18-FDG-PET as a Prognostic Indicator in the Treatment of Aggressive Non-Hodgkin's Lymphoma-Comparison with CT

Less than 50%, of newly diagnosed patients with aggressive histology Non-Hodgkin's Lymphoma (NHL) are cured with standard treatment. The ability to accurately monitor response to treatment is crucial in order to select out patients who need more intensive or salvage treatment. This study assess...

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Bibliographic Details
Published in:Leukemia & lymphoma 2000, Vol.39 (5-6), p.543-553
Main Authors: Mikhaeel, N. G., Timothy, A. R., O'Doherty, M. J., Hain, S., Maisey, M. N.
Format: Article
Language:English
Subjects:
Adult
Age Factors
Aged
Cohort Studies
Female
Fluorodeoxyglucose F18
Humans
Lymph Nodes - diagnostic imaging
Lymph Nodes - pathology
Lymphoma, Non-Hodgkin - diagnosis
Lymphoma, Non-Hodgkin - therapy
Male
Middle Aged
Non-Hodgkin's Lymphoma
PET
Predictive Value of Tests
Prognosis
Recurrence
remission assessment
Remission Induction
Retrospective Studies
Spleen - diagnostic imaging
Spleen - pathology
Tomography, Emission-Computed - methods
Tomography, X-Ray Computed
Treatment Outcome
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Summary:Less than 50%, of newly diagnosed patients with aggressive histology Non-Hodgkin's Lymphoma (NHL) are cured with standard treatment. The ability to accurately monitor response to treatment is crucial in order to select out patients who need more intensive or salvage treatment. This study assesses the accuracy of FDG-PET as compared to CT in remission assessment following treatment of aggressive NHL, and its value in estimating relapse-free survival. It also evaluates the prognostic value of early interim PET scan in prediction of treatment outcome. Forty-nine adult patients with biopsy-proven aggressive NHL between September 1993 and December 1997 were included. All patients had pre-treatment FDG-PET demonstrating increased uptake in sites of disease. Forty-five patients had a post-treatment PET to assess remission status and 4 had an interim but not a post-treatment PET. Thirty-three of these patients also had a pre- and a post-treatment CT scan. Twenty-three of the 49 patients had an interim PET during chemotherapy to assess early response. PET and CT scan results were correlated with relapse data to examine their accuracy in remission assessment and prediction of prognosis. The median follow-up duration is 30 months. Overall the result of post-treatment PET scan appears to predict diseasc outcome, with relapse rates of 100% (919) and 17% (6/36) for positive and negative PET respectively [p
ISSN:1042-8194
1029-2403
DOI:10.3109/10428190009113384