18-F-fluorodeoxyglucose-positron emission tomography as a new approach to detect lymphomatous bone marrow.

1998 ◽  
Vol 16 (2) ◽  
pp. 603-609 ◽  
Author(s):  
F Moog ◽  
M Bangerter ◽  
J Kotzerke ◽  
A Guhlmann ◽  
N Frickhofen ◽  
...  

PURPOSE Bone marrow involvement in patients with malignant lymphoma is considered a sign of generalized disease with less favorable prognosis. Bone marrow biopsy (BMB), which represents the standard diagnostic procedure, however, is associated with a high rate of false-negative findings, which may lead to errors in management. The present study was undertaken to investigate the efficacy of positron emission tomography (PET) with 18-F-fluorodeoxyglucose (FDG-PET) as a new method to evaluate bone marrow involvement in patients with malignant lymphoma. METHODS Seventy-eight consecutive, untreated patients with either non-Hodgkin's lymphoma (NHL; n = 39) or Hodgkin's disease (HD; n = 39) were prospectively evaluated. Static FDG-PET imaging was performed following application of 270 MBq (F-18)-FDG. Attenuation correction was performed in 63 of 78 patients. Visual evaluation was performed by two examiners unaware of the clinical data. Material for BMB (70 bilateral, 8 unilateral) was obtained from the posterior iliac crest. Discordant results of PET and biopsy were settled, when possible, on the basis of further biopsy or magnetic resonance imaging (MRI). RESULTS In addition to seven concordant positive and 57 concordant negative findings, biopsy revealed another four cases with bone marrow involvement not detectable by FDG-PET analysis (+5.1%). On the contrary, PET showed bone marrow areas of intensive FDG uptake that suggested bone marrow lymphoma in 10 patients with negative biopsies (+12.8%). In eight patients, FDG-PET findings were confirmed by either histologic verification (n = 4), MRI (n = 2), polymerase chain reaction (PCR) for rearranged immunoglobulin H sequences (n = 1), or clinical presentation (n = 1). Two cases remained unresolved. CONCLUSION The results indicate that FDG-PET has a high potential to detect bone marrow involvement in malignant lymphoma. Besides confirming lesions found at BMB, FDG-PET provided additional information, which, in eight of 78 patients (10.3%), led to an upgrade of the tumor stage.

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Miao Chen ◽  
Wenjia Zhu ◽  
Jianhua Du ◽  
Chen Yang ◽  
Bing Han ◽  
...  

AbstractThe optimal method of tumor burden evaluation in newly diagnosed multiple myeloma (NDMM) is yet to be determined. This study aimed to compare the value of 11C-acetate positron-emission tomography (PET)/computed tomography (CT) (AC-PET and 18F-fluorodeoxyglucose PET/CT (FDG-PET) in the assessment of tumor burden in NDMM. This study evaluated 64 NDMM patients between February 2015 and July 2018. AC-PET and FDG-PET were used to assess myeloma lesions. The clinical data, imaging results, and their correlations were analyzed. Diffuse bone marrow uptake in AC-PET was significantly correlated with biomarkers for tumor burden, including serum hemoglobin (P = 0.020), M protein (P = 0.054), the percentage of bone marrow plasma cells (P < 0.001), and the Durie–Salmon stage of the disease (P = 0.007). The maximum standard uptake value (SUVmax) of focal lesions and high diffuse bone marrow uptake in AC-PET showed stronger correlations with high-risk disease (P = 0.017, P = 0.013) than those in FDG-PET. Moreover, the presence of diffuse bone marrow uptake, more than ten focal lesions, and an SUVmax of focal lesions of > 6.0 in AC-PET, but not in FDG-PET, predicted a higher probability of disease progression and shorter progression-free survival (P < 0.05). AC-PET outperformed FDG-PET in tumor burden evaluation and disease progression prediction in NDMM.


2021 ◽  
Vol 10 (24) ◽  
pp. 5979
Author(s):  
Janet Denise Reed ◽  
Andries Masenge ◽  
Ane Buchner ◽  
Fareed Omar ◽  
David Reynders ◽  
...  

Lymphoma is the third most common paediatric cancer. Early detection of high-risk patients is necessary to anticipate those who require intensive therapy and follow-up. Current literature shows that residual tumor avidity on PET (Positron Emission Tomography) following chemotherapy corresponds with decreased survival. However, the value of metabolic parameters has not been adequately investigated. In this retrospective study, we aimed to evaluate the prognostic value of metabolic and other parameters in paediatric and adolescent Hodgkin lymphoma. We recorded tMTV (total Metabolic Tumor Volume), TLG (Total Lesion Glycolysis), and SUVmax (maximum Standard Uptake Value) on baseline PET, as well the presence of bone marrow or visceral involvement. HIV (human immunodeficiency virus) status and baseline biochemistry from clinical records were noted. All patients received stage-specific standard of care therapy. Response assessment on end-of-treatment PET was evaluated according to the Deauville criteria. We found that bone marrow involvement (p = 0.028), effusion (p < 0.001), and treatment response (p < 0.001) on baseline PET, as well as HIV status (p = 0.036) and baseline haemoglobin (p = 0.039), were significantly related to progression-free survival (PFS), whereas only effusion (p = 0.017) and treatment response (p = 0.050) were predictive of overall survival (OS). Only baseline tMTV predicted treatment response (p = 0.017). This confirms the value of F-18 FDG PET/CT (Fluoro-deoxy-glucose Positron Emission Tomography/Computed Tomography) in prognostication in paediatric and adolescent Hodgkin lymphoma; however, further studies are required to define the significance of metabolic parameters.


2001 ◽  
Vol 40 (01) ◽  
pp. 23-30 ◽  
Author(s):  
U. Fabry ◽  
J. Neuerburg ◽  
M. Zimny ◽  
R. Bares ◽  
R. Osieka ◽  
...  

Summary Aim: To evaluate the prognostic significance of positron emission tomography (PET) using fluorine-18-[2]-fluoro-2-deoxyglucose (FDG) in patients treated for Hodgkin’s disease (HD) or nori-Hodgkin’s lymphoma (NHL) compared to conventional restaging (CRS). Methods: Fifty-six patients with either HD (ç = 22), high-grade NHL (n = 26) or centrocyfic-centroblastic NHL (n = 8) were included. PET was performed in 41 patients for treatment reevaluation up to three months after therapy and in patients with persisting residual masses (n = 10) or suspected relapse (n = 5) four to twelve months after treatment. The scans were evaluated qualitatively and quantitatively using standardised uptake values (SUV). Progression-free survival (PFS) was estimated to assess the prognostic value of FDG PET and clinical follow-up was taken as gold standard. Results: PET was positive in nineteen of 41 patients studied for treatment reevaluation. Progression was observed after a median interval of two months (range 0-15) in sixteen of 19 patients after a positive PET scan and in three of 22 patients after a negative scan (p <.001). Median duration of follow-up in progression-free patients was 21 months (range 6-72). In patients with a partial remission in CRS progression was more common in PET-positive than in PET-negative patients (5 of 7 vs. 1 of 14; ñ <.01) and positivity with PET was associated with poorer PFS (p <.0025). PET studies performed four to twelve months after treatment were true negative in seven, true positive in five and false-positive in three patients. SUV > 11.35 of lymphoma lesions was associated with poorer PFS than SUV <11.35 (p <0.025). Conclusion: We conclude that FDG PET after treatment of malignant lymphoma has a high prognostic value and should be recommended in patients with persistence of residual masses.


Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 4738-4738
Author(s):  
Masaaki Takatoku ◽  
Takahiro Nagashima ◽  
Toshihiko Sato ◽  
Tadashi Nagai ◽  
Norio Komatsu ◽  
...  

Abstract Usefulness of FDG-PET (positron emission tomography) in the discrimination between hypoplastic myelodysplastic syndromes and aplastic anemia Masaaki Takatoku, MD PhD1, Takahiro Nagashima, MD*1, Toshihiko Sato, MD*2, Tadashi Nagai, MD PhD1, Norio Komatsu, MD PhD1, Keiya Ozawa, MD PhD1 1Division of Hematology, Department of Medicine, Jichi Medical School, Minamikawachi, Tochigi, Japan; 2Utsunomiya Central Clinic, Utsunomiya, Tochigi, Japan It is sometimes difficult to distinguish hypoplastic myelodysplastic syndromes (MDS) from aplastic anemia (AA) using current diagnostic methods, such as bone marrow pathology and chromosome analysis. Although magnetic resonance imaging (MRI) is useful for diagnosis of MDS with hypercellular marrow, it is not easy to discriminate between hypoplastic MDS and AA using this method, because the high intensity pattern on T1 enhanced image is similar in these disorders. Recently, quantitative imaging with fluorine-18 fluorodeoxyglucose (FDG) PET has been recognized as a useful method for the discrimination between benign and malignant regions in various conditions. Because the decrease in the FDG-uptake at the late phase is much slower in malignant region than in benign region, dual time point imaging provides more accurate information than single time point scanning. In this study, we investigated the usefulness of dual time protocol FDG-PET in the differential diagnosis of hypoplastic MDS and AA. Six patients [2 with AA, 4 with MDS (including one hypoplastic MDS)] and 30 healthy adults agreed to participate in this study. Bone marrow biopsy, FDG- PET, MRI, and computed tomography (CT) were carried out, and a PET functional image was integrated into a CT anatomical image. The spine, femur and sternum lesions were detected by their increased 18F-FDG uptake at 60 and 120 min after injection of 0.12 mCi/kg of 18F-FDG. The maximum and mean lesional standardized uptake values (SUVmax and SUVmean) after 60 and 120 min were determined. The median SUVmax and SUVmean values of normal lumbar regions at 60 min were 1.94 ± 0.16 and 1.77 ± 0.11, respectively. In the MDS cases, those values at 60 min were 2.39 (range 2.12–2.72) and 2.06 (range 1.91–2.23), respectively. At 120 min, the median SUVmax and SUVmean values of normal cases were 1.33 ± 0.21 and 1.20 ± 0.16, respectively, whereas those of MDS cases were 2.42 (range 2.08–2.78) and 2.14 (range 1.50–2.26), respectively. Thus, the SUVmax and SUVmean values in MDS cases remained at high levels at 120 min in contrast to the decreased levels in normal cases. It is noteworthy that the SUVmax and SUVmean values of a hypoplastic MDS case were also high (2.21 and 2.01 at 60 min, 2.16 and 1.97 at 120 min), suggesting that bone marrow in MDS has a hyper metabolic state of glucose like other malignant disorders. We also observed patchy hot areas, which may be a visualization of ineffective hematopoiesis, throughout the spine image of hypoplastic MDS. In contrast, the SUVmax and SUVmean values of AA cases were 1.82 and 1.66 at 60 min and 1.31 and 1.19 at 120 min (case 1), 1.69 and 1.61 at 60 min and 1.30 and 1.13 at 120 min (case 2), indicating that there is no difference in the SUVmax and SUVmean values at the both time points between AA and normal cases. These results raised the possibility that the discrimination between hypoplastic MDS and AA, in which MRI shows a common observation, can be made using FDG-PET.


1999 ◽  
Vol 84 (7) ◽  
pp. 2291-2302 ◽  
Author(s):  
Weiping Wang ◽  
Homer Macapinlac ◽  
Steven M. Larson ◽  
Samuel D. J. Yeh ◽  
Timothy Akhurst ◽  
...  

Progressive dedifferentiation of thyroid cancer cells leads to a loss of iodine-concentrating ability, with resultant false negative, whole body radioactive iodine scans in approximately 20% of all differentiated metastatic thyroid cancer lesions. We tested the hypothesis that all metastatic thyroid cancer lesions that did not concentrate iodine, but did produce thyroglobulin (Tg), could be localized by [18F]2-fluoro-2-deoxy-d-glucose (FDG)-positron emission tomography (PET). We performed FDG-PET on 37 patients with differentiated thyroid cancer after surgery and radioiodine ablation who had negative diagnostic 131I whole body scans during routine follow-up. Serum Tg, Tg autoantibodies, neck ultrasounds, and other clinically indicated imaging procedures were performed to detect residual disease. In those with elevated Tg levels, FDG-PET localized occult disease in 71%, was false positive in one, and was false negative in five patients. The majority of false negative FDG-PET occurred in patients with minimal cervical adenopathy. Surgical resections, biopsies, 131I therapy, and differentiation therapy were performed based on the PET results. The FDG-PET result changed the clinical management in 19 of the 37 patients. In patients with elevated Tg levels, FDG-PET had a positive predictive value of 92%. In patients with low Tg levels, FDG-PET had a negative predictive value of 93%. No FDG-PET scans were positive in stage I patients; however, they were always positive in stage IV patients with elevated Tg levels. An elevated TSH level (i.e. hypothyroidism) did not increase the ability to detect lesions. FDG-PET is able to localize residual thyroid cancer lesions in patients who have negative diagnostic 131I whole body scans and elevated Tg levels, although it was not sensitive enough to detect minimal residual disease in cervical nodes.


Respiration ◽  
2010 ◽  
Vol 79 (1) ◽  
pp. 25-31 ◽  
Author(s):  
Nicolas de Prost ◽  
Khaldoun Kerrou ◽  
Mathilde Sibony ◽  
Jean-Noël Talbot ◽  
Marie Wislez ◽  
...  

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