Predictive Potential of FDG-PET/CT for Histological Transformation in Patients with Indolent ...

Predictive Potential of FDG-PET/CT for Histological Transformation in Patients with Indolent ...

10 Pages · 2014 · 759 KB · English

Peter E. Blase1, Pieternel C. M. Pasker-de Jong2, Anton Hagenbeek3, Rob Indolent; Lymphoma; Transformation; PET/CT; Predictive Value. 1.

Predictive Potential of FDG-PET/CT for Histological Transformation in Patients with Indolent ... free download

Advances in Molecular Imaging, 2014 , 4 , 110 Published Online January 2014 (http://www scirporg/journal/ ami ) http://dxdoiorg/ 104236/ami201441001 Predictive Potential of FDG PET/CT for Histological Transformation in Patients with Indolent Lymphoma Peter E Blase 1, Pieternel C M Paskerde Jong 2, Anton Hagenbeek 3, Rob Fijnheer 4, Marie J de Haas 1, Jo hn M H de Klerk 1 1Department of Nuclear medicine, Meander Medical Centre, Amersfoort, The Netherlands 2Department of Meander Academy, Meander Medical Centre, Amersfoort, The Netherlands 3Department of Haematology, Academical Medical Centre, Amsterdam, The Netherlands 4Department of Internal medicine, Meander Medical Centre, Amersfoort, The Netherlands Email: [email protected] Received November 18, 2013; revised December 18, 2013; accepted December 25, 2013 Copyright © 2014 Peter E Blase et al This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited In accor dance of the Creative Commons Attribution License all Copyrights © 2014 are reserved for SCIRP and the owner of the intellectual property Peter E Blase et al All Copyright © 201 4 are guarded by l aw and by SCIRP as a guardian ABSTRACT Backgrounds and Purpose—In indolent non Hodgkin lymphoma, histological transformation is a dramatic event which reduces the prognosis significantly SUVmax values from FDG PET/CT help differentiate between a g gressive and indolent lymphomas, and tr ansformed indolent lymphomas also show an increased FDG uptake Possibly FDG uptake increases early in the clinical course and could predict histological transformation Our objective was to predict histological transformation in indolent lymphomas from in itial staging FDGPET/CT Patients and Methods —A retrospective study was performed Patients with biopsy proven indolent lymphoma who had had initial staging FDG PET/CT were included Qualitative (foci compared with FDG uptake liver) and semiquantitative ( SUVmaxvalue per focus) analyses were performed of all abnormal foci Patient characteristics and outcome were evaluated Results —We included 88 patients, 5 of whom developed a histological transform a tion Semiquantitative analysis showed a relation betwee n maximum standardized uptake value and histological transformation (odds ratio 125, 95% CI 1024 1513) Qualitative analysis showed a negative predictive relation of FDG uptake less than or equal to liver in the occurrence of histological transformati on Transformationfree survival was 100% over 30 months in those with FDG uptake lower than or equal to liver More FDG uptake than liver showed transformation free survival of 88% over 30 months Conclusion —Qualitative analysis of staging FDG PET/CT in indolent lymphomas could be useful to rule out transformation in the next 30 months In our study , semiquantitative analysis was statistically significantly associated with histological transformation and maximum standardized uptake value However, because of the small number of patients, cautious interpr e tation of the results is warranted More studies are needed to investigate the role of staging PET/CT in patient with indolent non Hodkin lymphoma in the prediction of transformation KEYWORDS Indolent; Lymphoma; Transformation ; PET/CT; Predictive Value 1 Introduction The clinical course of indolent non Hodgkin lymphoma (NHL) is slow with a relatively long survival Indolent lymphomas are characterized by years without sympt o matology and an occasional show of progression [ 13] Follicular lymphoma grade I II (FL I II) is the most co m mon type and accounts for 70% of indole nt lymphomas [ 4, 5] In Europe, the incidence of follicular lymphoma is 218 per 100000 per ye ar [6] Other frequent indolent

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