[en] BACKGROUND: Although PET has been shown to be highly sensitive in the primary staging of lymphoma, previous studies with small numbers of patients indicated that low-grade NHL may not always be adequately detected by PET. We undertook this study to determine factors influencing the detection of lesions by PET in low-grade NHL and to evaluate the utility of PET in this indication. PATIENTS AND METHODS: Forty-two patients underwent conventional staging procedures (clinical examination, oto-rhino-laryngologic examination, computed tomography of the chest, abdomen and pelvis, gastroscopy and bone marrow biopsy as well as whole-body non-attenuation corrected 18F-FDG-PET RESULTS: PET detected 40% more abnormal lymph node areas than conventional staging in follicular lymphoma but was inappropriate for the staging of small lymphocytic lymphoma where it detected less than 58% of abnormal lymph node areas. PET showed more lesions than conventional staging for peripheral (34% more lymph node areas detected) and thoracic lymph node (39% more) areas but not for abdominal or pelvic lymph nodes (26% fewer areas detected). The sensitivity to detect bone marrow infiltration was unacceptably low for PET. In contrast, PET was as effective as standard procedures for the detection of other extranodal localizations, although a few localizations were detected only by PET and a few others only by conventional procedures. CONCLUSIONS: PET may contribute to the management of patients with low-grade follicular NHL. For the other low-grade lymphoma subtypes, the role of PET is less evident. Further studies using PET to evaluate the results of treatment or to diagnose disease recurrence are warranted in low-grade follicular NHL.
Disciplines :
Hematology
Author, co-author :
Jerusalem, Guy ; Centre Hospitalier Universitaire de Liège - CHU > Oncologie médicale
Beguin, Yves ; Centre Hospitalier Universitaire de Liège - CHU > Hématologie clinique
Najjar, F.
Hustinx, Roland ; Centre Hospitalier Universitaire de Liège - CHU > Médecine nucléaire
Fassotte, Marie-France ; Centre Hospitalier Universitaire de Liège - CHU > Hématologie clinique
Rigo, Pierre ; Université de Liège - ULiège > Département des sciences de la motricité > Pathologie générale et médecine nucléaire
Fillet, Georges ; Centre Hospitalier Universitaire de Liège - CHU > Hématologie clinique
Language :
English
Title :
Positron emission tomography (PET) with 18F-fluorodeoxyglucose (18F-FDG) for the staging of low-grade non-Hodgkin's lymphoma (NHL).
Rigo P., Paulus P., Kaschten B.J. (1996) Oncological applications of positron emission tomography with fluorine-18 fluorodeoxyglucose. Eur J Nucl Med 23:1641-1674.
Kostakoglu L., Goldsmith S.J. (2000) Positron emission tomography in lymphoma: Comparison with computed tomography and gallium-67 single photon emission computed tomography. Clin Lymph 1:67-74.
Jerusalem G., Beguin Y. (2000) Commentary on 'Positron emission tomography in lymphoma: Comparison with computed tomography and gallium-67 single photon emission computed tomography'. Clin Lymph 1:75-76.
Hoekstra O.S., Ossenkoppele G.J., Golding R. (1993) Early treatment response in malignant lymphoma, as determined by planar fluorine-18-fluorodeoxyglucose scintigraphy. J Nucl Med 34:1706-1710.
Dimitrakopoulou-Strauss A., Strauss L.S., Goldschmidt H. (1995) Evaluation of tumour metabolism and multidrug resistance in patients with treated malignant lymphomas. Eur J Nucl Med 22:434-442.
Romer W., Hanauske A.R., Ziegler S. (1998) Positron emission tomography in non-Hodgkin's lymphoma: Assessment of chemotherapy with fluorodeoxyglucose. Blood 91:4464-4471.
Jerusalem G., Beguin Y., Fassotte M.F. (2000) Persistent tumor 18F-FDG uptake after a few cycles of polychemotherapy is predictive of treatment failure in non-Hodgkin's lymphoma. Haematologica 85:613-618.
de Wit M., Bumann D., Beyer W. (1997) Whole-body positron emission tomography (PET) for diagnosis of residual mass in patients with lymphoma. Ann Oncol 8:57-60.
Cremerius U., Fabry U., Neuerburg J. (1998) Positron emission tomography with 18F-FDG to detect residual disease after therapy for malignant lymphoma. Nucl Med Commun 19:1055-1063.
Jerusalem G., Beguin Y., Fassotte M.F. (1999) 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 classical computed tomography scan imaging. Blood 94:429-433.
Zinzani P.L., Magagnoli M., Chierichetti F. (1999) The role of positron emission tomography (PET) in the management of lymphoma patients. Ann Oncol 10:1181-1184.
Mikhael N.G., Timothy A.R., Hain S.F., O'Doherty M.J. (2000) 18-FDG-PET for the assessment of residual masses on CT following treatment of lymphomas. Ann Oncol 11:S147-S150.
Jerusalem G., Beguin Y., Fassotte M.F. (2000) Early detection of relapse by whole-body positron emission tomography (PET) using 18F-fluorodeoxyglucose (18F-FDG) in the follow-up of patients with Hodgkin's disease (HD). Proc Am Soc Clin Oncol , (Abstr); 19:10a.
Newman J.S., Francis I.R., Kaminski M.S., Wahl R.L. (1994) Imaging of lymphoma with PET with 2-[F-18]-fluoro-2-deoxy-D-glucose: Correlation with CT. Radiology 190:111-116.
Hoh C.K., Glaspy J., Rosen P. (1997) Whole-body FDG-PET imaging for staging of Hodgkin's disease and lymphoma. J Nucl Med 38:343-348.
Moog F., Bangerter M., Diederichs C.G. (1997) Lymphoma: Role of whole-body 2-deoxy-2-[F-18]fluoro-D-glucose (FDG) PET in nodal staging. Radiology 203:795-800.
Stumpe K.D., Urbinelli M., Steinert H.C. (1998) Whole-body positron emission tomography using fluorodeoxyglucose for staging of lymphoma: Effectiveness and comparison with computed tomography. Eur J Nucl Med 25:721-728.
Bangerter M., Moog F., Buchmann I. (1998) Whole-body 2-[18F]-fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) for accurate staging of Hodgkin's disease. Ann Oncol 9:1117-1122.
Jerusalem G., Warland V., Najjar F. (1999) Whole-body 18F-FDG PET for the evaluation of patients with Hodgkin's disease and non-Hodgkin's lymphoma. Nucl Med Commun 20:13-20.
Leskinen-Kallio S., Ruotsalainen U., Nagren K. (1991) Uptake of carbon-11-methionine and fluorodeoxyglucose in non-Hodgkin's lymphoma: A PET study. J Nucl Med 32:1211-1218.
Hoffmann M., Kletter K., Diemling M. (1999) 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 10:1185-1189.
Castellino R.A., Hoppe R.T., Blank N. (1984) Computed tomography, lymphography, and staging laparotomy: Correlations in initial staging of Hodgkin disease. AJR Am J Roentgenol 143:37-41.
Castellino R.A., Blank N., Hoppe R.T., Cho C. (1986) Hodgkin disease: Contributions of chest CT in the initial staging evaluation. Radiology 160:603-605.
Okada J., Yoshikawa K., Itami M. (1992) Positron emission tomography using fluorine-18-fluorodeoxyglucose in malignant lymphoma: A comparison with proliferative activity. J Nucl Med 33:325-329.
Lapela M., Leskinen S., Minn H.R. (1995) Increased glucose metabolism in untreated non-Hodgkin's lymphoma: A study with positron emission tomography and fluorine-18-fluorodeoxyglucose. Blood 86:3522-3527.
Rodriguez M., Rehn S., Ahlstrom H. (1995) Predicting malignancy grade with PET in non-Hodgkin's lymphoma. J Nucl Med 36:1790-1796.
Ben Haim S., Bar-Shalom R., Israel O. (1996) Utility of gallium-67 scintigraphy in low-grade non-Hodgkin's lymphoma. J Clin Oncol 14:1936-1942.
Levi J.A., O'Connell M.J., Murphy W.L. (1975) Role of 67gallium citrate scanning in the management of non-Hodgkin's lymphoma. Cancer 36:1690-1741.
Seabold J.E., Votaw M.L., Keyes J.W. (1976) Gallium citrate Ga 67 scanning: Clinical usefulness in lymphoma patients. Arch Intern Med 136:1370-1374.
McCaffrey J.A., Rudders R.A., Kahn P.C. (1976) Clinical usefulness of 67gallium scanning in the malignant lymphomas. Am J Med 60:523-530.
Horn N.L., Ray G.R., Kriss J.P. (1976) Gallium-67 citrate scanning in Hodgkin's disease and non-Hodgkin's lymphoma. Cancer 37:250-257.
Brown M.L., O'Donnell J.B., Thrall J.H. (1978) Gallium-67 scintigraphy in untreated and treated non-hodgkin lymphomas. J Nucl Med 19:875-879.
Longo D.L., Schilsky R.L., Blei L. (1980) Gallium-67 scanning: Limited usefulness in staging patients with non-Hodgkin's lymphoma. Am J Med 68:695-700.
Waxman A.D., Eller D., Ashook G. (1996) Comparison of gallium-67-citrate and thallium-201 scintigraphy in peripheral and intrathoracic lymphoma. J Nucl Med 37:46-50.
Delcambre C., Reman O., Henry-Amar M. (2000) Clinical relevance of gallium-67 scintigraphy in lymphoma before and after therapy. Eur J Nucl Med 27:176-184.
Kotzerke J., Guhlmann A., Moog F. (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.
