Remarkable prognostic value and contribution in staging of F-18-FDG-positron emission tomography in follicular lymphoma
| Authors | |
|---|---|
| Year of publication | 2008 |
| Type | Article in Proceedings |
| Conference | Annals of Oncology 19; 2008 Suppl 4 |
| MU Faculty or unit | |
| Citation | |
| Keywords | FDG-PET, follicular lymphoma, prognosis |
| Description | Introduction: F-18-fluorodeoxyglucose positron emission tomography (FDG-PET) is a powerful tool for the imaging of aggressive NonHodgkin lymphomas and Hodgkin lymphoma. In contrast, there is relatively little data on FDG-PET in follicular lymphoma (FL) in spite of its high FDG uptake. Methods: A retrospective analysis of 127 FDG-PET scans was performed among 100 patients with FL (93% grade I or II). FDG-PET was obtained at initial staging (n= 56) and results were compared with conventional staging. Post-treatment scans (n=71, in 87% patients treated by conventional therapy) were compared with clinical follow-up. Results: FDG-PET compared with CT and clinical examination showed more foci of involvement in 30/56 (55%) FL patients, less in 7/56, the same extension in 15/56 and 4 patients revealed discordant founds on PET or CT only (p<0,001). FDG-PET upstaged essentially FL in 15 patients (from stage 0-2 to 3-4). Including results of trephine biopsy the stage was substantially changed in 13/56 (23%) patients, which was projected into treatment strategy. Post-treatment PET-positive patients (11/71) had shorter progression free survival (9/11 relapsed in median of 6 months) compared with PET-negative patients (56/71), 9 of whom relapsed in median of 10 months, 47 of them remain in remission (median follow up 19 months) (p<0,001) . All of remaining 4/71 patients with PET-positivity of undetermined significance (close to cut-off) are in long-term remission (median follow up 39 months). Conclusions: Our results indicate that FDG-PET is accurate and reliable method for staging of FL. Post-treatment PET positive patients are likely to relapse prior to PET negative patients. Surprisingly, presented data are very similar to those observed in studies with aggressive lymphomas. |