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18F-FDG-PET in patients with malignant lymphoma having long-term follow-up: staging and restaging, and evaluation of treatment response and recurrence

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Abstract

Objective

The aim of this study was to evaluate the diagnostic accuracy of positron emission tomography (PET) with 2-[18F]fluoro-2-deoxy-d-glucose (18F-FDG) for staging/restaging, evaluating the treatment response, and screening of recurrence in patients with malignant lymphoma (ML) during long-term follow-up, and to compare that with computer tomography (CT)/magnetic resonance imaging (MRI).

Methods

The study was conducted in 59 ML patients who underwent whole-body 18F-FDG-PET examinations three times or more from October 1998 to August 2006. The location of the lesions in the patients with positive findings on 18F-FDG-PET and/or the corresponding CT/MRI was classified into supradiaphragmatic (n = 10), infradiaphragmatic (n = 7), and extranodal sites (n = 20), and the findings were compared on a site basis according to the gold standard, which consisted of all clinical information available, including follow-up results.

Results

A total of 156 18F-FDG-PET examinations for which the corresponding CT/MRI images were also available were evaluated, and a total of 305 sites showed positive findings on 18F-FDG-PET and/or CT/MRI. Concordant positive findings were obtained in 76% for staging/restaging, 34% for evaluation of the treatment response, and 50% for screening of recurrence. The accuracy of 18F-FDG-PET versus CT/MRI was 92% versus 84% (P = 0.06) for staging/restaging, 84% versus 50% (P < 0.05) for the evaluation of the treatment response, and 83% versus 72% (P = 0.21) for the screening of recurrence. At pathologic sites with discrepant findings between 18F-FDG-PET and CT/MRI (n = 122), the frequency of accurate diagnosis by 18F-FDG-PET (76%) was higher than that by CT/MRI (24%), especially for the evaluation of the treatment response.

Conclusions

18F-FDG-PET is expected to play a significant role in the management of ML patients even after effective treatment is initiated.

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Authors and Affiliations

  1. Department of Nuclear Medicine and Tracer Kinetics, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan

    Kayako Isohashi, Ichiro Higuchi, Atsuo Inoue, Kazuya Nakajo, Eku Shimosegawa & Jun Hatazawa

  2. Department of Radiology, Osaka University Graduate School of Medicine, Osaka, Japan

    Mitsuaki Tatsumi & Hironobu Nakamura

  3. Department of Hematology and Oncology, Osaka University Graduate School of Medicine, Osaka, Japan

    Jun Ishikawa & Yuzuru Kanakura

Authors
  1. Kayako Isohashi
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  2. Mitsuaki Tatsumi
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  3. Ichiro Higuchi
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  6. Jun Ishikawa
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Correspondence to Jun Hatazawa.

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Isohashi, K., Tatsumi, M., Higuchi, I. et al. 18F-FDG-PET in patients with malignant lymphoma having long-term follow-up: staging and restaging, and evaluation of treatment response and recurrence. Ann Nucl Med 22, 795–802 (2008). https://doi.org/10.1007/s12149-008-0186-4

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  • DOI: https://doi.org/10.1007/s12149-008-0186-4

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