Different roles of surveillance positron emission tomography according to the histologic subtype of non-Hodgkin's lymphoma
Open Access
- 1 March 2021
- journal article
- research article
- Published by Korean Association of Internal Medicine in The Korean Journal of Internal Medicine
- Vol. 36 (Suppl 1), S245-S252
- https://doi.org/10.3904/kjim.2019.376
Abstract
Background/Aims: Although the use of surveillance F-18-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) is discouraged in patients with diffuse large B-cell lymphoma, its usefulness in different subtypes has not been thoroughly investigated. Methods: We retrospectively evaluated 157 patients who showed positive results on surveillance FDG-PET/CT every 6 months following complete response for up to 5 years. All of the patients also underwent biopsies. Results: Seventy-eight (49.6%) of 157 patients had true positive results; the remaining 79 ( 50.3%), including eight (5.1%) with secondary malignancies, were confirmed to yield false positive results. Among the 78 patients with true positive results, the disease in seven (8.9%) had transformed to a different subtype. The positive predictive value (PPV) of FDG-PET/CT for aggressive B-cell non-Hodgkin's lymphoma (NHL) was lower than that for indolent B-cell or aggressive T-cell NHL (p = 0.003 and p = 0.018, respectively), especially in patients with a low/low-intermediate international prognostic index (IPI) upon a positive PET/CT finding. On the other hand, indolent B-cell and aggressive T-cell NHL patients showed PPVs of > 60%, including those with low/low-intermediate secondary IPIs. Conclusions: The role of FDG-PET/CT surveillance is limited, and differs according to the lymphoma subtype. FDG-PET/CT may be useful in detecting early relapse in patients with aggressive T-cell NHL, including those with low/low-intermediate risk secondary IPI; as already known, FDG-PET/CT has no role in aggressive B-cell NHL. Repeat biopsy should be performed to discriminate relapse or transformation from false positive findings in patients with positive surveillance FDG-PET/CT results.This publication has 25 references indexed in Scilit:
- Positron Emission Tomographic Scans in Lymphoma: Convention and ControversyMayo Clinic Proceedings, 2012
- Surveillance imaging of Hodgkin lymphoma patients in first remissionCancer, 2010
- Risk-adapted FDG–PET/CT-based follow-up in patients with diffuse large B-cell lymphoma after first-line therapyAnnals of Oncology, 2010
- Role of [18F]Fluorodeoxyglucose Positron Emission Tomography Scan in the Follow-Up of LymphomaJournal of Clinical Oncology, 2009
- High incidence of false-positive PET scans in patients with aggressive non-Hodgkin’s lymphoma treated with rituximab-containing regimensAnnals of Oncology, 2009
- Report on the First International Workshop on interim-PET scan in lymphomaLeukemia & Lymphoma, 2009
- Revised Response Criteria for Malignant LymphomaJournal of Clinical Oncology, 2007
- Age-adjusted International Prognostic Index predicts autologous stem cell transplantation outcome for patients with relapsed or primary refractory diffuse large B-cell lymphomaBlood, 2003
- 18-FDG-PET as a Prognostic Indicator in the Treatment of Aggressive Non-Hodgkin's Lymphoma-Comparison with CTLeukemia & Lymphoma, 2000
- UPDATED KIEL CLASSIFICATION FOR LYMPHOMASThe Lancet, 1988