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THE QUARTERLY JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING

Rivista di Medicina Nucleare e Imaging Molecolare


A Journal on Nuclear Medicine and Molecular Imaging
Affiliated to the Society of Radiopharmaceutical Sciences and to the International Research Group of Immunoscintigraphy
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  THERAPY RESPONSE IN NUCLEAR MEDICINE
Guest Editor: Bombardieri E.


The Quarterly Journal of Nuclear Medicine 2003 Marzo;47(1):14-21

lingua: Inglese

Prognostic value of FDG-PET in malignant lymphoma

Becherer A. 1, Jaeger U. 2, Szabo M. 1, Kletter K. 1

1 Depart­ments of ­Nuclear Med­i­cine and
2 Internal Med­i­cine I, Division of Hae­ma­tology and Hae­mos­tas­e­ology Uni­ver­sity of ­Vienna, Med­ical ­School, ­Vienna, Aus­tria


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Lym­phomas ­have rep­re­sented an indi­ca­tion for ­nuclear med­i­cine inves­ti­ga­tions for 30 ­years. Gal­lium-67 scintigraphy has ­been ­shown to be a val­u­able com­ple­men­tary ­method in ­Hodgkin’s dis­ease and non-­Hodgkin lym­phoma for ­detecting ­viable ­residual ­lesions ­after chem­o­therapy and for diag­nosis of a ­relapse. Thal­lium-201 is of ­interest in dif­fer­en­tiating cere­bral lym­phomas ­from infec­tious ­lesions in ­AIDS ­patients but ­less ­useful in ­extra-cere­bral lym­phomas. PET ­with flu­o­rine-18-FDG is ­more accu­rate ­than 67Ga in lym­phoma. In ­patients ­with a pos­i­tive PET ­scan ­after chem­o­therapy an ­early ­relapse ­occurs in up to 100%, ­while ­more ­than 80% of ­patients ­with a neg­a­tive PET ­will ­have a ­long-­term remis­sion. ­Most ­studies ­show ­that FDG-PET is sig­nif­i­cantly cor­re­lated ­with ­patient out­come ­whereas ­there is ­much ­weaker or ­even no cor­re­la­tion for CT. The ­main ­reason is ­that PET is not ­bound to mor­pho­log­ical cri­teria ­like ­lymph ­node ­size ­while CT is ­often not ­able to dif­fer­en­tiate ­between ­residual ­tumour and ­post-ther­a­peutic ­fibrosis. There­fore, ­based on a con­sid­er­able ­number of clin­ical ­studies, FDG-PET ­gains ­increasing sig­nif­i­cance for ­staging, ­restaging and ­therapy mon­i­toring in malig­nant lym­phomas.

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