Diagnostic and Clinical Impact of Staging 18F-FDG PET/CT in Mantle-Cell Lymphoma: A Two-Center Experience.

Abstract

INTRODUCTION:

The diagnostic accuracy of fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) in staging mantle-cell lymphoma has not yet investigated. The aim of this 2-center retrospective study was to investigate the utility of 18F-FDG PET/CT in assessing nodal, splenic, bone marrow (BM), and gastrointestinal (GI) disease compared to CT, BM, and GI endoscopy; and to assess its clinical impact.

PATIENTS AND METHODS:

One hundred twenty-two patients with histologically proven mantle-cell lymphoma were included. PET/CT BM findings were considered positive if isolated/multiple focal uptake in the BM not explained by benign findings and/or diffuse BM uptake higher than liver with/without focal uptakes were present. PET/CT findings were considered positive for GI involvement in the presence of isolated/multiple focal uptake in the GI organ.

RESULTS:

All patients had positive PET/CT showing the presence of at least one hypermetabolic lesion, with the exception of one case. PET/CT results, compared to CT, detected more nodal and/or splenic lesions in 26 patients. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of PET/CT for BM were 52%, 98%, 97%, 65%, and 74%; for GI 64%, 91%, 69%, 90%, and 85%; and for GI excluding diabetic patients, 78%, 92%, 72%, 94%, and 89%. PET/CT permitted upstaging of 21 cases and downstaging of 2.

CONCLUSION:

18F-FDG PET/CT showed excellent detection rate in nodal and splenic disease-a rate better than CT. For BM and GI evaluation, in order to reach good accuracy, the selection of patients and the use of specific criteria for evaluation of these organs seems to be crucial. Moreover, PET/CT altered the management and therapeutic approach in about 20% of patients.

• Authors: Domenico Albano, Paola Ferro, Giovanni Bosio, Federico Fallanca, Alessandro Re, Alessandra Tucci, Andrés José Maria Ferreri, Piera Angelillo, Luigi Gianolli, Raffaele Giubbini, Francesco Bertagna
• Journal: Clinical lymphoma, myeloma & leukemia (Clin Lymphoma Myeloma Leuk) Vol. 19 Issue 8 Pg. e457-e464 (08 2019) ISSN: 2152-2669 [Electronic] United States
• PMID: 31129112 (Publication Type: Journal Article, Multicenter Study)
• Copyright: Copyright © 2019 Elsevier Inc. All rights reserved.

Chemical References

• Radiopharmaceuticals
• Fluorodeoxyglucose F18

Topics

• Adult
• Aged
• Aged, 80 and over
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Combined Modality Therapy
• Female
• Fluorodeoxyglucose F18 (metabolism)
• Follow-Up Studies
• Humans
• Lymphoma, Mantle-Cell (diagnostic imaging, metabolism, pathology, therapy)
• Male
• Middle Aged
• Positron Emission Tomography Computed Tomography (methods)
• Prognosis
• Radiopharmaceuticals (metabolism)
• Retrospective Studies
• Stem Cell Transplantation (mortality)
• Survival Rate