Role of 18F‐FDG‐PET/CT in the management of marginal zone B cell lymphoma. Issue 4 (19th November 2014)

• Record Type: Journal Article
• Authors: Carrillo‐Cruz, Estrella; Marín‐Oyaga, Victor A.; de la Cruz Vicente, Fátima; Borrego‐Dorado, Isabel; Ruiz Mercado, Marta; Acevedo Báñez, Irene; Solé Rodríguez, Maria; Fernández López, Rosa; Pérez Vega, Herminia; Calderón‐Cabrera, Cristina; Espigado Tocino, Ildefonso; Pérez‐Simón, Jose A.; Vázquez‐Albertino, Ricardo
• Is Part Of: Hematological oncology. Volume 33:Issue 4(2015:Dec.)
• Page Start: 151
• Page End: 158
• Publication Date: 2014-11-19
• Subjects: 18F‐FDG‐PET/CT -- PET/CT -- marginal zone B cell lymphoma -- MALT -- staging; Hematological oncology -- Periodicals; Hematology; Medical Oncology; 616.99418005
• DOI: 10.1002/hon.2181
• Languages: English
• ISSNs: 0278-0232

Abstract

Abstract: The use of PET in patients with marginal zone B cell lymphoma (MZL) is controversial because of variability of fluorodeoxyglucose (FDG) avidity. We analyzed 40 PET/CT in 25 consecutive patients to compare its performance with CT at staging and as a first‐line response assessment. Sensitivity of PET/CT and CT was 96 and 76%. Mean standard uptake value was 6.1, 6.9 and 3.4 ( p = 0.3) in nodal, extranodal and splenic subtypes, respectively. Of 17 patients (extranodal: n = 9; nodal: n = 6; splenic subtype: n = 2) with both imaging tests available at diagnosis, 8 (47%) had more involved areas with PET/CT than with CT, 75% of which were extranodal lesions. PET/CT resulted in upstaging of five patients although treatment of only two of them was changed. Responses of 15 patients with post‐treatment PET/CT were the following: 9 negative and 6 positive of which 3 were isolated residual lesions. Progression was documented in two of these three patients. Response was also assessed by CT in 11 patients. Discrepancies were found in three: Two were in complete remission by CT while PET/CT detected localized residual disease; another patient was in partial remission by CT, whereas PET/CT showed only one positive lesion. Two of these three patients relapsed. Patients with negative post‐treatment PET/CT did not relapse. With a median follow‐up of 50 months (10–152 months), 3‐year overall survival was 100 and 80% for patients with negative and positive post‐treatment PET/CT ( p = 0.2). Three‐year disease‐free survival was 86%; the negative predictive value (NPV) was 100%, and the positive predictive value (PPV) was 83.3%. Although a larger number of patients will be required to further confirm these data, we can conclude that PET/CT is a useful imaging tool for both staging and response assessment in patients with nodal and extranodal MZL as a result of its high sensitivity, NPV and PPV. Copyright © 2014 John Wiley & Sons, Ltd.