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FDG-PET scans in patients with lymphoma

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Abstract

Lymphoma comprises a complex set of diseases, including Hodgkin and non-Hodgkin subtypes. An expected goal of management is chronic disease control over decades in most patients with indolent subtypes, and cure is a realistic target for aggressive histologies, including Hodgkin lymphoma. Making methods available to better assess prognosis and to more specifically tailor therapy toward individual subtypes is a priority. Positron emission tomography using the tracer 18fluoro-2-deoxyglucose (FDG-PET) has become a valuable tool in the care of patients with lymphoma; it contributes information on staging and response assessment that has the potential to affect and improve patient care. This imaging modality is also being explored as an early response assessor, potentially allowing early prediction of an individual’s response to a specific therapy. This information ultimately may lead to modifications of treatment to improve efficacy or reduce toxicity. Although FDG-PET offers valuable information, it is important to recognize its limitations as well as areas that require further exploration in order to optimally integrate its use into the clinical management of lymphoma patients.

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References and Recommended Reading

  1. Warburg O: On the origin of cancer cells. Science 1956, 123:309–314.

    Article  PubMed  CAS  Google Scholar 

  2. Elstrom R, Guan L, Baker G, et al.: Utility of FDG-PET scanning in lymphoma by WHO classification. Blood 2003, 101:3875–3876.

    Article  PubMed  CAS  Google Scholar 

  3. Tsukamoto N, Kojima M, Hasegawa M, et al.: 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 2007, 110:652–659.

    Article  PubMed  Google Scholar 

  4. Beal KP, Yeung HW, Yahalom J: FDG-PET scanning for detection and staging of extranodal marginal zone lymphomas of the MALT type: a report of 42 cases. Ann Oncol 2005, 16:473–480.

    Article  PubMed  CAS  Google Scholar 

  5. Hoffmann M, Kletter K, Diemling M, et al.: Positron emission tomography with fluorine-18-2-fluoro-2-deoxy-D-glucose (F18-FDG) does not visualize extranodal B-cell lymphoma of the mucosa-associated lymphoid tissue (MALT)-type. Ann Oncol 1999, 10:1185–1189.

    Article  PubMed  CAS  Google Scholar 

  6. Kako S, Izutsu K, Ota Y, et al.: FDG-PET in T-cell and NK-cell neoplasms. Ann Oncol 2007, 18:1685–1690.

    Article  PubMed  CAS  Google Scholar 

  7. Jerusalem G, Beguin Y, Najjar F, et al.: Positron emission tomography (PET) with 18F-fluorodeoxyglucose (18F-FDG) for the staging of low-grade non-Hodgkin’s lymphoma (NHL). Ann Oncol 2001, 12:825–830.

    Article  PubMed  CAS  Google Scholar 

  8. Hoffmann M, Chott A, Puspok A, et al.: 18F-fluorodeoxyglucose positron emission tomography (18F-FDG-PET) does not visualize follicular lymphoma of the duodenum. Ann Hematol 2004, 83:276–278.

    Article  PubMed  Google Scholar 

  9. Liu Q, Fayad L, Cabanillas F et al.: Improvement of overall and failure-free survival in stage IV follicular lymphoma: 25 years of treatment experience at The University of Texas M.D. Anderson Cancer Center. J Clin Oncol 2006, 24:1582–1589.

    Article  PubMed  Google Scholar 

  10. 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.

    PubMed  CAS  Google Scholar 

  11. Moog F, Bangerter M, Diederichs CG, et al.: Extranodal malignant lymphoma: detection with FDG PET versus CT. Radiology 1998, 206:475–481.

    PubMed  CAS  Google Scholar 

  12. Buchmann I, Reinhardt M, Elsner K, et al.: 2-(fluorine-18)fluoro-2-deoxy-D-glucose positron emission tomography in the detection and staging of malignant lymphoma. A bicenter trial. Cancer 2001, 91:889–899.

    Article  PubMed  CAS  Google Scholar 

  13. Partridge S, Timothy A, O’Doherty MJ, et al.: 2-Fluorine-18-fluoro-2-deoxy-D glucose positron emission tomography in the pretreatment staging of Hodgkin’s disease: influence on patient management in a single institution. Ann Oncol 2000, 11:1273–1279.

    Article  PubMed  CAS  Google Scholar 

  14. Naumann R, Beuthien-Baumann B, Reiss A, et al.: Substantial impact of FDG PET imaging on the therapy decision in patients with early-stage Hodgkin’s lymphoma. Br J Cancer 2004, 90:620–625.

    Article  PubMed  CAS  Google Scholar 

  15. Isasi CR, Lu P, Blaufox MD: A metaanalysis of 18F-2-deoxy-2-fluoro-D-glucose positron emission tomography in the staging and restaging of patients with lymphoma. Cancer 2005, 104:1066–1074.

    Article  PubMed  Google Scholar 

  16. Brenner DJ, Hall EJ: Computed tomography—an increasing source of radiation exposure. N Engl J Med 2007, 357:2277–2284.

    Article  PubMed  CAS  Google Scholar 

  17. Schaefer NG, Hany TF, Taverna C, et al.: Non-Hodgkin lymphoma and Hodgkin disease: coregistered FDG PET and CT at staging and restaging—do we need contrastenhanced CT? Radiology 2004, 232:823–829.

    Article  PubMed  Google Scholar 

  18. Raanani P, Shasha Y, Perry C, et al.: Is CT scan still necessary for staging in Hodgkin and non-Hodgkin lymphoma patients in the PET/CT era? Ann Oncol 2006, 17:117–122.

    Article  PubMed  CAS  Google Scholar 

  19. Gollub MJ, Hong R, Sarasohn DM, Akhurst T: Limitations of CT during PET/CT. J Nucl Med 2007, 48:1583–1591.

    Article  PubMed  Google Scholar 

  20. Elstrom RL, Leonard JP, Coleman M, Brown RK: Combined PET and low-dose, noncontrast CT scanning obviates the need for additional diagnostic contrast-enhanced CT scans in patients undergoing staging or restaging for lymphoma. Ann Oncol 2008 Jun 10 (Epub ahead of print).

  21. Pakos EE, Fotopoulos AD, Ioannidis JP: 18F-FDG PET for evaluation of bone marrow infiltration in staging of lymphoma: a meta-analysis. J Nucl Med 2005, 46:958–963.

    PubMed  Google Scholar 

  22. Carr R, Barrington SF, Madan B, et al.: Detection of lymphoma in bone marrow by whole-body positron emission tomography. Blood 1998 91:3340–3346.

    PubMed  CAS  Google Scholar 

  23. Elstrom RL, Tsai DE, Vergilio JA, et al.: Enhanced marrow [18F]fluorodeoxyglucose uptake related to myeloid hyperplasia in Hodgkin’s lymphoma can simulate lymphoma involvement in marrow. Clin Lymphoma 2004, 5:62–64.

    Article  PubMed  Google Scholar 

  24. Elstrom RL, Brown RKJ: FDG-PET/CT is superior to anatomic imaging for the staging and follow up of bony involvement in patients with lymphoma [abstract 2330]. Blood 2007, 110.

  25. Jerusalem G, Beguin Y, Fassotte MF, et al.: Whole-body positron emission tomography using 18F-fluorodeoxyglucose for posttreatment evaluation in Hodgkin’s disease and non-Hodgkin’s lymphoma has higher diagnostic and prognostic value than classical computed tomography scan imaging. Blood 1999, 94:429–433.

    PubMed  CAS  Google Scholar 

  26. Spaepen K, Stroobants S, Dupont P, et al.: Can positron emission tomography with [(18)F]-fluorodeoxyglucose after first-line treatment distinguish Hodgkin’s disease patients who need additional therapy from others in whom additional therapy would mean avoidable toxicity? Br J Haematol 2001, 115:272–278.

    Article  PubMed  CAS  Google Scholar 

  27. Weihrauch MR, Re D, Scheidhauer K, et al.: Thoracic positron emission tomography using 18F-fluorodeoxyglucose for the evaluation of residual mediastinal Hodgkin disease. Blood 2001, 98:2930–2934.

    Article  PubMed  CAS  Google Scholar 

  28. Friedberg JW, Fischman A, Neuberg D, et al.: FDG-PET is superior to gallium scintigraphy in staging and more sensitive in the follow-up of patients with de novo Hodgkin lymphoma: a blinded comparison. Leuk Lymphoma 2004, 45:85–92.

    Article  PubMed  Google Scholar 

  29. Lowe VJ, Wiseman GA: Assessment of lymphoma therapy using (18)F-FDG PET. J Nucl Med 2002, 43:1028–1030.

    PubMed  Google Scholar 

  30. Sugawara Y, Fisher SJ, Zasadny KR, et al.: Preclinical and clinical studies of bone marrow uptake of fluorine-1-fluorodeoxyglucose with or without granulocyte colony-stimulating factor during chemotherapy. J Clin Oncol 1998, 16:173–180.

    PubMed  CAS  Google Scholar 

  31. Sugawara Y, Zasadny KR, Kison PV, et al.: Splenic fluorodeoxyglucose uptake increased by granulocyte colony-stimulating factor therapy: PET imaging results. J Nucl Med 1999, 40:1456–1462.

    PubMed  CAS  Google Scholar 

  32. Juweid ME, Wiseman GA, Vose JM, et al.: Response assessment of aggressive non-Hodgkin’s lymphoma by integrated International Workshop Criteria and fluorine-18-fluorodeoxyglucose positron emission tomography. J Clin Oncol 2005, 23:4652–4661.

    Article  PubMed  Google Scholar 

  33. Cheson BD, Pfistner B, Juweid ME, et al.: Revised response criteria for malignant lymphoma. J Clin Oncol 2007, 25:579–586.

    Article  PubMed  Google Scholar 

  34. Thomas A, Gingrich R, Smith BJ, et al.: FDG-PET as predictor of outcome in diffuse large B-cell lymphoma (DLBCL): first analysis of “indeterminate” reports [abstract 8510]. J Clin Oncol 2008, 26(Suppl).

  35. A predictive model for aggressive non-Hodgkin’s lymphoma. The International Non-Hodgkin’s Lymphoma Prognostic Factors Project. N Engl J Med 1993, 329:987–994.

  36. Rosenwald A, Wright G, Chan WC, et al.: The use of molecular profiling to predict survival after chemotherapy for diffuse large-B-cell lymphoma. N Engl J Med 2002, 346:1937–1947.

    Article  PubMed  Google Scholar 

  37. Romer W, Hanauske AR, Ziegler S, et al.: Positron emission tomography in non-Hodgkin’s lymphoma: assessment of chemotherapy with fluorodeoxyglucose. Blood 1998, 91:4464–4471.

    PubMed  CAS  Google Scholar 

  38. Jerusalem G, Beguin Y, Fassotte MF, et al.: Persistent tumor 18F-FDG uptake after a few cycles of polychemotherapy is predictive of treatment failure in non-Hodgkin’s lymphoma. Haematologica 2000, 85:613–618.

    PubMed  CAS  Google Scholar 

  39. Spaepen K, Stroobants S, Dupont P, et al.: Early restaging positron emission tomography with (18)F-fluorodeoxyglucose predicts outcome in patients with aggressive non-Hodgkin’s lymphoma. Ann Oncol 2002, 13:1356–1363.

    Article  PubMed  CAS  Google Scholar 

  40. Haioun C, Itti E, Rahmouni A, et al.: [18F]fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) in aggressive lymphoma: an early prognostic tool for predicting patient outcome. Blood 2005, 106:1376–1381.

    Article  PubMed  CAS  Google Scholar 

  41. Mikhaeel NG, Hutchings M, Fields PA, et al.: FDG-PET after two to three cycles of chemotherapy predicts progression-free and overall survival in high-grade non-Hodgkin lymphoma. Ann Oncol 2005, 16:1514–1523.

    Article  PubMed  CAS  Google Scholar 

  42. Hutchings M, Loft A, Hansen M, et al.: FDG-PET after two cycles of chemotherapy predicts treatment failure and progression-free survival in Hodgkin lymphoma. Blood 2006, 107:52–59.

    Article  PubMed  CAS  Google Scholar 

  43. Kostakoglu L, Goldsmith SJ, Leonard JP, et al.: FDG-PET after 1 cycle of therapy predicts outcome in diffuse large cell lymphoma and classic Hodgkin disease. Cancer 2006, 107:2678–2687.

    Article  PubMed  Google Scholar 

  44. Gallamini A, Hutchings M, Rigacci L, et al.: Early interim 2-[18F]fluoro-2-deoxy-D-glucose positron emission tomography is prognostically superior to international prognostic score in advanced-stage Hodgkin’s lymphoma: a report from a joint Italian-Danish study. J Clin Oncol 2007, 25:3746–3752.

    Article  PubMed  CAS  Google Scholar 

  45. Dann EJ, Fuchs E, Tamir A, et al.: In patients with aggressive non-Hodgkin lymphoma treated with CHOP therapy the rapidity of early response, as determined by residual FDG uptake, does not impact on the overall prognosis [abstract 2328]. Blood 2007, 110.

  46. Pregno P, Chiappella A, Penna D, et al.: Mid-treatment evaluation of 18-FDG-positron emission tomography/computed tomography (PET) as predictive value of response assessment in aggressive non-Hodgkin lymphoma (NHL) [abstract 2333]. Blood 2007, 110.

  47. Juweid ME, Stroobants S, Hoekstra OS, et al.: Use of positron emission tomography for response assessment of lymphoma: consensus of the Imaging Subcommittee of International Harmonization Project in Lymphoma. J Clin Oncol 2007, 25:571–578.

    Article  PubMed  Google Scholar 

  48. Spaepen K, Stroobants S, Dupont P, et al.: Prognostic value of pretransplantation positron emission tomography using fluorine 18-fluorodeoxyglucose in patients with aggressive lymphoma treated with high-dose chemotherapy and stem cell transplantation. Blood 2003, 102:53–59.

    Article  PubMed  CAS  Google Scholar 

  49. Cremerius U, Fabry U, Wildberger JE, et al.: Pre-transplant positron emission tomography (PET) using fluorine-18-fluoro-deoxyglucose (FDG) predicts outcome in patients treated with high-dose chemotherapy and autologous stem cell transplantation for non-Hodgkin’s lymphoma. Bone Marrow Transplant 2002, 30:103–111.

    Article  PubMed  CAS  Google Scholar 

  50. Svoboda J, Andreadis C, Elstrom R, et al.: Prognostic value of FDG-PET scan imaging in lymphoma patients undergoing autologous stem cell transplantation. Bone Marrow Transplant 2006, 38:211–216.

    Article  PubMed  CAS  Google Scholar 

  51. Schot BW, Zijlstra JM, Sluiter WJ, et al.: Early FDG-PET assessment in combination with clinical risk scores determines prognosis in recurring lymphoma. Blood 2007, 109:486–491.

    Article  PubMed  CAS  Google Scholar 

  52. 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, 14:123–130.

    Article  PubMed  CAS  Google Scholar 

  53. Zuckerman D, Lacasce A, Jacobsen E, et al.: High false positive rate with the use of CT and FDG-PET in post-remission surveillance for Hodgkin lymphoma [abstract 2327]. Blood 2007, 110.

  54. Rodriguez M, Rehn S, Ahlstrom H, et al.: Predicting malignancy grade with PET in non-Hodgkin’s lymphoma. J Nucl Med 1995, 36:1790–1796.

    PubMed  CAS  Google Scholar 

  55. Schoder H, Noy A, Gonen M, et al.: Intensity of 18fluorodeoxyglucose uptake in positron emission tomography distinguishes between indolent and aggressive non-Hodgkin’s lymphoma. J Clin Oncol 2005, 23:4643–4651.

    Article  PubMed  Google Scholar 

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Correspondence to John P. Leonard.

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Elstrom, R.L., Leonard, J.P. FDG-PET scans in patients with lymphoma. Curr Hematol Malig Rep 3, 197–203 (2008). https://doi.org/10.1007/s11899-008-0028-4

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