Skip to main content

Advertisement

SpringerLink
Log in

Pulmonary drug toxicity: FDG-PET findings in patients with lymphoma

  • Original Article
  • Published:
Annals of Nuclear Medicine Aims and scope Submit manuscript

Abstract

Objective

The objective of this study was to evaluate the prevalence and positron emission tomography (PET) imaging features of pulmonary drug toxicity in patients with lymphoma during or just following chemotherapy.

Methods

A total of 677 PET scans on 460 patients with lymphoma (351 non-Hodgkin’s lymphoma, 92 Hodgkin’s disease, and 17 both Hodgkin’s and non-Hodgkin’s lymphoma) were performed for the evaluation of chemotherapy response. In 51 patients, abnormal accumulation on both sides of the chest was reported. A review of medical records, 18fluorodeoxyglucose (18FDG)-PET scans, and chest computed tomography (CT) was performed, and cases with probable drug toxicity were identified. Inclusion criteria of probable drug toxicity were abnormal but symmetrical FDG accumulation in both lungs seen during or just following the completion of chemotherapy, the abnormal accumulation or corresponding abnormal CT findings resolved on sub sequent studies, exclusion of clinical diagnosis of pneumonia, radiation pneumonitis, or lymphoma involvement.

Results

In 10 patients (six men and four women, average age 47.3), 2.2% of cases, probable drug toxicity was identified. In all 10 cases, diffuse and subpleural-dominant FDG accumulation was seen on FDG-PET scans, and scattered or diffuse ground-glass opacities were observed on chest CT. Four patients reported symptoms, and six patients did not report any symptoms.

Conclusions

Diffuse and peripheral-dominant FDG accumulation in the lung, which may represent pulmonary drug toxicity, was not uncommon in patients with lymphoma who underwent chemotherapy. FDG-PET scan might be able to detect pulmonary drug toxicity in asymptomatic patients.

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

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Kostakoglu L, Goldsmith SJ. 18F-FDG PET evaluation of the response to therapy for lymphoma and for breast, lung, and colorectal carcinoma. J Nucl Med 2003;44:224–239.

    PubMed  Google Scholar 

  2. Kazama T, Faria SC, Varavithya V, Phongkitkarun S, Ito H, Macapinlac HA. FDG PET in the evaluation of treatment for lymphoma: clinical usefulness and pitfalls. Radiographics 2005;25:191–207.

    Article  PubMed  Google Scholar 

  3. Castellucci P, Zinzani PL, Pourdehnad M, Alinari L, Nanni C, Farsad M, et al. 18F-FDG PET in malignant lymphoma: significance of positive findings. Eur J Nucl Med Mol Imaging 2005;32:749–756.

    Article  PubMed  CAS  Google Scholar 

  4. de Wit M, Bohuslavizki KH, Buchert R, Bumann D, Clausen M, Hossfeld DK. 18FDG-PET following treatment as valid predictor for disease-free survival in Hodgkin’s lymphoma. Ann Oncol 2001;12:29–37.

    Article  PubMed  Google Scholar 

  5. Sleijfer S. Bleomycin-induced pneumonitis. Chest 2001;120:617–624.

    Article  PubMed  CAS  Google Scholar 

  6. Rossi SE, Erasmus JJ, McAdams HP, Sporn TA, Goodman PC. Pulmonary drug toxicity: radiologic and pathologic manifestations. Radiographics 2000;20:1245–1259.

    PubMed  CAS  Google Scholar 

  7. Barrington SF, O’Doherty MJ. Limitations of PET for imaging lymphoma. Eur J Nucl Med Mol Imaging 2003;30:S117–S127.

    Article  PubMed  Google Scholar 

  8. Hain SF, Beggs AD. Bleomycin-induced alveolitis detected by FDG positron emission tomography. Clin Nucl Med 2002;27:522–523.

    Article  PubMed  Google Scholar 

  9. Kirsch J, Arrossi AV, Yoon JK, Wu G, Neumann DR. FDG positron emission tomography/computerized tomography features of bleomycin-induced pneumonitis. J Thorac Imaging 2006;21:228–230.

    Article  PubMed  Google Scholar 

  10. Lowe VJ, Fletcher JW, Gobar L, Lawson M, Kirchner R, Valk P, et al. Prospective investigation of positron emission tomography in lung nodules. J Clin Oncol 1998;16:1075–1084.

    PubMed  CAS  Google Scholar 

  11. Luna MA, Bedrossian CW, Lichtiger B, Salem PA. Interstitial pneumonitis associated with bleomycin therapy. Am J Clin Pathol 1972;58:501–510.

    PubMed  CAS  Google Scholar 

  12. Hassaballa HA, Cohen ES, Khan AJ, Ali A, Bonomi P, Rubin DB. Positron emission tomography demonstrates radiation-induced changes to nonirradiated lungs in lung cancer patients treated with radiation and chemotherapy. Chest 2005;128:1448–1452.

    Article  PubMed  Google Scholar 

  13. Lyburn ID, Lowe JE, Wong WL. Idiopathic pulmonary fibrosis on F-18 FDG positron emission tomography. Clin Nucl Med 2005;30:27.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Diagnostic Imaging, the University of Texas M.D. Anderson Cancer Center, Houston, TX, USA

    Toshiki Kazama, Silvana C. Faria & Homer A. Macapinlac

  2. Department of Radiology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8677, Japan

    Toshiki Kazama, Yoshitaka Uchida & Hisao Ito

Authors
  1. Toshiki Kazama
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Silvana C. Faria
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yoshitaka Uchida
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hisao Ito
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Homer A. Macapinlac
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Toshiki Kazama.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kazama, T., Faria, S.C., Uchida, Y. et al. Pulmonary drug toxicity: FDG-PET findings in patients with lymphoma. Ann Nucl Med 22, 111–114 (2008). https://doi.org/10.1007/s12149-007-0089-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12149-007-0089-9

Keywords

Search

Navigation