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Application of Quantitative Indexes of FDG PET to Treatment Response Evaluation in Indolent Lymphoma

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Abstract

Purpose

Although 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) is a standard imaging modality for response evaluation in FDG-avid lymphoma, there is a controversy using FDG PET in indolent lymphoma. The purpose of this study was to investigate the effectiveness of quantitative indexes on FDG PET in response evaluation of the indolent lymphoma.

Methods

Fifty-seven indolent lymphoma patients who completed chemotherapy were retrospectively enrolled. FDG PET/computed tomography (CT) scans were performed at baseline, interim, and end of treatment (EOT). Response was determined by Lugano classification, and progression-free survival (PFS) by follow-up data. Maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were measured in the single hottest lesion (target A) or five hottest lesions (target B). Their efficacies regarding response evaluation and PFS prediction were evaluated.

Results

On EOT PET, SUVmax, and MTV of both targets were well associated with visual analysis. Changes between initial and EOT PET were not significantly different between CR and non-CR groups. On interim PET, SUVmax, and %ΔSUVmax in both targets were significantly different between CR and non-CR groups. For prediction of PFS, most tested indexes were significant on EOT and interim PET, with SUVmax being the most significant prognostic factor.

Conclusion

Quantitative indexes of FDG PET are well associated with Lugano classification in indolent lymphoma. SUVmax measured in the single hottest lesion can be effective in response evaluation and prognosis prediction on interim and EOT PET.

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Authors and Affiliations

  1. Department of Nuclear Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, South Korea

    Hyun Joo Kim, Reeree Lee, Hongyoon Choi, Jin Chul Paeng, Gi Jeong Cheon, Dong Soo Lee, June-Key Chung & Keon Wook Kang

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  1. Hyun Joo Kim
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Correspondence to Jin Chul Paeng.

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Conflict of Interest

Hyun Joo Kim, Reeree Lee, Hongyoon Choi, Jin Chul Paeng, Gi Jeong Cheon, Dong Soo Lee, June-Key Chung, and Keon Wook Kang declare that they have no conflict of interest.

Ethical Approval

All procedures followed were performed in accordance with the ethical standards of the responsible committee on human experimentation and with the Helsinki Declaration of 1975, as revised in 2013.

Informed Consent

The study design of the retrospective analysis and exemption of informed consent were approved by the Institutional Review Board of the Seoul National University Hospital (H-1703-108-840). This manuscript has not been published before or is not under consideration for publication anywhere else and has been approved by all co-authors.

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Kim, H.J., Lee, R., Choi, H. et al. Application of Quantitative Indexes of FDG PET to Treatment Response Evaluation in Indolent Lymphoma. Nucl Med Mol Imaging 52, 342–349 (2018). https://doi.org/10.1007/s13139-018-0543-8

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  • DOI: https://doi.org/10.1007/s13139-018-0543-8

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