The role of FDG-PET scans in patients with lymphoma

Blood ◽  
2007 ◽  
Vol 110 (10) ◽  
pp. 3507-3516 ◽  
Author(s):  
Pamela Seam ◽  
Malik E. Juweid ◽  
Bruce D. Cheson
Keyword(s):  
Fdg Pet ◽  
Imaging Modality ◽  
False Negative ◽  
Surrogate Marker ◽  
3 Dimensional ◽  
Positron Emission ◽  
Development Data ◽  
Pretreatment Staging ◽  
Pet Scans

Abstract18-Fluoro-deoxyglucose positron emission tomography (FDG-PET) is a noninvasive, 3-dimensional imaging modality that has become widely used in the management of patients with malignant lymphomas. This technology has been demonstrated to be more sensitive and specific than either 67gallium scintigraphy or computerized tomography, providing a more accurate distinction between scar or fibrosis and active tumor. PET scans have been evaluated in pretreatment staging, restaging, monitoring during therapy, posttherapy surveillance, assessment of transformation, and, more recently, as a surrogate marker in new drug development. Data to support these various roles require prospective validation. Moreover, caution must be exercised in the interpretation of PET scans because of technical limitations, variability of FDG avidity among the different lymphoma histologic subtypes, and in the large number of etiologies of false-negative and false-positive results. Recent attempts to standardize PET in clinical trials and incorporation of this technology into uniformly adopted response criteria will hopefully lead to improved outcome for patients with lymphoma.

scholarly journals EVALUATING THE ROLE OF FDG PET-CT SCAN AS A SOLE IMAGING MODALITY IN THE MANAGEMENT OF MUO NECK

2020 ◽  
pp. 39-41
Author(s):  
Krishnappa Krishnappa ◽  
Krishna Prasad ◽  
Shruti Satish ◽  
Murali R Nadig
Keyword(s):  
Ct Scan ◽  
Predictive Value ◽  
Fdg Pet ◽  
Imaging Modality ◽  
False Negative ◽  
Unknown Primary ◽  
Pet Ct ◽  
Fdg Pet Ct ◽  
Pet Ct Scan

Aim:to study the role of PET- CT SCAN as a single imaging modality in the diagnosis of MUO neck. methodology: retrospective study analysis of 51 cases of clinical unknown primary with cervical metastasis . RESULTS: FDG PET CT tracer uptake was detected in 24/51. true positive in 18 cases out of 24,false positive in 6 cases, false negative in 2 cases with sensitivity of 90%, specificity of 82%,positive predictive value of 75%,negative predictive value of 93% and accuracy of 84.91%. conclusion: FDG PET CT can be used as a sole imaging modality in the diagnosis of MUO neck.it is complimentary to endoscopy.

FDG-PET in the Serial Assessment of Patients with Lymphoma in Complete Remission.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 216-216 ◽  
Author(s):  
Pier Luigi Zinzani ◽  
Vittorio Stefoni ◽  
Valentina Ambrosini ◽  
Enrico Derenzini ◽  
Gerardo Musuraca ◽  
...  
Keyword(s):  
Complete Remission ◽  
Fdg Pet ◽  
False Negative ◽  
Great Majority ◽  
True Negative ◽  
Non Hodgkin Lymphoma ◽  
Pet Scans ◽  
Negative Scan

Abstract FDG-PET role in the assessment of lymphoma patients is well established but only few papers evaluated the usefulness of FDG-PET during follow up. Aim: to prospectively investigate the value of serial FDG-PET scans in the follow up of lymphoma patients in complete remission. All lymphoma patients who achieved a complete remission were prospectively enrolled in the study and scheduled for serial FDG-PET scans at 6, 12, 18 and 24 months; further scans were then carried out on annual basis (overall 421 pts, 160 pts with Hodgkin’s Disease (HD) and 261 pts with non-Hodgkin Lymphoma (NHL) were studied). All patients had a final assessment using other imaging procedures and/or biopsy and/or clinical evolution. FDG-PET findings were reported as positive, indeterminate or negative for relapse; after comparison with all available data, PET results were categorized as true positive (TP), true negative (TN), false positive (FP), indeterminate turned out to be relapse (I+) and indeterminate turned out to be complete remission (I-). Results: PET documented relapse in 42 cases at 6 mo (14 HD (8.8%) and 28 NHL (10.7%); in 31 cases at 12 mo (14 HD (9.5%) and 17 NHL (7.3%); in 27 cases at 18 mo (6 HD (4.5%) and 21 NHL (3.2%); in 9 cases at 24 mo (3 HD (2.4%) and 6 NHL (3.2%); and in 5 cases at > 36 mo (2 HD (2.8%) and 3 NHL (6.5%). Out of 125 scans reported as positive for relapse, 109 turned out to be TP (PPV of 87%); no false negative scan was recorded, and in the great majority of cases PET detected the presence of relapse before clinical evidence. Our results confirm that FDG-PET is a valid tool for lymphoma patients follow-up. The higher incidence of relapse occurred in both HD and NHL quite early after complete remission (at 6 and 12 months for HD and at 6, 12 and 18 months for NHD), thus confirming the usefulness of performing FDG-PET scans at these times in order to identify recurrence. The role of serial PET at later times (after 18 months for HD and 24 months for NHL) was found less relevant.

Role of Functional Imaging in the Management of Lymphoma

2011 ◽  
Vol 29 (14) ◽  
pp. 1844-1854 ◽  
Author(s):  
Bruce D. Cheson
Keyword(s):  
Fdg Pet ◽  
B Cell Lymphoma ◽  
Post Treatment ◽  
Metabolic Imaging ◽  
Interim Pet ◽  
Positron Emission ◽  
Pet Ct ◽  
Pretreatment Assessment ◽  
Pet Scans

18-F-fluorodeoxyglucose (FDG) –positron emission tomography (PET), and more recently PET/computed tomography (CT), is the most sensitive and specific imaging technique currently available for patients with lymphoma. Nevertheless, despite being increasingly used in pretreatment assessment, midtreatment evaluation of response, post-treatment restaging, and surveillance during follow-up of patients with lymphoma, its impact on clinical outcome in most clinical situations remains to be confirmed. PET/CT provides its greatest clinical benefit in the post-treatment evaluation of Hodgkin's lymphoma and diffuse large B-cell lymphoma; however, the role of metabolic imaging in other indications and in other histologies remains to be demonstrated. Ongoing risk-adapted studies will hopefully provide evidence for clinical improvement on the basis of altering treatment as a result of interim PET results. Efforts are ongoing to better standardize the conduct and interpretation of FDG-PET scans. FDG-PET has the potential to improve lymphoma patient management; however, its usefulness will likely vary by histology, stage, therapy, and clinical setting.

FDG-Positron Emission Tomography in T-Cell Lymphoma

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 1614-1614
Author(s):  
Chiara Rusconi ◽  
Cristina Gabutti ◽  
Vittorio Ruggero Zilioli ◽  
Erika Meli ◽  
Maddalena Mazzucchelli ◽  
...  
Keyword(s):  
T Cell ◽  
Fdg Pet ◽  
Cell Lymphoma ◽  
Clinical Stage ◽  
T Cell Lymphoma ◽  
Emission Tomography ◽  
Positron Emission ◽  
Pet Scans

Abstract Abstract 1614 Background: Few data are available on the role of fluoro-deoxy-glucose positron emission tomography (FDG-PET) in T-cell non Hodgkin Lymphoma (NHL). We compared standard contrast-enhanced computerized tomography (CECT) and FDG-PET for initial staging and restaging after treatment in T-cell NHL. Methods: We reviewed 58 FDG-PET scans performed in 29 patients (pts) affected by T-cell NHL and we focused on the 42 cases for which a simultaneous standard CECT was available for comparison. The specific T-cell histology was Peripheral T-Cell Lymphoma Not Otherwise Specified in 12 pts, Angioimmunoblastic T-Cell Lymphoma in 4 pts, Anaplastic Large Cell Lymphoma in 10 pts, other T-NHL hystologies in 3 pts. Twelve pts were males and median age at diagnosis was 57 years (range: 25–77). Baseline FDG-PET scans were 20, while FDG-PET performed for disease reassessment were 22. Results: FDG-PET performed at baseline was positive in all cases. In 6 cases (30%) FDG-PET identified fewer disease sites than CECT, while in 14 cases (70%) FDG-PET identified additional disease sites. New sites identified by FDG-PET were: other nodal sites (11 pts), spleen (2 pts), nasopharynx (1 pt) and testicles (1 pt). Different disease extent evaluation according to FDG-PET modified clinical stage in 10 pts (50%): one pt was downstaged and 9 pts were upstaged. FDG-PET-based stage was not considered for therapeutic decision. FDG-PET scans performed at restaging were negative in 16 cases (72%) and positive in the remaining 6 cases (28%). In 13/16 (81%) negative cases CECT was concordant and showed a complete remission, while in the remaining 3 cases CECT showed a residual nodal disease. In the 6 FDG-PET positive cases, CECT was as follows: abnormal in the same site of FDG-PET in 1 case, abnormal in fewer sites than FDG-PET in 3 cases and abnormal in more sites than FDG-PET in 2 cases. With a median follow-up of 32 months, the median overall survival (OS) of the 6 positive FDG-PET cases at restaging was 26 months. With a median follow-up of 23 months, the median OS of the 16 negative FDG-PET cases at restaging was not reached. Conclusion: FDG-PET can be useful in the initial staging of T-cell NHL, since it can allow a more accurate disease extension evaluation: in our experience it could identify additional sites, both nodal and extra-nodal, in 70% of pts. A change in clinical stage according to FDG-PET was observed in 50% of cases, with an upstaging in the majority of pts. We could confirm the high sensitivity of baseline FDG-PET in T-cell NHL. A high level of concordance was observed between PET and CECT at restaging. However, independently on CECT result, the worse OS of FDG-PET positive cases confirms the role of FDG-PET as prognostic factor for survival. Larger prospective trials are needed to confirm the utility of FDG-PET in baseline staging, reassessment after chemotherapy and treatment planning. Disclosures: No relevant conflicts of interest to declare.

F-18 Fluorodeoxyglucose Positron Emission Tomography in the Evaluation of Distant Metastases From Renal Cell Carcinoma

2003 ◽  
Vol 21 (21) ◽  
pp. 3995-4000 ◽  
Author(s):  
Navneet S. Majhail ◽  
Jean-Luc Urbain ◽  
Justin M. Albani ◽  
Mangesh H. Kanvinde ◽  
Thomas W. Rice ◽  
...  
Keyword(s):  
Positron Emission Tomography ◽  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Fdg Pet ◽  
Renal Cell ◽  
Imaging Modality ◽  
False Negative ◽  
Distant Metastases ◽  
Emission Tomography ◽  
Positron Emission

Purpose: We conducted a study to evaluate the role of F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) in the detection of distant metastases from renal cell carcinoma (RCC). Materials and Methods: Twenty-four patients with histologically proven clear-cell RCC undergoing surgical evaluation for possible resection of recurrent disease were investigated. All patients had suspected distant metastases based on conventional anatomic imaging techniques (computed tomography and magnetic resonance imaging). A total of 36 distant metastatic sites were identified. Pathology for all sites was obtained by biopsy or after surgical resection. Results: Histologically documented distant metastases from RCC were present in 33 sites (21 patients). Overall sensitivity, specificity, and positive predictive value of FDG-PET for the detection of distant metastases from RCC was 63.6% (21 of 33), 100% (three of three), and 100% (21 of 21), respectively. The mean size of distant metastases in patients with true-positive FDG-PET was 2.2 cm (95% CI, 1.7 to 2.6 cm) compared with 1.0 cm in patients with false-negative FDG-PET (95% CI, 0.7 to 1.4 cm; P = .001). Conclusion: FDG-PET is not a sensitive imaging modality for the evaluation of metastatic RCC and may not adequately characterize small metastatic lesions. However, positive FDG-PET is predictive for the presence of RCC in lesions imaged, may complement anatomic radiologic imaging modalities, and may alleviate the need for a biopsy in selected situations. A negative FDG-PET, however does not rule out active malignancy.

Role of 18- Fluoro Deoxyglucose Positron Emission Tomography in Children with Leukemia

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 5605-5605
Author(s):  
Zühre Kaya ◽  
Özgür Akdemir ◽  
Ulker Kocak ◽  
Idil Yenicesu ◽  
Turkiz Gürsel
Keyword(s):  
Positron Emission Tomography ◽  
Fdg Pet ◽  
Disease Status ◽  
Pet Scan ◽  
Emission Tomography ◽  
Pediatric Leukemia ◽  
Positron Emission ◽  
Fdg Pet Scan ◽  
Pet Scans

Abstract Introduction 18-Fluoro deoxyglucose positron emission tomography (FDG-PET) is a noninvasive imaging tool for initial staging and evaluation of treatment response in several malignancy. Role of FDG-PET scan is extensively studied for lymphoma and recently findings were incorporated into the response criteria but there is lack of data for pediatric leukemia in this field. The purpose of this study was to evaluate the role of FDG-PET for disease status, for determining the effect of therapy and predicting the prognosis of pediatric leukemia. Methods We retrospectively reviewed the results of FDG-PET in 20 leukemic children treated in our department from 2005 to 2015. Whole body PET scans were performed at initial diagnosis in only two patients (2 ALL), after the first line therapy in 3 patients (3 ALL), at relapse in 6 patients (5 lymphoma-leukemia, 1 ALL) and in 9 patients following allogeneic stem cell transplantation (Allo-SCT) (5 AML, 4 ALL) for evaluation of disease status. Maximum standardized uptake values (SUVmax) were used to assess the results of FDG-PET scan. All data were analysed by SPSS 15.0 programme. Results Twenty patients were enrolled in our study, 14 boys and 6 girls. Median age was 11 years (range 2 -17). Treatment response was evaluated with FDG-PET in consecutive 20 patients and 9 were negative PET scan. From these patients, two showed relapsed in a median of 20 months after their negative scan and one with surgically removed chloroma lesion was also negative PET scan. The other six patients were in complete remmision. The remaining 11 patients were positive PET scan, which was multifocal bone marrow (BM) lesions in 3 patients after allo-SCT, diffuse BM involvement in 2 patients at diagnosis and either multifocal different area (spleen, kidney, BM) or diffuse BM lesions in 6 patients at relapse. SUVmax value was significantly higher in patients with multifocal lesions (8.6±3.2) than those of patients with diffuse involvement (3.4±0.9) (p<0.05). However, only three cases showed discordant results on FDG-PET and BM biopsy following allo-SCT. These three cases with negative BM biopsy had multifocal BM lesions in PET scan simultaneously but later developed BM relapse in a median of 2 months after positive scan. Their PET scans after salvage chemotherapy were negative. Event free survival of the PET negative groups (55.6%) were insignificantly better than those of PET positive groups (18.2%) (p>0.05). Conclusions To our knowledge, there are no previous studies associated with FDG-PET values in children with leukemia. Although our results should be confirmed in a prospective study in a large number of patients, we believe that FDG-PET value may guide physicians to show multifocal BM lesions for possible early relapse, even if BM examination indicate normal and thus it may also be helpful to identify high risk leukemic patients who need a more intensive treatment approach. Disclosures No relevant conflicts of interest to declare.

Brain FDG PET for the Etiological Diagnosis of Clinically Uncertain Cognitive Impairment During Delirium in Remission

2020 ◽  
Vol 77 (4) ◽  
pp. 1609-1622
Author(s):  
Franziska Mathies ◽  
Catharina Lange ◽  
Anja Mäurer ◽  
Ivayla Apostolova ◽  
Susanne Klutmann ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Fdg Pet ◽  
False Negative ◽  
Ground Truth ◽  
Etiological Diagnosis ◽  
Geriatric Unit ◽  
Positron Emission ◽  
The Brain ◽  
Hospitalized Geriatric Patients

Background: Positron emission tomography (PET) of the brain with 2-[F-18]-fluoro-2-deoxy-D-glucose (FDG) is widely used for the etiological diagnosis of clinically uncertain cognitive impairment (CUCI). Acute full-blown delirium can cause reversible alterations of FDG uptake that mimic neurodegenerative disease. Objective: This study tested whether delirium in remission affects the performance of FDG PET for differentiation between neurodegenerative and non-neurodegenerative etiology of CUCI. Methods: The study included 88 patients (82.0±5.7 y) with newly detected CUCI during hospitalization in a geriatric unit. Twenty-seven (31%) of the patients were diagnosed with delirium during their current hospital stay, which, however, at time of enrollment was in remission so that delirium was not considered the primary cause of the CUCI. Cases were categorized as neurodegenerative or non-neurodegenerative etiology based on visual inspection of FDG PET. The diagnosis at clinical follow-up after ≥12 months served as ground truth to evaluate the diagnostic performance of FDG PET. Results: FDG PET was categorized as neurodegenerative in 51 (58%) of the patients. Follow-up after 16±3 months was obtained in 68 (77%) of the patients. The clinical follow-up diagnosis confirmed the FDG PET-based categorization in 60 patients (88%, 4 false negative and 4 false positive cases with respect to detection of neurodegeneration). The fraction of correct PET-based categorization did not differ between patients with delirium in remission and patients without delirium (86% versus 89%, p = 0.666). Conclusion: Brain FDG PET is useful for the etiological diagnosis of CUCI in hospitalized geriatric patients, as well as in patients with delirium in remission.

Comparison of 18F-FDG and 67Ga-citrate in sarcoidosis imaging

2008 ◽  
Vol 47 (01) ◽  
pp. 18-23 ◽  
Author(s):  
M. Wehrschuetz ◽  
B. Bisail ◽  
M. Woltsche ◽  
T. Schwarz ◽  
H. Lanz ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Complete Agreement ◽  
Pet Tracer ◽  
Positron Emission ◽  
Significant Difference ◽  
Kappa Value ◽  
18F Fdg ◽  
Primary Assessment ◽  
67Ga Citrate

SummaryAim: 67Ga citrate has been used long and successfully to diagnose and stage sarcoidosis. 18F-fluorodeoxyglucose (18F-FDG) has been suggested as a positron emission tomography (PET) tracer for sarcoidosis imaging. This study aimed to analyze possible advantages of 18F-FDG-PET over 67Ga citrate scintigraphy during the primary assessment of patients with sarcoidosis. Patients and methods: Twentyfour patients (11 men, 13 women, aged 52 years ±12.4) with histologically proven sarcoidosis were investigated with 18F-FDG and 67Ga citrate. Equipment included a fullring PET scanner (ECAT EXACT HR+, Siemens/CTI, Knoxville TN, USA) and a double-headed gamma camera (ECAM, Siemens, Illinois, USA) for scintigraphy. The mean time difference between the two studies was 6.5 days (range: 5–8 days). Results: There was a significant difference in the detection of pulmonary and nonpulmonary sarcoidosis lesions between planar 67Ga citrate scans and 18F-FDG-PET images (<0.0021). A total of 64 lesions were detected with 67Ga citrate scans in the thorax and elsewhere with a mean of 2.6 lesions (4%) per patient, while 85 lesions were found with 18F-FDG-PET, with a mean of 3.5 lesions (4.1%) per patient. There was complete agreement between 18F-FDG and 67Ga citrate in thoracic manifestations in four (16.6%) patients, and in non-thoracic manifestations in five (20.8%) patients. The interobserver variability showed a kappa value of 0.79. Conclusion: 67Ga citrate and 18F-FDG are useful tracers for diagnostic evaluation of thoracic sarcoidosis. 18F-FDG seems to be more suitable for imaging the mediastinum, the bi-hilar lymph nodes, the posterior regions of the lungs and non-thoracic lesions. Further prospective studies are needed to clarify the role of both tracers in early diagnosis and staging of sarcoidosis, and to resolve questions concerning medical treatment and follow-up.

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