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The Quarterly Journal of Nuclear Medicine and Molecular Imaging 2018 Apr 24

DOI: 10.23736/S1824-4785.18.03043-1

Copyright © 2018 EDIZIONI MINERVA MEDICA

lingua: Inglese

2-deoxy-2-[18F]fluoro-D-glucose positron emission tomography/computed tomography in primary extranodal lymphomas: treatment response evaluation and prognosis

Barbara SALVATORE 1, Rosa FONTI 1 , Amalia DE RENZO 2, Sara PELLEGRINO 3, Ida L. FERRARA 4, Ciro G. MAINOLFI 3, Luana MARANO 2, Carmine SELLERI 4, Fabrizio PANE 2, Silvana DEL VECCHIO 3, Leonardo PACE 4

1 Istituto di Biostrutture e Bioimmagini, Consiglio Nazionale delle Ricerche, Napoli, Italy; 2 Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli “Federico II”, Napoli, Italy; 3 Dipartimento di Scienze Biomediche Avanzate, Università degli Studi di Napoli “Federico II”, Napoli, Italy; 4 Dipartimento di Medicina, Chirurgia e Odontoiatria "Scuola Medica Salernitana", Università di Salerno, Salerno, Italy


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BACKGROUND: We evaluated the role of [18F]FDG PET/CT in tumor response assessment and prognosis of Primary Extranodal Lymphoma (PEL) patients.
METHODS: We examined retrospectively, 56 PEL patients: 31 with aggressive diffuse large B cell lymphoma (DLBCL) and 25 with indolent lymphoma (20 mucosa-associated lymphoid tissue lymphoma-MALT and 5 follicular lymphoma). All patients had undergone [18F]FDG PET/CT at diagnosis (PET-I) and 50 of them also after therapy (PET-II). Moreover, 52 patients were subjected to a mean follow-up period of 76 months.
RESULTS: PET-I was positive in 50 (89%) patients (mean SUVmax 10.3±6.7). In the assessment of tumor response, according to Lugano classification, 45 patients showed complete metabolic response (CMR), 4 patients had partial metabolic response (PMR) and 1 had progressive metabolic disease (PMD). Based on 66% ΔSUVmax cut-off, among CMR patients, 41 showed a ΔSUVmax>66% whereas among nonresponders, 4 patients showed a ΔSUVmax<66%. At follow-up, univariate analysis showed that age, performance status, prognostic index, ΔSUVmax and Lugano classification predicted Progression Free Survival (PFS) (p<0.05), while, performance status, prognostic index, ΔSUVmax and Lugano classification predicted Overall Survival (OS) (p<0.05). At multivariate analysis only Lugano classification was retained in the model for prediction of both PFS (p<0.05) and OS (p<0.05). By Kaplan-Meier analysis and log- rank testing both PFS and OS were significantly better in patients in CMR as compared to patients in PMR or PMD according to Lugano classification (p<0.01).
CONCLUSIONS: [18F]FDG PET/CT represents a useful tool in the detection of disease response and in the evaluation of outcome in PEL patients.


KEY WORDS: Primary extranodal lymphoma - [18F]FDG PET/CT - Response assessment - Survival analysis - Prognosis

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