Subscribe to RSS
DOI: 10.1055/s-0038-1625326
18F-FDG PET and conventional imaging for assessment of Hodgkin’s disease and non Hodgkin’s lymphoma
An analysis of 193 patient studies 18F-FDG-PET und konventionelle Bildgebung zur Diagnostik von Morbus Hodgkin und Non-Hodgkin-LymphomenAnalyse von 193 Patienten StudienPublication History
Received:
26 September 2005
07 December 2005
Publication Date:
12 January 2018 (online)
![](https://www.thieme-connect.de/media/10.1055-s-00034924/200603/lookinside/thumbnails/10-1055-s-0038-1625326_de-1.jpg)
Summary
The aim of this study was to assess the diagnostic value of FDG-PET and conventional imaging (CI) in a large series of patient with Hodgkin’s disease (HD) or non-Hodgkin’s lymphoma (NHL) at three time points during their course of disease. Patients, methods: 169 consecutive lymphoma patients (69 HD; 100 NHL) were included. 193 FDG-PET studies were performed for staging at baseline in 42 cases, for post-therapeutic monitoring in 103, and for diagnosis of recurrence in 48 cases. Performance indices of sensitivity, specificity, positive (PPV) and negative predictive value (NPV), and accuracy of metabolic FDG-PET and morphological CI were calculated. Differences in staging and diagnosis of residual or recurrent lymphoma were compared. Results: FDG-PET changed staging in 36% of cases for staging at baseline, in 52% of cases for monitoring response to treatment, and in 29% for diagnosis of recurrence. FDG-PET staging results were confirmed in 80% for staging at baseline, in 74% for monitoring response to treatment, and in 50% for diagnosis of recurrence. FDGPET and CI differed significantly at monitoring response to treatment for sensitivity (0.91 versus 0.69; p<0.02), specificity (0.90 versus 0.38; p<0.00001), PPV (0.77 versus 0.42; p<0.001), and accuracy (0.83 versus 0.55; p<0.02). Conclusion: FDG-PET should be considered as the diagnostic modality of choice for post-therapeutic assessment of lymphoma patients and may be a reliable alternative to CI for staging at baseline and diagnosis of recurrence.
Zusammenfassung
Ziel: Die Studie untersucht den diagnostischen Wert von FDG-PET und konventioneller Bildgebung (CI) in einer großen Patientenserie mit Morbus Hodgkin (HD) oder Non- Hodgkin Lymphom (NHL) zu drei Zeitpunkten während des Krankheitsverlaufs. Patienten, Methoden: 169 Lymphom- Patienten (69 HD; 100 NHL) wurden in die Studie eingeschlossen. 193 FDG-PET Untersuchungen wurden zu drei verschiedenen Zeitpunkten durchgeführt: 42 Untersuchungen zum Primärstaging, 103 zum posttherapeutischen Staging, und 48 zum Rezidivstaging. Die diagnostische Wertigkeit von FDG-PET und CI wurde anhand von Sensitivität, Spezifität, positiv (PPV) und negativ prädiktivem Wert (NPV) sowie der Treffsicherheit berechnet. Unterschiede beim Staging sowie bei der Diagnose von residuellen oder rezidivierenden Lymphomen wurden miteinander verglichen. Ergebnisse: FDG-PET führte zu Änderung des Stagings in 36% der Fälle beim Primärstaging, in 52% der Fälle beim posttherapeutischen Staging und in 29% beim Rezidivstaging. Ergebnisse des Stagings durch die FDG-PET wurden in 80% beim Primärstaging, in 74% beim posttherapeutischen Staging und in 50% beim Rezidivstaging bestätigt. Signifikante Differenzen zwischen FDG-PET und CI zeigten sich beim posttherapeutischen Staging hinsichtlich der Sensitivität (0,91 versus 0,69; p <0,02), der Spezifität (0,90 versus 0,38; p <0,00001), des PPV (0,77 versus 0,42; p <0,001) und der Treffsicherheit (0,83 versus 0,55; p <0,02). Schlussfolgerung: FDG-PET sollte als Methode der Wahl beim posttherapeutischen Staging von Lymphom-Patienten erwogen werden. Darüber hinaus erscheint die FDG-PET eine sinnvolle Alternative zur konventionellen Bildgebung beim Primär- und Rezidivstaging zu sein. Correspondence to: Jan Bucerius, MD Department of Nuclear Medicine University Hospital of Bonn Sigmund-Freud-Straße 25 53105 Bonn, Germany Tel. +49/(0)2 28/2 87–51 81, Fax –90 96 E-mail: jan.bucerius@ukb.uni-bonn.de
-
References
- 1 Bangerter M, Moog F, Buchmann I. et al. Wholebody 2-18F-fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) for accurate staging of Hodgkin’s disease. Ann Oncol 1998; 9: 1117-22.
- 2 Buchmann I, Reinhardt M, Elsner K. et al. 2-(fluorine- 18)fluoro-2-deoxy-D-glucose positron emission tomography in the detection and staging of malignant lymphomas. Cancer 2001; 91: 889-99.
- 3 Canellos GP. Residual mass in lymphoma may not be residual disease. J Clin Oncol 1988; 6: 931-3.
- 4 Carbone PP, Kaplan HS, Musshoff K. et al. Report of the Committee on Hodgkin’s Disease Staging Classification. Cancer Res 1971; 31: 1860-1.
- 5 Clouse ME, Harrison DA, Grassi CJ. et al. Lymphangiography, ultrasonography, and computed tomography in Hodgkin’s disease and non-Hodgkin’s lymphoma. J Comput Tomo 1985; 9: 1-8.
- 6 Coiffier B, Gisselbrecht C, Vose JM. et al. Prognostic factors in aggressive malignant lymphomas: description and validation of a prognostic index that could identify patients requiring a more intensive therapy. The Groupe d‘Etudes des Lymphomes Agressifs. J Clin Oncol 1991; 9: 211-9.
- 7 Cremerius U, Fabry U, Kroll U. et al. Clinical value of FDG PET for therapy monitoring of malignant lymphomas – results of a retrospective study of 72 patients. Nuklearmedizin 1999; 38: 24-30.
- 8 De Wit M, Bohuslavizki KH, Buchert R. et al. 18FDG-PET following treatment as valid predictor for disease-free survival in Hodgkin’s lymphoma. Ann Oncol 2001; 12: 29-37.
- 9 Gambhir SS, Czernin J, Schwimmer J. et al. A tabulated summary of the FDG PET literature. J Nucl Med 2001; 42: 1S-93S.
- 10 Glenn LD, Kumar PP. The residual mediastinal mass following radiation therapy for Hodgkin’s disease. Am J Clin Oncol 1991; 14: 16-24.
- 11 Guay C, Lepine M, Verreault J. et al. Prognostic value of PET using 18F-FDG in Hodgkin’s disease for posttreatment evaluation. J Nucl Med 2003; 44: 1225-31.
- 12 Guppy AE, Tebbutt NC, Norman A. et al. The role of surveillance CT scans in patients with diffuse large B-cell non-Hodgkin’s lymphoma. Leuk Lymphoma 2003; 44: 123-5.
- 13 Harris NL, Jaffe ES, Diebold J. et al. World Health Organization Classification of neoplastic diseases of the hematopoietic and lymphoid tissues. Report of the Clinical Advisory Committee Meeting. Airlie House, Virginia, November 1997. J Clin Oncology 1999; 17: 3835-49.
- 14 Hermann S, Wormanns D, Pixberg M. et al. Staging in childhood lymphoma. Differences between FDG-PET and CT. Nuklearmedizin 2005; 44: 1-7.
- 15 Hicks RJ, Mac Manus MP, Seymour JF. Initial staging of lymphoma with positron emission tomography and computed tomography. Sem Nucl Med 2005; 35: 165-76.
- 16 Hoh CK, Glaspy J, Rosen P. et al. Whole-body FDG-PET imaging for staging of Hodgkin’s disease and lymphomas. J Nucl Med 1997; 38: 343-8.
- 17 Israel O, Front D, Lam M. et al. Gallium 67 imaging in monitoring lymphoma response to treatment. Cancer 1988; 61: 2439-43.
- 18 Jerusalem G, Beguin Y, Fassotte MF. et al. Early detection of relapse by whole-body positron emis- sion tomography in the follow-up of patients with Hodgkin’s disease. Ann Oncol 2003; 14: 123-30.
- 19 Jerusalem G, Warland V, Najjar F. et al. Wholebody 18FDG-PET for the evaluation of patients with Hodgkin’s disease and non-Hodgkin’s lymphoma. Nucl Med Commun 1999; 20: 13-20.
- 20 Jochelson M, Mauch P, Balikian J. et al. The significance of the residual mediastinal mass in treated Hodgkin’s disease. J Clin Oncol 1985; 3: 637-40.
- 21 Kostakoglu L, Goldsmith SJ. Fluorine-18 fluorodeoxyglucose positron emission tomography in the staging and follow-up of lymphoma: is it time to shift gears?. Eur J Nucl Med 2000; 27: 1564-78.
- 22 Lister TA, Crowther D, Sutcliffe SB. et al. Report of a committee convened to discuss the evaluation and staging of patients with Hodgkin’s disease: the Cotswold meeting. J Clin Oncol 1989; 7: 1630-6.
- 23 Moog F, Bangerter M, Diederichs CG. et al. Lymphoma: role of whole-body 2-deoxy-2-[F-18]fluoro- D-glucose (FDG) PET in nodal staging. Radiology 1997; 203: 795-800.
- 24 Moog F, Bangerter M, Kotzerke J. et al. 18F-fluorodeoxyglucose- positron emission tomography as a new approach to detect lymphomatous bone marrow. J Clin Oncol 1998; 16: 603-9.
- 25 Moog F, Bangerter M, Diederichs CG. et al. Extranodal malignant lymphoma: detection with FDGPET versus CT. Radiology 2003; 206: 475-81.
- 26 Munker R, Stengel A, Stabler A. et al. Diagnostic accuracy of ultrasound and computed tomography in the staging of Hodgkin’s disease. Verification by laparotomy in 100 cases. Cancer 1995; 76: 1460-6.
- 27 Newman JS, Francis IR, Kaminski MS. et al. Imaging of lymphoma with PET with 2-[F-18]-fluoro- 2-deoxy-D-glucose: correlation with CT. Radiology 1994; 190: 111-6.
- 28 Radford JA, Cowan RA, Flanagan M. et al. The significance of residual mediastinal abnormality on the chest radiograph following treatment for Hodgkin’s disease. J Clin Oncol 1988; 6: 940-6.
- 29 Rankin SC. Assessment of response to therapy using conventional imaging. Eur J Nucl Med Mol Imaging 2003; 30 (Suppl. 01) S56-64.
- 30 Reinhardt MJ, Ehritt-Braun C, Vogelsang D. et al. Metastatic lymph nodes in patients with cervical cancer: detection with MR imaging and FDG PET. Radiology 218: 776-82.
- 31 Schöder H, Larson SM, Yeung HWD. PET/CT in Oncology: Integration into clinical management of lymphoma, melanoma, and gastrointestinal malignancies. J Nucl Med 2004; 45: 72S-81.
- 32 Stumpe KD, Urbinelli M, Steinert HC. et al. Whole-body positron emission tomography using fluorodeoxyglucose for staging of lymphoma: effectiveness and comparison with computed tomography. Eur J Nucl Med 1998; 25: 721-8.
- 33 Surbone A, Longo DL, DeVita VT. et al. Residual abdominal masses in aggressive non-Hodgkin’s lymphoma after combination therapy: significance and management. J Clin Oncol 1988; 6: 1832-7.
- 34 Vinnicombe SJ, Reznek RH. Computerised tomography in the staging of Hodgkin’s disease and non-Hodgkin’s lymphoma. Eur J Nucl Med Mol Imaging 2003; 30 (Suppl. 01) S42-55.
- 35 Weihrauch MR, Dietlein M, Schicha H. et al. Prognostic significance of 18F-fluorodeoxyglucose positron emission tomography in lymphoma. Leuk Lymphoma 2003; 44: 15-22.
- 36 Wiedmann E, Baican B, Hertel A. et al. Positron emission tomography (PET) for staging and evaluation of response to treatment in patients with Hodgkin’s disease. Leuk Lymphoma 1999; 34: 545-51.
- 37 Zinzani P, Magagnoli M, Chierichetti F. et al. The role of positron emission tomography (PET) in the management of lymphoma patients. Ann Oncol 1999; 10: 1181-4.