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The Association Between Liver and Tumor [18F]FDG Uptake in Patients with Diffuse Large B Cell Lymphoma During Chemotherapy

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Abstract

Purpose

The aim of this study was to explore the association between liver, mediastinum and tumor 2-deoxy-2-[18F]fluoro-d-glucose ([18F]FDG) uptake during chemotherapy in diffuse large B cell lymphoma (DLBCL).

Procedures

Nineteen patients with proven DLBCL underwent positron emission tomography (PET)/X-ray computed tomography scan at baseline, 1 week and 2 cycles after rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP) therapy, and again after chemotherapy completion. The mean and maximal standardized uptake value (SUVmean and SUVmax) of the liver and mediastinum were measured and correlated with the tumor SUVmax, SUVsum, whole-body metabolic tumor volume (MTVwb), and total lesion glycolysis (TLG).

Results

At baseline, both the liver and mediastinum SUVmean and SUVmax correlated inversely with the tumor MTVwb or TLG (p < 0.01 or 0.001). The liver SUVmean and SUVmax increased significantly after 1 week of R-CHOP therapy and remained at the high level until chemotherapy completion. The mediastinum SUVmean and SUVmax remained stable during chemotherapy. The tumor SUVmax, SUVsum, MTVwb, and TLG decreased significantly after 1 week of R-CHOP therapy. The change of the liver SUVmean correlated inversely with the change of tumor MTVwb and TLG after 1 week of chemotherapy (p < 0.05, respectively). The intersubject variability of liver and mediastinum [18F]FDG uptake ranged from 11 to 26 %.

Conclusions

The liver [18F]FDG uptake increased significantly after R-CHOP therapy. One of the possible reasons is the distribution of a greater fraction of the tracer to healthy tissues rather than tumor after effective chemotherapy. The variability of the liver [18F]FDG uptake during chemotherapy might affect the visual analysis of the interim PET scan and this needs to be confirmed in future studies with a large patient cohort. In addition, the intersubject variability of the liver and mediastinum [18F]FDG uptake should be considered.

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Acknowledgments

This study was supported by the Biomedical Image Quantification/University Alliance of Finland and the Elna Savolainen Fund (grant number 150603) and Seppo Nieminen Fund (grant number R14009) of Tampere University Hospital Research Center. Xingchen Wu was supported by the Emil Aaltonen Foundation. We would like to thank research nurse Emmi Vettenranta and research coordinator Irja Kolehmainen for their contributions.

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Authors and Affiliations

  1. Department of Oncology, Tampere University Hospital, Tampere, Finland

    Xingchen Wu, Hannu Pertovaara & Pirkko-Liisa Kellokumpu-Lehtinen

  2. Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland

    Xingchen Wu & Pirkko-Liisa Kellokumpu-Lehtinen

  3. Medical Imaging Centre, Department of Radiology, Tampere University Hospital, Tampere, Finland

    Abhisek Bhattarai & Hannu Eskola

  4. Faculty of Biomedical Engineering, Tampere University of Technology, Tampere, Finland

    Abhisek Bhattarai & Hannu Eskola

  5. Medical Imaging Centre, Department of Nuclear Medicine, Tampere University Hospital, Tampere, Finland

    Pasi Korkola

Authors
  1. Xingchen Wu
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  2. Abhisek Bhattarai
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  3. Pasi Korkola
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  4. Hannu Pertovaara
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  5. Hannu Eskola
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  6. Pirkko-Liisa Kellokumpu-Lehtinen
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Corresponding author

Correspondence to Xingchen Wu.

Ethics declarations

The study protocols were approved by the local ethics committee and all patients gave written informed consent.

Conflict of Interest

The authors declare that they have no conflict of interest.

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Wu, X., Bhattarai, A., Korkola, P. et al. The Association Between Liver and Tumor [18F]FDG Uptake in Patients with Diffuse Large B Cell Lymphoma During Chemotherapy. Mol Imaging Biol 19, 787–794 (2017). https://doi.org/10.1007/s11307-017-1044-3

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  • DOI: https://doi.org/10.1007/s11307-017-1044-3

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