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18F-FDG PET/CT in splenic marginal zone lymphoma

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Abstract

Purpose

The detection rate and the metabolic behavior of 18F-FDG-PET/CT in splenic marginal zone lymphoma (SMZL) are not yet clear. Our aim was to investigate the metabolic behavior of SMZL and whether the tumor stage (acc. Ann Arbor) epidemiological (age, gender), histological (Ki-67 index, plasmacytic differentiation), and morphological (splenic diameter maximum) features might be related to 18F-FDG PET/CT results.

Methods

Fifty-one patients (34 male, 17 female; average age 70 years) with histologically confirmed SMZL who underwent a 18F-FDG PET/CT for initial staging were included: PET/CT images were analyzed visually and semi-quantitatively (SUVmax, lesion-to-liver SUVmax ratio, and lesion-to-blood pool SUVmax ratio). Splenic uptake was divided as diffuse or focal.

Results

Thirty-nine patients (76%) had FDG-avid SMZL (7 with focal splenic lesions and 32 with diffuse splenic uptake), while the remaining 12 had no increased splenic uptake. Among patients with FDG-avid lesions, average SUVmax was 4.3, lesion-to-liver SUVmax ratio 2.3, and lesion-to-blood pool SUVmax ratio 3. 18F-FDG avidity was significantly associated with Ki-67 index and not correlated with other features. Semiquantitative PET/CT parameters (SUVmax, lesion-to-liver SUVmax ratio, and lesion-to-blood pool SUVmax ratio) did not correlate significantly with any variable. Progression-free survival time was not influenced by FDG avidity of SMZL.

Conclusions

18F-FDG avidity was noted in 76% of SMZL with diffuse splenic uptake as main pattern of presentation and is correlated with Ki-67 score only.

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References

  1. Vannata B, Stathis A, Zucca E (2015) Management of the marginal zone lymphomas. Cancer Treat Res 165:227–249

    Article  PubMed  Google Scholar 

  2. Campo E, Swerdlow SH, Harris NL, et al. (2011) The 2008 WHO classification of lymphoid neoplasms and beyond: evolving concepts and practical applications. Blood 117:5019–5032

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  3. Dreyling M, Thieblemont C, Gallamini A, et al. (2013) ESMO Consensus conferences: guidelines on malignant lymphoma. Part 2: marginal zone lymphoma, mantle cell lymphoma, peripheral T-cell lymphoma. Ann Oncol 24:857–877

    Article  PubMed  CAS  Google Scholar 

  4. Franco V, Florena AM, Iannitto E (2003) Splenic marginal zone lymphoma. Blood 101:2464–2472

    Article  PubMed  CAS  Google Scholar 

  5. Matutes E, Oscier D, Montalban C, et al. (2008) Splenic marginal zone lymphoma proposals for a revision of diagnostic, staging and therapeutic criteria. Leukemia 22:487–495

    Article  PubMed  CAS  Google Scholar 

  6. Thieblemont C, Davi F, Noguera ME, et al. (2012) Splenic marginal zone lymphoma: current knowledge and future directions. Oncology 26:194–202

    PubMed  Google Scholar 

  7. Cheson BD, Fisher RI, Barrington SF, et al. (2014) Recommendations for initial evaluation, staging, and response assessment of Hodgkin and non-Hodgkin lymphoma: the Lugano classification. J Clin Oncol 32:3059–3068

    Article  PubMed  PubMed Central  Google Scholar 

  8. Barrington SF, Mikhaeel NG, Kostakoglu L (2014) Role of imaging in the staging and response assessment of lymphoma: consensus of the International Conference on Malignant Lymphomas Imaging Working Group. J Clin Oncol 32:3048–3058

    Article  PubMed  PubMed Central  Google Scholar 

  9. Cheson BD (2015) Staging and response assessment in lymphomas: the new Lugano classification. Chin Clin Oncol 4:5

    PubMed  Google Scholar 

  10. Treglia G, Zucca E, Sadeghi R, et al. (2015) Detection rate of fluorine-18-fluorodeoxyglucose positron emission tomography in patients with marginal zone lymphoma of MALT type: a meta-analysis. Hematol Oncol 33:113–124

    Article  PubMed  Google Scholar 

  11. Hwang JW, Jee SR, Lee SH, et al. (2016) Efficacy of positron emission tomography/computed tomography in gastric mucosa-associated lymphoid tissue lymphoma. Korean J Gastroenterol 67:183–188

    Article  PubMed  Google Scholar 

  12. Albano D, Borghesi A, Bosio G, et al. (1079) Pulmonary mucosa-associated lymphoid tissue lymphoma: 18F-FDG PET/CT and CT findings in 28 patients. Br J Radiol 2017(90):20170311

    Google Scholar 

  13. Park SH, Lee JJ, Kim HO, et al. (2015) 18F-Fluorodeoxyglucose (FDG)-positron emission tomography/computed tomography in mucosa-associated lymphoid tissue lymphoma: variation in 18F-FDG avidity according to site involvement. Leuk Lymphoma 56(12):3288–3294

    Article  PubMed  Google Scholar 

  14. Albano D, Giubbini R, Bertagna F (2016) 18F-FDG PET/CT and primary hepatic MALT: a case series. Abdom Radiol 41:1956–1959

    Article  Google Scholar 

  15. Albano D, Bosio G, Orlando E, Bertagna F (2016) Role of fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography in evaluating breast mucosa-associated lymphoid tissue lymphoma: a case series. Hematol Oncol . https://doi.org/10.1002/hon.2376

    Article  PubMed  Google Scholar 

  16. Albano D, Bertoli M, Ferro P, et al. (2017) 18F-FDG PET/CT in gastric MALT lymphoma: a bicentric experience. Eur J Nucl Med Mol Imaging 44:589–597

    Article  PubMed  CAS  Google Scholar 

  17. Hoffmann M, Wöhrer S, Becherer A, et al. (2006) 18F-Fluoro-deoxyglucose positron emission tomography in lymphoma of mucosa-associated lymphoid tissue: histology makes the difference. Ann Oncol 17:1761–1765

    Article  PubMed  CAS  Google Scholar 

  18. Albano D, Bosio G, Giubbini R, Bertagna F (2017) 18F-FDG PET/CT and extragastric MALT lymphoma: role of Ki-67 score and plasmacytic differentiation. Leuk Lymphoma 58:2328–2334

    Article  PubMed  CAS  Google Scholar 

  19. Weiler-Sagie M, Bushelev O, Epelbaum R, et al. (2010) (18)F-FDG avidity in lymphoma readdressed: a study of 766 patients. J Nucl Med 51:25–30

    Article  PubMed  Google Scholar 

  20. Tsukamoto N, Kojima M, Hasegawa M, et al. (2007) The usefulness of (18)F-fluorodeoxyglucose positron emission tomography ((18)F-FDG-PET) and a comparison of (18)F-FDG-pet with (67)gallium scintigraphy in the evaluation of lymphoma: relation to histologic subtypes based on the World Health Organization classification. Cancer 110:652–659

    Article  PubMed  Google Scholar 

  21. Carrillo-Cruz E, Marin-Oyaga V, de la Cruz Vicente F, et al. (2015) Role of 18F-FDG-PET/CT in the management of marginal zone B cell lymphoma. Hematol Oncol 33(4):151–158

    Article  PubMed  CAS  Google Scholar 

  22. Arcaini L, Rossi D, Paulli M (2016) Splenic marginal zone lymphoma: from genetics to management. Blood 127:2072–2081

    Article  PubMed  CAS  Google Scholar 

  23. Gobbi PG, Grignani GE, Pozzetti U, et al. (1994) Primary splenic lymphoma: does it exist? Haematologica 79:286–293

    PubMed  CAS  Google Scholar 

  24. Rueffer U, Sieber M, Stemberg M, et al. (2003) Spleen involvement in Hodgkin’s lymphoma: assessment and risk profile. Ann Hematol 82:390–396

    Article  PubMed  CAS  Google Scholar 

  25. Kang M, Kalra N, Gulati M, et al. (2007) Image guided percutaneous splenic interventions. Eur J Radiol 64:140–146

    Article  PubMed  Google Scholar 

  26. Rini JN, Leonidas JC, Tomas MB, et al. (2003) 18F-FDG PET versus CT for evaluating the spleen during initial staging of lymphoma. J Nucl Med 44:1072–1074

    PubMed  Google Scholar 

  27. de Jong PA, van Ufford HM, Baarslag HJ, et al. (2009) CT and 18F-FDG PET for noninvasive detection of splenic involvement in patients with malignant lymphoma. AJR Am J Roentgenol 192:745–753

    Article  PubMed  Google Scholar 

  28. Karunanithi S, Sharma P, Guha SR, et al. (2014) Use of 18F-FDG PET/CT imaging for evaluation of patients with primary splenic lymphoma. Clin Nucl Med 39:772–776

    Article  PubMed  Google Scholar 

  29. Rini J, Manalili EY, Hoffman MA, et al. (2002) F-18 FDG versus Ga-67 for detecting splenic involvement in Hodgkin’s disease. Clin Nucl Med 27:572–577

    Article  PubMed  Google Scholar 

  30. Meier JM, Alavi A, Iruvuri S, et al. (2007) Assessment of age-related changes in abdominal organ structure and function with computed tomography and positron emission tomography. Semin Nucl Med 37:154–172

    Article  PubMed  Google Scholar 

  31. Kotzerke J, Guhlmann A, Moog F, et al. (1999) Role of attenuation correction for fluorine-18-fluorodeoxyglucose positron emission tomography in the primary staging of malignant lymphoma. Eur J Nucl Med 26:31–38

    Article  PubMed  CAS  Google Scholar 

  32. Gerdes J, Li L, Schlueter C, et al. (1991) Immunobiochemical and molecular biologic characterization of the cell proliferation-associated nuclear antigen that is defined by monoclonal antibody Ki-67. Am J Pathol 138:867–873

    PubMed  PubMed Central  CAS  Google Scholar 

  33. Watanabe Y, Suefuji H, Hirose Y, et al. (2013) 18F-FDG uptake in primary gastric malignant lymphoma correlates with glucose transporter 1 expression and histologic malignant potential. Int J Hematol 97:43–49

    Article  PubMed  CAS  Google Scholar 

  34. Molina TJ, Lin P, Swerdlow S, et al. (2011) Marginal zone lymphomas with plasmacytic differentiation and related disorders. Am J Clin Pathol 136:211–225

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Nuclear Medicine, University of Brescia and Spedali Civili Brescia, P.le Spedali Civili 1, 25123, Brescia, Italy

    Domenico Albano, Raffaele Giubbini & Francesco Bertagna

Authors
  1. Domenico Albano
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  2. Raffaele Giubbini
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  3. Francesco Bertagna
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Correspondence to Domenico Albano.

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The authors declare they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

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Informed consent was obtained from all individual participant included in the study.

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Albano, D., Giubbini, R. & Bertagna, F. 18F-FDG PET/CT in splenic marginal zone lymphoma. Abdom Radiol 43, 2721–2727 (2018). https://doi.org/10.1007/s00261-018-1542-z

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