The Value Of¹⁸F-FDG PET/CT In Diagnosis And Treatment Of Lymphoma

Objective To evaluate the value of18F-FDG PET/CT in different histological grades andclinical stages, and prognosis in follicular lymphoma (FL) patients after first-line treatment.Methods From May2007to April2014, FL patients (13males,15females; median age55years) proved by pathology were retrospectively studied. All patients were evaluated with18F-FDG PET/CT before the fist-line treatment. According to different histological gradesand clinical stages of FL,28patients were divided into several groups, and the sensitivity,specificity and SUVmax of different groups were calculated.18F-FDG PET/CT imagingwere performed in sixteen FL patients after first-line treatment and divided into positiveand negative group according to the results of PET/CT. All the19patients were followedup6－49months to evaluate the prognosis of those patients. The rates of overall survival(OS) and progression-free survival (PFS) were calculated.Results (1)The sensitivities of PET/CT in indolent FL and aggressive FL were92.3%(12/13)and100.0%(11/11) respectively. The SUVmax was4.72±1.87and10.52±5.42(F=13.926，P=0.01);(2)The SUVmax of stage Ⅰ-Ⅱ FL and Ⅲ-Ⅳ FL was6.02±5.32and7.86±4.39(F=1.010，P=0.325)；(3)For the19FL patients who were performed PET/CTimaging after first-line treatment, the PET/CT negative group and positive group haddifferent OS and PFS. The6month-，3year-OS were100.0%（14/14）,4/5and4/5,2/3.The6month-,3year-PFS were92.8%(13/14),3/5and3/5,1/3.Conclusions18F-FDG PET/CT is valuable in evaluating FL of different histological gradesand clinical stages.18F-FDG PET/CT after fist-line treatment helps assess the prognosis ofFL patients. Objective To evaluate the value of pre-and post-transplantation18F-FDG PET-CT inprognosis of lymphoma patients undergoing hematopoietic stem cell transplantationMethods From May2007to January2014,65lymphoma patients evaluated with pre-andpost-transplantation18F-FDG PET-CT were retrospectively studied. All patients underwenthematopoietic stem cell transplantation including autologous and allogeneic hematopoieticstem cell transplantation(Auto-and Allo-HSCT). All patients were followed up6－64months or died in6months.34of65patients underwent pretransplantation18F-FDGPET-CT,31of65underwent posttransplantation18F-FDG PET-CT. The prognostic valueof PET-CT was evaluated by analysing progression-free survival (PFS) and overallsurvival(OS) using Kaplan–Meier estimates. Differences in PFS and OS betweensubgroups were assessed by P values resulting from log-rank tests.Results（1）pretransplantation18F-FDG PET-CT: For the16NHL patients who underwentAuto-HSCT pretransplantation PET-CT imaging results were strongly correlated withPFS(2=4.371，P=0.037, significant) but not OS(2=2.333，p=0.127,not significant).Patients with negative PET results had better6month-PFS ratio:94.4%（17/18）vs57.1%（4/7）（P=0.001）. All3HL patients with positive pretransplantation PET results did notshow evidence of recurrent or progressive disease. For the6NHL patients who underwentAllo-HSCT，1patient with negative pretransplantation PET results and2patients withpositive pretransplantation PET results did not show evidence of recurrent or progressivedisease.2patients with positive pretransplantation PET results progressed.1patients withpositive pretransplantation PET results died from Engraftment syndrome.（2）posttransplantation18F-FDG PET-CT: For the23lymphoma patients, including NHLand HL,who underwent Allo-HSCT posttransplantation PET-CT imaging results werestrongly correlated with PFS(2=6.471，p=0.011,significant) but not OS.Patients withnegative PET results had better6month-PFS ratio:100%（10/10）vs53.8%（7/13） （P=0.017）. For the20NHL patients who underwent Allo-HSCT posttransplantationPET-CT imaging results were strongly correlated with PFS(2=5.608，p=0.018significant)but not OS.Patients with negative PET results had better6month-PFS ratio:100%（9/9）vs63.6%（7/11）（P=0.030）.1HL patients with positive post-auto-HSCT PET results and1HL patients with negative post-auto-HSCT PET results did not show evidence ofrecurrent or progressive disease.Anothor HL patients with positive post-auto-HSCT PETresults progressed. For the8NHL patients who underwent Allo-HSCT，1patient withnegative posttransplantation PET results and3patients with positive posttransplantationPET results did not show evidence of recurrent or progressive disease.1patients had arelapse after a negtive posttransplantation PET scan.3patients with positiveposttransplantation PET results progressed.Conclusion The pre-and post-transplantation18F-FDG PET-CT helps assess the prognosisof lymphoma patients.