bayat S, Devillers A, Houot R, Rolland Y, Cuggia M, Le Jeune F, Bahri H, Barge ML, Lamy T, Garin E. Diagnostic and prognostic impact of 18F-FDG PET/CT in follicular lymphoma. Eur J Nucl Med Mol Imaging. 2010;37(12):2307–14.

    Article  PubMed  Google Scholar 

  18. Hutchings M. How does PET/CT help in selecting therapy for patients with Hodgkin lymphoma? Hematol Am Soc Hematol Educ Program. 2012;2012:322–7. doi:10.1182/asheducation-2012.1.322. Review. PubMed.

    Google Scholar 

  19. Kako S, Izutsu K, Ota Y, Minatani Y, Sugaya M, Momose T, et al. FDG-PET in T-cell and NK-cell neoplasms. Ann Oncol Off J Eur Soc Med Oncol ESMO. 2007;18(10):1685–90.

    Article  CAS  Google Scholar 

  20. Schöder H, Noy A, Gönen M, Weng L, Green D, Erdi YE, Larson SM, Yeung HW. Intensity of 18fluorodeoxyglucose uptake in positron emission tomography distinguishes between indolent and aggressive non-Hodgkin’s lymphoma. J Clin Oncol. 2005;23(21):4643–51.

    Article  PubMed  Google Scholar 

  21. Weiler-Sagie M, Bushelev O, Epelbaum R, Dann EJ, Haim N, Avivi I, Ben-Barak A, Ben-Arie Y, Bar-Shalom R, Israel O. (18)F-FDG avidity in lymphoma readdressed: a study of 766 patients. J Nucl Med. 2010;51(1):25–30.

    Article  PubMed  Google Scholar 

  22. Wirth A, Foo M, Seymour JF, Macmanus MP, Hicks RJ. Impact of [18f] fluorodeoxyglucose positron emission tomography on staging and management of early-stage follicular non-hodgkin lymphoma. Int J Radiat Oncol Biol Phys. 2008;71(1):213–9.

    Article  PubMed  Google Scholar 

  23. Luminari S, Biasoli I, Arcaini L, Versari A, Rusconi C, Merli F, Spina M, Ferreri AJ, Zinzani PL, Gallamini A, Mastronardi S, Boccomini C, Gaidano G, D’Arco AM, Di Raimondo F, Carella AM, Santoro A, Musto P, Federico M. The use of FDG-PET in the initial staging of 142 patients with follicular lymphoma: a retrospective study from the FOLL05 randomized trial of the Fondazione Italiana Linfomi. Ann Oncol. 2013;24(8):2108–12.

    Article  CAS  PubMed  Google Scholar 

  24. Bodet-Milin C, Touzeau C, Leux C, Sahin M, Moreau A, Maisonneuve H, Morineau N, Jardel H, Moreau P, Gallazini-Crépin C, Gries P, Gressin R, Harousseau JL, Mohty M, Moreau P, Kraeber-Bodere F, Le Gouill S. Prognostic impact of 18F-fluoro-deoxyglucose positron emission tomography in untreated mantle cell lymphoma: a retrospective study from the GOELAMS group. Eur J Nucl Med Mol Imaging. 2010;37(9):1633–42.

    Article  CAS  PubMed  Google Scholar 

  25. Noy A, Schöder H, Gönen M, Weissler M, Ertelt K, Cohler C, Portlock C, Hamlin P, Yeung HW. The majority of transformed lymphomas have high standardized uptake values (SUVs) on positron emission tomography (PET) scanning similar to diffuse large B-cell lymphoma (DLBCL). Ann Oncol. 2009;20(3):508–12.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Castellucci P, Nanni C, Farsad M, Alinari L, Zinzani P, Stefoni V, Battista G, Valentini D, Pettinato C, Marengo M, Boschi S, Canini R, Baccarani M, Monetti N, Franchi R, Rampin L, Fanti S, Rubello D. Potential pitfalls of 18F-FDG PET in a large series of patients treated for malignant lymphoma: prevalence and scan interpretation. Nucl Med Commun. 2005;26(8):689–94.

    Article  PubMed  Google Scholar 

  27. Schaefer NG, Strobel K, Taverna C, Hany TF. Bone involvement in patients with lymphoma: the role of FDG-PET/CT. Eur J Nucl Med Mol Imaging. 2007;34(1):60–7.

    Article  PubMed  Google Scholar 

  28. Berthet L, Cochet A, Kanoun S, Berriolo-Riedinger A, Humbert O, Toubeau M, Dygai-Cochet I, Legouge C, Casasnovas O, Brunotte F. In newly diagnosed diffuse large B-cell lymphoma, determination of bone marrow involvement with 18F-FDG PET/CT provides better diagnostic performance and prognostic stratification than does biopsy. J Nucl Med. 2013;54(8):1244–50.

    Article  CAS  PubMed  Google Scholar 

  29. Terasawa T, Nihashi T, Hotta T, Nagai H. 18F-FDG PET for posttherapy assessment of Hodgkin’s disease and aggressive Non-Hodgkin’s lymphoma: a systematic review. J Nucl Med. 2008;49(1):13–21.

    Article  PubMed  Google Scholar 

  30. Cerci JJ, Pereira Neto CC, Krauzer C, Sakamoto DG, Vitola JV. The impact of coaxial core biopsy guided by FDG PET/CT in oncological patients. Eur J Nucl Med Mol Imaging. 2013;40(1):98–103.

    Article  PubMed  Google Scholar 

  31. Cronin CG, Swords R, Truong MT, Viswanathan C, Rohren E, Giles FJ, O’Dwyer M, Bruzzi JF. Clinical utility of PET/CT in lymphoma. AJR Am J Roentgenol. 2010;194(1):W91–103.

    Article  PubMed  Google Scholar 

  32. Montoto S, Fitzgibbon J. Transformation of indolent B-cell lymphomas. J Clin Oncol. 2011;29(14):1827–34.

    Article  PubMed  Google Scholar 

  33. Okada M, Sato N, Ishii K, Matsumura K, Hosono M, Murakami T. FDG PET/CT versus CT, MR imaging, and 67Ga scintigraphy in the posttherapy evaluation of malignant lymphoma. Radiographics. 2010;30(4):939–57.

    Article  PubMed  Google Scholar 

  34. Tang B, Malysz J, Douglas-Nikitin V, Zekman R, Wong RH, Jaiyesimi I, Wong CY. Correlating metabolic activity with cellular proliferation in follicular lymphomas. Mol Imaging Biol. 2009;11(5):296–302.

    Article  PubMed  Google Scholar 

  35. Al-Tourah AJ, Gill KK, Chhanabhai M, Hoskins PJ, Klasa RJ, Savage KJ, Sehn LH, Shenkier TN, Gascoyne RD, Connors JM. Population-based analysis of incidence and outcome of transformed non-Hodgkin’s lymphoma. J Clin Oncol. 2008;26(32):5165–9.

    Article  PubMed  Google Scholar 

  36. Blase PE, Pasker-de Jong PCM, Hagenbeek A, Fijnheer R, de Haas M, de Klerk JMH. Predictive potential of FDG-PET/CT for histological transformation in patients with indolent lymphoma. Adv Mol Imaging. 2014;4:1–10.

    Article  Google Scholar 

  37. Bruzzi JF, Macapinlac H, Tsimberidou AM, Truong MT, Keating MJ, Marom EM, Munden RF. Detection of Richter’s transformation of chronic lymphocytic leukemia by PET/CT. J Nucl Med. 2006;47(8):1267–73.

    PubMed  Google Scholar 

  38. Bodet-Milin C, Kraeber-Bodéré F, Moreau P, Campion L, Dupas B, Le Gouill S. Investigation of FDG-PET/CT imaging to guide biopsies in the detection of histological transformation of indolent lymphoma. Haematologica. 2008;93(3):471–2.

    Article  PubMed  Google Scholar 

  39. Muzahir S, Mian M, Munir I, Nawaz MK, Faruqui ZS, Mufti KA, Bashir H, Uddin N, Siddiqui N, Maaz AU, Mahmood MT. Clinical utility of 18F FDG-PET/CT in the detection of bone marrow disease in Hodgkin’s lymphoma. Br J Radiol. 2012;85(1016):e490–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  40. El-Najjar I, Barwick T, Avril N, Montoto S. The role of FDG-PET and bone marrow examination in lymphoma staging. Ann Oncol. 2012;23 Suppl 10:x89–91. PubMed.

    Article  PubMed  Google Scholar 

  41. Adams HJ, Kwee TC, de Keizer B, Fijnheer R, de Klerk JM, Littooij AS, Nievelstein RA. Systematic review and meta-analysis on the diagnostic performance of FDG-PET/CT in detecting bone marrow involvement in newly diagnosed Hodgkin lymphoma: is bone marrow biopsy still necessary? Ann Oncol. 2014;25(5):921–7.

    Article  CAS  PubMed  Google Scholar 

  42. El-Galaly TC, d’Amore F, Mylam KJ, de Brown Nully P, Bøgsted M, Bukh A, Specht L, Loft A, Iyer V, Hjorthaug K, Nielsen AL, Christiansen I, Madsen C, Johnsen HE, Hutchings M. Routine bone marrow biopsy has little or no therapeutic consequence for positron emission tomography/computed tomography-staged treatment-naive patients with Hodgkin lymphoma. J Clin Oncol. 2012;30(36):4508–14.

    Article  PubMed  Google Scholar 

  43. Cortés-Romera M, Sabaté-Llobera A, Mercadal-Vilchez S, Climent-Esteller F, Serrano-Maestro A, Gámez-Cenzano C, González-Barca E. Bone marrow evaluation in initial staging of lymphoma: 18F-FDG PET/CT versus bone marrow biopsy. Clin Nucl Med. 2014;39(1):e46–52.

    Article  PubMed  Google Scholar 

  44. Adams HJ, Kwee TC, de Keizer B, Fijnheer R, de Klerk JM, Nievelstein RA. FDG PET/CT for the detection of bone marrow involvement in diffuse large B-cell lymphoma: systematic review and meta-analysis. Eur J Nucl Med Mol Imaging. 2014;41(3):565–74.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Oncological Clinic Fundación Arturo López Pérez, Santiago, Chile

    Francisca Redondo Moneta

  2. Ospedale Policlinico S.Orsola-Malpighi, Bologna, Italy

    Monica Celli

Authors
  1. Francisca Redondo Moneta
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Monica Celli
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Francisca Redondo Moneta .

Editor information

Editors and Affiliations

  1. PET/CT Center, Quanta Diagnóstico e Terapia, Curitiba, Paraná, Brazil

    Juliano Cerci

  2. Ospedale S. Orsola Malpighi, Universitary Hospital, Bologna, Italy

    Stefano Fanti

  3. Radiology&Radiological Sciences, Vanderbilt University Medical Cente, Nashville, Tennessee, USA

    Dominique Delbeke

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing

About this chapter

Cite this chapter

Moneta, F.R., Celli, M. (2016). 18F-FDG PET/CT for Guiding Biopsy in Lymphoma Patients. In: Cerci, J., Fanti, S., Delbeke, D. (eds) Oncological PET/CT with Histological Confirmation. Springer, Cham. https://doi.org/10.1007/978-3-319-27880-3_4

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-27880-3_4

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-27878-0

  • Online ISBN: 978-3-319-27880-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation