Advertisement

18F-FDG PET in children with lymphomas

  • Gisele DepasEmail author
  • Caroline De Barsy
  • Guy Jerusalem
  • Claire Hoyoux
  • Marie-Françoise Dresse
  • Marie-France Fassotte
  • Nancy Paquet
  • Jacqueline Foidart
  • Pierre Rigo
  • Roland Hustinx
Original Article

Abstract

Purpose

The aim of this study was to retrospectively evaluate the performance of positron emission tomography (PET) with 18F-fluorodeoxyglucose (18F-FDG) in children with lymphomas, at various stages of their disease.

Methods

Twenty-eight children (mean age 12.5 years, 14 girls, 14 boys) with Hodgkin’s disease (HD, n=17) or non-Hodgkin’s lymphoma (NHL, n=11) were evaluated. Patients were investigated at initial staging (n=19), early in the course of treatment (n=19), at the end of treatment (n=16) and during long-term follow-up (n=19). A total of 113 whole-body PET studies were performed on dedicated scanners. PET results were compared with the results of conventional methods (CMs) such as physical examination, laboratory studies, chest X-rays, computed tomography, magnetic resonance imaging, ultrasonography and bone scan when available.

Results

At initial evaluation (group 1), PET changed the disease stage and treatment in 10.5% of the cases. In early evaluation of the response to treatment (group 2), PET failed to predict two relapses and one incomplete response to treatment. In this group, however, PET did not show any false positive results. There were only 4/75 false positive results for PET among patients studied at the end of treatment (group 3, specificity 94%) or during the systematic follow-up (group 4, specificity 95%), as compared with 27/75 for CMs (specificity 54% and 66%, respectively).

Conclusion

18F-FDG-PET is a useful tool for evaluating children with lymphomas. Large prospective studies are needed to appreciate its real impact on patient management.

Keywords

18F-fluorodeoxyglucose Positron emission tomography Child Lymphoma Oncology 

References

  1. 1.
    Oberlin O. Hodgkin’s disease. In: Voûte PA, Kalifa C, Barrett A, editors. Cancer in children. Clinical management. 4th ed. New York: Oxford University; 1998. p. 137–53.Google Scholar
  2. 2.
    Lanzkowski P. Hodgkin’s disease. In: Lanzkowski P, editor. Manual of pediatric hematology and oncology. 3rd ed. San Diego: Academic; 1999. p. 413–43.Google Scholar
  3. 3.
    Lukes R, Butler J, Hicks E. Natural history of Hodgkin’s disease as related to its pathological picture. Cancer 1966;19:317–44.Google Scholar
  4. 4.
    Büyükpamukçu M. Non-Hodgkin’s lymphomas. In: Voûte PA, Kalifa C, Barrett A, editors. Cancer in children. Clinical management. 4th ed. New York: Oxford University; 1998. p. 119–36.Google Scholar
  5. 5.
    Lanzkowski P. Non-Hodgkin’s lymphoma. In: Lanzkowski P, editor. Manual of pediatric hematology and oncology. 3rd ed. San Diego: Academic; 1999. p. 445–69.Google Scholar
  6. 6.
    Harris NL, Haffe ES, Stein H, et al. A revised European–American classification of lymphoid neoplasms: a proposal from the International Lymphoma Study Group. Blood 1994;84(5):1361–92.Google Scholar
  7. 7.
    Thomson AB, Wallace WHB. Treatment of paediatric Hodgkin’s disease: a balance of risks. Eur J Cancer 2002;38:468–77.CrossRefPubMedGoogle Scholar
  8. 8.
    Pinkerton CR. Review: the continuing challenge of treatment for non-Hodgkin’s lymphoma in children. Br J Haematol 1999;107:220–34.CrossRefPubMedGoogle Scholar
  9. 9.
    Jadvar H, Connolly LP, Shulkin BL, Treves ST, Fischman AJ. Positron-emission tomography in pediatrics. In: Freeman LM, editor. Nuclear medicine annual 2000. Philadelphia: Lippincott Williams & Wilkins; 2000. p. 53–83.Google Scholar
  10. 10.
    O’Hara S, Donnelly LF, Coleman RE. Pediatric body applications of FDG-PET. Am J Radiol 1999;172:1019–24.Google Scholar
  11. 11.
    Thomas B, Manalili E, Leonidas JC, Karayalcin G, Lipton J. 18F FDG imaging of lymphoma in children using a hybrid PET system: comparison with 67Ga [abstract]. J Nucl Med 2000;41(Suppl):96P.Google Scholar
  12. 12.
    Moody R, Shulkin B, Yanik G, Hutchinson R, Castle V. PET FDG imaging in pediatric lymphomas [abstract]. J Nucl Med 2002;42(Suppl):39P.Google Scholar
  13. 13.
    Montravers F, McNamara D, Landman-Parket J, et al. 18F-FDG in childhood lymphoma: clinical utility and impact on management. Eur J Nucl Med Mol Imaging 2002;29:1155–65.CrossRefPubMedGoogle Scholar
  14. 14.
    Zinzani PL, Magagnoli M, Chierichetti F, et al. Role of positron emission tomography in the management of lymphoma patient. Ann Oncol 1999;10:1181–4.CrossRefPubMedGoogle Scholar
  15. 15.
    Jerusalem G, Warland V, Najjar F, et al. Whole-body 18FDG-PET for the evaluation of patients with Hodgkin’s disease and non-Hodgkin’s lymphoma. Nucl Med Commun 1999;20:13–20.PubMedGoogle Scholar
  16. 16.
    Kostakoglu L, Goldsmith SJ. Fluorine-18 fluorodeoxyglucose positron emission tomography in the staging and follow-up of lymphoma: is it time to shift gears? Eur J Nucl Med 2000;27:1564–78.CrossRefPubMedGoogle Scholar
  17. 17.
    Wirth A, Seymour JF, Hicks RJ, et al. Fluorine-18 fluorodeoxyglucose positron emission tomography, gallium-67 scintigraphy and conventional staging for Hodgkin’s disease and non-Hodgkin’s lymphoma. Am J Med 2002;112:262–8.CrossRefPubMedGoogle Scholar
  18. 18.
    Carbone PP, Kaplan HS, Musshoff K, Smithers DW, Tubiana M. Report of the Committee on Hodgkin’s Disease Staging Classification. Cancer Res 1971;31:1860–1.PubMedGoogle Scholar
  19. 19.
    Murphy SB. Current concepts in cancer: childhood non-Hodgkin’s lymphoma. N Engl J Med 1978;299:1446.PubMedGoogle Scholar
  20. 20.
    Kostakoglu L, Leonard JP, Kuji I, Coleman M, Vallabhajosula S, Goldsmith SJ. Comparison of fluorine-18 fluorodeoxyglucose positron emission tomography and gallium-67 scintigraphy in evaluation of lymphoma. Cancer 2002;94:879–88.CrossRefPubMedGoogle Scholar
  21. 21.
    Guay C, Lépine M, Verreault J, Bénard F. Prognostic value of PET using 18F-FDG in Hodgkin’s disease for posttreatment evaluation. J Nucl Med 2003;44:1225–31.PubMedGoogle Scholar
  22. 22.
    Jerusalem G, Beguin Y, Fassotte MF, et al. Whole-body positron emission tomography using 18F-fluorodeoxyglucose for post-treatment evaluation in Hodgkin’s disease and non Hodgkin’s lymphoma has higher diagnostic and prognostic value than clinical computed tomography scan imaging. Blood 1999;94:429–33.PubMedGoogle Scholar
  23. 23.
    Jerusalem G, Beguin Y, Fassotte MF, et al. Early detection of relapse by whole-body positron-emission tomography in the follow-up of patients with Hodgkin’s disease. Ann Oncol 2003;14:123–30.CrossRefPubMedGoogle Scholar
  24. 24.
    Moog F, Bangerter M, Diederichs CG, et al. Lymphoma: role of whole-body 2-deoxy-2-[F-18]fluoro-d-glucose (FDG) PET in nodal staging. Radiology 1997;203:795–800.PubMedGoogle Scholar
  25. 25.
    Moog F, Bangerter M, Diederichs CG, et al. Extranodal malignant lymphoma detection with FDG PET versus CT. Radiology 1998;206:475–81.PubMedGoogle Scholar
  26. 26.
    Bangerter M, Moog F, Buchmann I, et al. Whole-body 2-[18F]-fluoro-2-deoxy-d-glucose positron emission tomography (FDG-PET) for accurate staging of Hodgkin’s disease. Ann Oncol 1998;9:1117–22.CrossRefPubMedGoogle Scholar
  27. 27.
    Spaepen C, Stroobants C, Dupont P, et al. Prognostic value of positron emission tomography with fluorine-18-fluorodeoxyglucose after first line chemotherapy in non-Hodgkin’s lymphoma: is 18F-FDG-PET a valid alternative to conventional diagnostic methods? J Clin Oncol 2001;19:414–9.PubMedGoogle Scholar
  28. 28.
    Oberlin O. Present and future strategies of treatment in childhood Hodgkin’s lymphomas. Ann Oncol 1996;7(Suppl 4):S73–8.Google Scholar
  29. 29.
    Patte C. Non-Hodgkin’s lymphoma. Paediatric update. Eur J Cancer 1998;34(3):359–69.Google Scholar
  30. 30.
    Pintelon H, Jonckheere MH, Piepsz A. Paediatric nuclear medicine procedures: routine sedation or management of anxiety? Nucl Med Commun 1994;15:664–6.PubMedGoogle Scholar
  31. 31.
    Gordon I. Issues surrounding preparation, information and handling the child and parent in nuclear medicine. J Nucl Med 1998;39:490–4.PubMedGoogle Scholar
  32. 32.
    Ruotsalainem U, Suhonen-Polis H, Eronen E, et al. Estimated radiation dose to the new-born in FDG-PET studies. J Nucl Med 1996;37:387–93.PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  • Gisele Depas
    • 1
    Email author
  • Caroline De Barsy
    • 1
  • Guy Jerusalem
    • 2
  • Claire Hoyoux
    • 3
  • Marie-Françoise Dresse
    • 3
  • Marie-France Fassotte
    • 4
  • Nancy Paquet
    • 5
  • Jacqueline Foidart
    • 1
  • Pierre Rigo
    • 1
  • Roland Hustinx
    • 1
  1. 1.Division of Nuclear MedicineUniversity HospitalLiègeBelgium
  2. 2.Division of Medical OncologyUniversity HospitalLiègeBelgium
  3. 3.Division of Pediatric Hematology and OncologyCHR CitadelleLiègeBelgium
  4. 4.Division of HematologyUniversity HospitalLiègeBelgium
  5. 5.Division of Nuclear MedicineHôtel de Dieu, LévisQuébecCanada

Personalised recommendations