J 2008

Value of [F-18]fluorodeoxyglucose positron emission tomography in the management of follicular lymphoma: The end of a dilemma?

JANÍKOVÁ, Andrea, Karol BOLČÁK, Tomáš PAVLÍK, Jiří MAYER, Zdeněk KRÁL et. al.

Basic information

Original name

Value of [F-18]fluorodeoxyglucose positron emission tomography in the management of follicular lymphoma: The end of a dilemma?

Name in Czech

Význam FDG PET v léčbě folikulárního lymfomu. Konec dilematu?

Name (in English)

Value of [F-18]fluorodeoxyglucose positron emission tomography in the management of follicular lymphoma: The end of a dilemma?

Authors

JANÍKOVÁ, Andrea (203 Czech Republic, guarantor), Karol BOLČÁK (203 Czech Republic), Tomáš PAVLÍK (203 Czech Republic), Jiří MAYER (203 Czech Republic) and Zdeněk KRÁL (203 Czech Republic)

Edition

CLINICAL LYMPHOMA & MYELOMA, 2008, 1557-9190

Other information

Language

Czech

Type of outcome

Článek v odborném periodiku

Field of Study

30200 3.2 Clinical medicine

Country of publisher

Czech Republic

Confidentiality degree

není předmětem státního či obchodního tajemství

Impact factor

Impact factor: 1.596

RIV identification code

RIV/00216224:14110/08:00034559

Organization unit

Faculty of Medicine

UT WoS

000260006700004

Keywords (in Czech)

nehodgkinský lymfom; přesná diagnostika; F-18-FDG; klasifikace; PET; transplantace

Keywords in English

NON-HODGKINS-LYMPHOMA; DIAGNOSTIC-ACCURACY; RESPONSE CRITERIA; WHOLE-BODY; PET; TRANSPLANTATION; CLASSIFICATION; F-18-FDG; INDOLENT; THERAPY

Tags

Reviewed
Změněno: 1/4/2010 09:24, RNDr. Tomáš Pavlík, Ph.D.

Abstract

V originále

[F-18]Fluorodeoxyglucose (FDG) positron emission tomography (PET) is a powerful tool for the imaging of various lymphomas. Despite its high FDG avidity, there is little data on PET in follicular lymphoma (FL). In this work, we present findings concerning PET at staging and posttreatment evaluation in FL. Patients and Methods: A total of 181 PET scans were evaluated in 117 patients with FL in a retrospective study. Positron emission tomography-based results were compared with conventional staging in 82 patients. Posttreatment PET evaluation was performed in 99 patients; there were comparable progression-free survivals of PET-positive and PET-negative patients. Results: Positron emission tomography showed more involvement than computed tomography (CT) with clinical examination in 41 of 82 patients (50%), less in 11 of 82 (13%); the same extension was found in 27 of 82 patients (33%), and 3 patients revealed discordant foci visible on PET only and lymphadenopathy without PET activity (P < .001). Including the results of trephine biopsy, PET finally upstaged FL in 15 of 82 patients (18%), which was projected in change of treatment strategy. There were 73 of 99 negative posttreatment PET scans; 54 of 73 PET-negative patients (74%) remain in complete remission (median follow-up, 27 months); 19 (26%) of them relapsed with median of 12 months. Fourteen of 20 (70%) PET-positive patients relapsed with a median of 4.5 months regardless of findings on CT and subsequent therapy. The difference in relapse rates between PET-positive and PET-negative patients is statistically significant (P < .001). Conclusion: Positron emission tomography at staging is able to substantially change treatment strategy in an important proportion of patients with FL. Persisting PET positivity after treatment predicts for a high risk of an early relapse and can identify patients with poor prognosis.

In English

[F-18]Fluorodeoxyglucose (FDG) positron emission tomography (PET) is a powerful tool for the imaging of various lymphomas. Despite its high FDG avidity, there is little data on PET in follicular lymphoma (FL). In this work, we present findings concerning PET at staging and posttreatment evaluation in FL. Patients and Methods: A total of 181 PET scans were evaluated in 117 patients with FL in a retrospective study. Positron emission tomography-based results were compared with conventional staging in 82 patients. Posttreatment PET evaluation was performed in 99 patients; there were comparable progression-free survivals of PET-positive and PET-negative patients. Results: Positron emission tomography showed more involvement than computed tomography (CT) with clinical examination in 41 of 82 patients (50%), less in 11 of 82 (13%); the same extension was found in 27 of 82 patients (33%), and 3 patients revealed discordant foci visible on PET only and lymphadenopathy without PET activity (P < .001). Including the results of trephine biopsy, PET finally upstaged FL in 15 of 82 patients (18%), which was projected in change of treatment strategy. There were 73 of 99 negative posttreatment PET scans; 54 of 73 PET-negative patients (74%) remain in complete remission (median follow-up, 27 months); 19 (26%) of them relapsed with median of 12 months. Fourteen of 20 (70%) PET-positive patients relapsed with a median of 4.5 months regardless of findings on CT and subsequent therapy. The difference in relapse rates between PET-positive and PET-negative patients is statistically significant (P < .001). Conclusion: Positron emission tomography at staging is able to substantially change treatment strategy in an important proportion of patients with FL. Persisting PET positivity after treatment predicts for a high risk of an early relapse and can identify patients with poor prognosis.

Links

MSM0021622430, plan (intention)
Name: Funkční a molekulární charakteristiky nádorových a normálních kmenových buněk - identifikace cílů pro nová terapeutika a terapeutické strategie
Investor: Ministry of Education, Youth and Sports of the CR, Functional and molecular characteristics of cancer and normal stem cells - identification of targets for novel therapeutics and therapeutic strategies