18F-FDG-PET/CT in the surveillance of patients with lymphoma: Detection of asymptomatic recurrences

• Published in: Revista Española de medicina nuclear e imagen molecular (English ed.) 2012-01, Vol.31 (1), p.22-27
• Main Authors: García Vicente, A.M., Bellón Guardia, M., Soriano Castrejón, A., Calle Primo, C., Cordero García, J.M., Palomar Muñoz, A., Pilkington Woll, J.P., Talavera Rubio, M.P., Hernández Ruiz, B.
• Format: Article
• Language: English
• Subjects: 18F-FDG; Asymptomatic recurrence; Linfoma; Lymphoma; PET-TAC; PET/CT; Recidiva asintomática; Seguimiento; Surveillance
• ISSN: 1578-200X; 2253-8089; 1578-200X; 2253-8089
• DOI: 10.1016/j.remngl.2011.04.006

To assess the diagnostic accuracy of 18F-FDG-PET/CT in detecting asymptomatic recurrences in patients with lymphoma. To define uptake patterns of recurrence indicative of recurrence. Those patients with lymphoma who fulfilled the following inclusion criteria of clinical complete remission and negative PET/CT study were included retrospectively and longitudinally. Conventional surveillance of these patients was performed only by 18F-FDG PET/CT following a standardized procedure. Pathologic locations (supra- and infradiaphragmatic) and their character (single or multiple) were analyzed in order to determine reliable metabolic patterns of recurrence. The final diagnosis was established by histopathological analysis or clinical follow-up greater than 8 months. A total of 199 explorations belonging to 106 patients with lymphoma were included. Of these patients, 59 had Hodgkin's lymphoma and 47 non-Hodgkin's lymphoma. There was suspicion of relapse from the metabolic point of view in 27 of the PET/CT scans. Of these, 14 (10 patients) were false positive (FP), and 13 (8 patients) true positive. The remaining studies were true negative, no false negatives being detected. The pattern most frequently related to recurrence was infradiaphragmatic lymph node involvement while most of the FP had isolated supradiaphragmatic involvement. Sensitivity, specificity, PPV, NPV and diagnostic accuracy of PET/CT parameters for the study were 100%, 92%, 48%, 100% and 93%, respectively. 18F-FDG-PET/CT is a sensitive technique in the detection of asymptomatic recurrences in patients with lymphoma during their follow-up. Multiple character and infradiaphragmatic locations were the patterns that best correlated to the diagnosis of recurrence. Determinar la rentabilidad diagnóstica de la PET-TAC con 18F-FDG en la detección de recidivas asintomáticas en pacientes con linfoma. Definir patrones de captación indicativos de recidiva. Se incluyeron de forma retrospectiva y longitudinal pacientes afectos de linfoma con los siguientes criterios de inclusión: remisión completa clínica con estudio PET-TAC negativo. Se realizó seguimiento convencional de estos pacientes únicamente mediante PET-TAC con 18F-FDG según técnica estándar. Se analizaron las localizaciones patológicas (supra e infradiafragmáticas) y su carácter (único o múltiple) con vistas a determinar patrones metabólicos fidedignos de recidiva. El diagnóstico final se estableció por análisis histopatológico o seguimiento clínico-radi