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Jiménez Londoño GA, García Vicente AM, Poblete García VM, Amo-Salas M, Calle Primo C, Ibañez García Á, Martínez Sanchís B, López-Fidalgo JF, Solano Ramos F, Martínez Hellín A, Díaz Morfa M, Soriano Castrejón Á. Basal (18)F-FDG PET/CT in follicular lymphoma: A comparison of metabolic and clinical variables in the prognostic assessment. Rev Esp Med Nucl Imagen Mol 2016; 35:298-305. [PMID: 27312693 DOI: 10.1016/j.remn.2016.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Revised: 03/31/2016] [Accepted: 04/01/2016] [Indexed: 10/21/2022]
Abstract
AIM To analyze the relationship of clinical variables related to prognosis and tumor burden, with metabolic variables obtained in the staging (18)F-FDG PET/CT, and their value in the prognosis in follicular lymphoma (FL). METHODS 82 patients with FL, a (18)F-FDG PET/CT at diagnosis and a follow-up for a minimum of 12 months, were retrospectively enrolled in the present study. Clinical variables (Tumor grade, Follicular Lymphoma International Prognostic Index (FLIPI) and Tumor burden) were evaluated. Metabolic variables such as SUVmax in the highest hypermetabolic lesion, extralymphatic locations, number of involved lymph node locations, bone marrow (BM) involvement, PET stage and diameter of the biggest hypermetabolic lesion, were analyzed in order to establish a PET score and classify the studies in low, intermediate and high metabolic risk. Clinical and metabolic variables (included metabolic risk) were compared. The relation among all variables and disease-free survival (DFS) was studied. RESULTS The 28% of patients had a high-grade tumor. The 30.5% had FLIPI risk low, 29.3% intermediate y 40.2% high. The 42.7% presented a high tumor burden. The PET/CT was positive in 94% of patients. The tumor grade did not show significant relation with metabolic variable. FLIPI risk and tumor burden showed statistical relations with the SUV max and the PET score (p<0.008 and p=0.003 respectively). With respect to DFS, significant differences were detected for the PET stage and FLIPI risk (p=0.015 and p=0.047 respectively). FLIPI risk was the only significant predictor in Cox regression analysis, with a Hazard Ratio of 5.13 between high risk and low risk. CONCLUSION The present research highlights the significant relation between metabolic variables obtained with FDG PET/CT and clinical variables although their goal as an independent factor of prognosis was not demonstrated in the present work.
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Affiliation(s)
- G A Jiménez Londoño
- Department of Nuclear Medicine, Hospital General Universitario de Ciudad Real, Spain.
| | - A M García Vicente
- Department of Nuclear Medicine, Hospital General Universitario de Ciudad Real, Spain
| | - V M Poblete García
- Department of Nuclear Medicine, Hospital General Universitario de Ciudad Real, Spain
| | - M Amo-Salas
- Department of Mathematics, University of Castilla La Mancha, Ciudad Real, Spain
| | - C Calle Primo
- Department of Hematology, Hospital General Universitario de Ciudad Real, Spain
| | - Á Ibañez García
- Department of Hematology, Complejo Hospitalario Universitario de Albacete, Spain
| | - B Martínez Sanchís
- Department of Nuclear Medicine, Hospital General Universitario de Ciudad Real, Spain
| | - J F López-Fidalgo
- Department of Mathematics, University of Castilla La Mancha, Ciudad Real, Spain
| | - F Solano Ramos
- Department of Hematology, Hospital Ntra. Sra. del Prado, Talavera de la Reina, Toledo, Spain
| | - A Martínez Hellín
- Department of Hematology, Complejo Hospitalario Universitario de Albacete, Spain
| | - M Díaz Morfa
- Department of Hematology, Hospital Universitario de Guadalajara, Spain
| | - Á Soriano Castrejón
- Department of Nuclear Medicine, Hospital General Universitario de Ciudad Real, Spain
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52
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Burkitt Lymphoma Presented as Acute Lower Back Pain and Revealed by 18F-NaF PET/CT. Clin Nucl Med 2016; 41:e253-4. [DOI: 10.1097/rlu.0000000000001109] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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53
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Assessment of Sequential PET/MRI in Comparison With PET/CT of Pediatric Lymphoma: A Prospective Study. AJR Am J Roentgenol 2016; 206:623-31. [DOI: 10.2214/ajr.15.15083] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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54
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Perry C, Lerman H, Joffe E, Sarid N, Amit O, Avivi I, Kesler M, Ben-Ezra J, Even-Sapir E, Herishanu Y. The Value of PET/CT in Detecting Bone Marrow Involvement in Patients With Follicular Lymphoma. Medicine (Baltimore) 2016; 95:e2910. [PMID: 26945387 PMCID: PMC4782871 DOI: 10.1097/md.0000000000002910] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Follicular lymphoma (FL) is the 2nd most common type of lymphoma diagnosed in the Western World. Bone marrow (BM) involvement is an adverse prognostic factor in FL, routinely assessed by an arbitrary biopsy of the iliac crest. This study was aimed to investigate the role of positron emission tomography/computed tomography (PET/CT) in identifying BM involvement by FL. In this retrospective, single-center study we reviewed the records of consecutive patients with FL at diagnosis or relapse who underwent staging/restaging workup visual assessment of BM uptake was categorized as either normal, diffusely increased, or focally increased. Quantitative BM fluorine-18-fluro-deoxyglucose (FDG) uptake was measured using mean standardized uptake value (BM-SUVmean). The diagnosis of BM involvement was based on either BM histological findings or disappearance of increased uptake at end-treatment PET/CT in patients who responded to treatment. Sixty eight cases with FL were included. Sixteen (23.5%) had BM involvement, 13 (19.1%) had a biopsy proven involvement, and 3 (4.4%) had a negative BM biopsy, but increased medullary uptake that normalized post-treatment. BM FDG uptake in these patients was diffuse in 8 (50%) and focal in 8 (50%). Focal increased uptake was indicative of BM involvement; however, diffuse uptake was associated with 17 false positive cases (32.7%). Overall, visual assessment of BM involvement had a negative predictive value (NPV) of 100% and a positive predictive value (PPV) of 48.5%. On a quantitative assessment, BM-SUVmean was significantly higher in patients with BM involvement (SUVmean of 3.7 [1.7-6] vs 1.4 [0.4-2.65], P < 0.001). On receiver operator curve (ROC) analysis, BM-SUVmean > 2.7 had a PPV of 100% for BM involvement (sensitivity of 68%), while BM-SUVmean < 1.7 had an NPV of 100% (specificity of 73%). Visual assessment of PET/CT is appropriate for ruling out BM involvement by FL. Although focal increased uptake indicates marrow involvement, diffuse uptake is nonspecific. SUV measurement improves PET/CT diagnostic accuracy, identifying additional 19% of patients with BM involvement that would have been otherwise missed.
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Affiliation(s)
- Chava Perry
- From the Department of Hematology (CP, EJ, NS, OA, IA, YH); Department of Nuclear Medicine (HL, MK, EES); Department of Pathology, Tel Aviv Sourasky Medical Center (B-E); and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel (B-E, EES, IA, YH)
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55
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Adams HJA, Nievelstein RAJ, Kwee TC. Prognostic value of interim and end-of-treatment FDG-PET in follicular lymphoma: a systematic review. Ann Hematol 2016; 95:11-18. [PMID: 26576560 PMCID: PMC4700102 DOI: 10.1007/s00277-015-2553-2] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Accepted: 11/09/2015] [Indexed: 11/18/2022]
Abstract
This study aimed to systematically review the prognostic value of interim and end-of-treatment (18)F-fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) in follicular lymphoma during and after first-line therapy. The PubMed/MEDLINE database was searched for relevant original studies. Included studies were methodologically assessed, and their results were extracted and descriptively analyzed. Three studies on the prognostic value of interim FDG-PET and eight studies on the prognostic value of end-of-treatment FDG-PET were included. Overall, studies were of poor methodological quality. In addition, there was incomplete reporting of progression-free survival (PFS) and overall survival (OS) data by several studies, and none of the studies incorporated the Follicular Lymphoma International Prognostic Index (FLIPI) in the OS analyses. Two studies reported no significant difference in PFS between interim FDG-PET positive and negative patients, whereas one study reported a significant difference in PFS between the two groups. Two studies reported no significant difference in OS between interim FDG-PET positive and negative patients. Five studies reported end-of-treatment FDG-PET positive patients to have a significantly worse PFS than end-of-treatment FDG-PET negative patients, and one study reported a non-significant trend towards a worse PFS for end-of-treatment FDG-PET positive patients. Three studies reported end-of-treatment FDG-PET positive patients to have a significantly worse OS than end-of-treatment FDG-PET negative patients. In conclusion, the available evidence does not support the use of interim FDG-PET in follicular lymphoma. Although published studies suggest end-of-treatment FDG-PET to be predictive of PFS and OS, they suffer from numerous biases and failure to correct OS prediction for the FLIPI.
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Affiliation(s)
- Hugo J A Adams
- Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.
| | - Rutger A J Nievelstein
- Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Thomas C Kwee
- Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
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Knogler T, Thomas K, El-Rabadi K, Karem ER, Weber M, Michael W, Karanikas G, Georgios K, Mayerhoefer ME, Marius Erik M. Three-dimensional texture analysis of contrast enhanced CT images for treatment response assessment in Hodgkin lymphoma: comparison with F-18-FDG PET. Med Phys 2015; 41:121904. [PMID: 25471964 DOI: 10.1118/1.4900821] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE To determine the diagnostic performance of three-dimensional (3D) texture analysis (TA) of contrast-enhanced computed tomography (CE-CT) images for treatment response assessment in patients with Hodgkin lymphoma (HL), compared with F-18-fludeoxyglucose (FDG) positron emission tomography/CT. METHODS 3D TA of 48 lymph nodes in 29 patients was performed on venous-phase CE-CT images before and after chemotherapy. All lymph nodes showed pathologically elevated FDG uptake at baseline. A stepwise logistic regression with forward selection was performed to identify classic CT parameters and texture features (TF) that enable the separation of complete response (CR) and persistent disease. RESULTS The TF fraction of image in runs, calculated for the 45° direction, was able to correctly identify CR with an accuracy of 75%, a sensitivity of 79.3%, and a specificity of 68.4%. Classical CT features achieved an accuracy of 75%, a sensitivity of 86.2%, and a specificity of 57.9%, whereas the combination of TF and CT imaging achieved an accuracy of 83.3%, a sensitivity of 86.2%, and a specificity of 78.9%. CONCLUSIONS 3D TA of CE-CT images is potentially useful to identify nodal residual disease in HL, with a performance comparable to that of classical CT parameters. Best results are achieved when TA and classical CT features are combined.
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Affiliation(s)
| | - Knogler Thomas
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Waehringer Guertel 18-20, Vienna 1090, Austria
| | | | - El-Rabadi Karem
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Waehringer Guertel 18-20, Vienna 1090, Austria
| | | | - Weber Michael
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Waehringer Guertel 18-20, Vienna 1090, Austria
| | | | - Karanikas Georgios
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Waehringer Guertel 18-20, Vienna 1090, Austria
| | - Marius E Mayerhoefer
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Waehringer Guertel 18-20, Vienna 1090, Austria
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57
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Bone marrow uptake of indolent non-Hodgkin lymphoma on PET/CT with histopathological correlation. Nucl Med Commun 2015. [PMID: 26225940 DOI: 10.1097/mnm.0000000000000361] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Adams HJA, Nievelstein RAJ, Kwee TC. Opportunities and limitations of bone marrow biopsy and bone marrow FDG-PET in lymphoma. Blood Rev 2015; 29:417-25. [PMID: 26113144 DOI: 10.1016/j.blre.2015.06.003] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Revised: 06/10/2015] [Accepted: 06/12/2015] [Indexed: 12/17/2022]
Abstract
Bone marrow involvement in lymphoma may have prognostic and therapeutic consequences. Bone marrow biopsy (BMB) is the established method for the evaluation of the bone marrow. (18)F-fluoro-2-deoxy-d-glucose positron emission tomography (FDG-PET) plays an important role in lymphoma staging, but its value in the assessment of the bone marrow and whether it can replace BMB is still a topic of debate and investigation. The purpose of this scientific communication is to provide an evidence-based overview about the opportunities and limitations of BMB and FDG-PET in the evaluation of the bone marrow in patients with lymphoma. This article first reviews the basic properties, opportunities and limitations of BMB and bone marrow FDG-PET, and then focuses on the clinical utility of BMB and bone marrow FDG-PET in three major lymphoma subtypes including Hodgkin lymphoma, diffuse large B-cell lymphoma, and follicular lymphoma.
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Affiliation(s)
- Hugo J A Adams
- Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Utrecht, The Netherlands.
| | - Rutger A J Nievelstein
- Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Thomas C Kwee
- Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
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Luminari S, Ceriani L, Dührsen U. FDG-PET(CT)-adapted trials in non-Hodgkin lymphoma. Clin Transl Imaging 2015. [DOI: 10.1007/s40336-015-0125-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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El-Galaly TC, Hutchings M. Imaging of non-Hodgkin lymphomas: diagnosis and response-adapted strategies. Cancer Treat Res 2015; 165:125-46. [PMID: 25655608 DOI: 10.1007/978-3-319-13150-4_5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
Optimal lymphoma management requires accurate pretreatment staging and reliable assessment of response, both during and after therapy. Positron emission tomography with computerized tomography (PET/CT) combines functional and anatomical imaging and provides the most sensitive and accurate methods for lymphoma imaging. New guidelines for lymphoma imaging and recently revised criteria for lymphoma staging and response assessment recommend PET/CT staging, treatment monitoring, and response evaluation in all FDG-avid lymphomas, while CT remains the method of choice for non-FDG-avid histologies. Since interim PET imaging has high prognostic value in lymphoma, a number of trials investigate PET-based, response-adapted therapy for non-Hodgkin lymphomas (NHL). PET response is the main determinant of response according to the new response criteria, but PET/CT has little or no role in routine surveillance imaging, the value which is itself questionable. This review presents from a clinical point of view the evidence for the use of imaging and primarily PET/CT in NHL before, during, and after therapy. The reader is given an overview of the current PET-based interventional NHL trials and an insight into possible future developments in the field, including new PET tracers.
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Barrington SF, Mikhaeel NG, Kostakoglu L, Meignan M, Hutchings M, Müeller SP, Schwartz LH, Zucca E, Fisher RI, Trotman J, Hoekstra OS, Hicks RJ, O'Doherty MJ, Hustinx R, Biggi A, Cheson BD. Role of imaging in the staging and response assessment of lymphoma: consensus of the International Conference on Malignant Lymphomas Imaging Working Group. J Clin Oncol 2015; 32:3048-58. [PMID: 25113771 DOI: 10.1200/jco.2013.53.5229] [Citation(s) in RCA: 1075] [Impact Index Per Article: 119.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
PURPOSE Recent advances in imaging, use of prognostic indices, and molecular profiling techniques have the potential to improve disease characterization and outcomes in lymphoma. International trials are under way to test image-based response–adapted treatment guided by early interim positron emission tomography (PET)–computed tomography (CT). Progress in imaging is influencing trial design and affecting clinical practice. In particular, a five-point scale to grade response using PET-CT, which can be adapted to suit requirements for early- and late-response assessment with good interobserver agreement, is becoming widely used both in practice- and response-adapted trials. A workshop held at the 11th International Conference on Malignant Lymphomas (ICML) in 2011 concluded that revision to current staging and response criteria was timely. METHODS An imaging working group composed of representatives from major international cooperative groups was asked to review the literature, share knowledge about research in progress, and identify key areas for research pertaining to imaging and lymphoma. RESULTS A working paper was circulated for comment and presented at the Fourth International Workshop on PET in Lymphoma in Menton, France, and the 12th ICML in Lugano, Switzerland, to update the International Harmonisation Project guidance regarding PET. Recommendations were made to optimize the use of PET-CT in staging and response assessment of lymphoma, including qualitative and quantitative methods. CONCLUSION This article comprises the consensus reached to update guidance on the use of PET-CT for staging and response assessment for [18F]fluorodeoxyglucose-avid lymphomas in clinical practice and late-phase trials.
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Abstract
The role of PET and PET/computed tomography (CT) has evolved significantly in the last few decades. 2-Deoxy-2-[18F]-fluoro-d-glucose (FDG)-PET/CT is now an integral part of the management of patients with lymphoma. FDG-PET/CT at the time of initial staging can help in appropriate staging of the patients. Both interim and end-of-therapy PETs have significant prognostic value in patients with Hodgkin lymphoma and aggressive non-Hodgkin lymphoma and more accurately assess for the presence of residual malignancy than anatomic imaging. The impact of interim FDG-PET/CT on risk-adapted strategies is an area of active investigation and the results of ongoing clinical trials will be informative.
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Gallamini A, Zwarthoed C, Borra A. Positron Emission Tomography (PET) in Oncology. Cancers (Basel) 2014; 6:1821-89. [PMID: 25268160 PMCID: PMC4276948 DOI: 10.3390/cancers6041821] [Citation(s) in RCA: 203] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Revised: 07/25/2014] [Accepted: 08/07/2014] [Indexed: 02/07/2023] Open
Abstract
Since its introduction in the early nineties as a promising functional imaging technique in the management of neoplastic disorders, FDG-PET, and subsequently FDG-PET/CT, has become a cornerstone in several oncologic procedures such as tumor staging and restaging, treatment efficacy assessment during or after treatment end and radiotherapy planning. Moreover, the continuous technological progress of image generation and the introduction of sophisticated software to use PET scan as a biomarker paved the way to calculate new prognostic markers such as the metabolic tumor volume (MTV) and the total amount of tumor glycolysis (TLG). FDG-PET/CT proved more sensitive than contrast-enhanced CT scan in staging of several type of lymphoma or in detecting widespread tumor dissemination in several solid cancers, such as breast, lung, colon, ovary and head and neck carcinoma. As a consequence the stage of patients was upgraded, with a change of treatment in 10%-15% of them. One of the most evident advantages of FDG-PET was its ability to detect, very early during treatment, significant changes in glucose metabolism or even complete shutoff of the neoplastic cell metabolism as a surrogate of tumor chemosensitivity assessment. This could enable clinicians to detect much earlier the effectiveness of a given antineoplastic treatment, as compared to the traditional radiological detection of tumor shrinkage, which usually takes time and occurs much later.
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Affiliation(s)
- Andrea Gallamini
- Department of Research and Medical Innovation, Antoine Lacassagne Cancer Center, Nice University, Nice Cedex 2-06189 Nice, France.
| | - Colette Zwarthoed
- Department of Nuclear Medicine, Antoine Lacassagne Cancer Center, Nice University, Nice Cedex 2-06189 Nice, France.
| | - Anna Borra
- Hematology Department S. Croce Hospital, Via M. Coppino 26, Cuneo 12100, Italy.
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Cheson BD, Fisher RI, Barrington SF, Cavalli F, Schwartz LH, Zucca E, Lister TA. Recommendations for initial evaluation, staging, and response assessment of Hodgkin and non-Hodgkin lymphoma: the Lugano classification. J Clin Oncol 2014; 32:3059-68. [PMID: 25113753 PMCID: PMC4979083 DOI: 10.1200/jco.2013.54.8800] [Citation(s) in RCA: 3397] [Impact Index Per Article: 339.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The purpose of this work was to modernize recommendations for evaluation, staging, and response assessment of patients with Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL). A workshop was held at the 11th International Conference on Malignant Lymphoma in Lugano, Switzerland, in June 2011, that included leading hematologists, oncologists, radiation oncologists, pathologists, radiologists, and nuclear medicine physicians, representing major international lymphoma clinical trials groups and cancer centers. Clinical and imaging subcommittees presented their conclusions at a subsequent workshop at the 12th International Conference on Malignant Lymphoma, leading to revised criteria for staging and of the International Working Group Guidelines of 2007 for response. As a result, fluorodeoxyglucose (FDG) positron emission tomography (PET)–computed tomography (CT) was formally incorporated into standard staging for FDG-avid lymphomas. A modification of the Ann Arbor descriptive terminology will be used for anatomic distribution of disease extent, but the suffixes A or B for symptoms will only be included for HL. A bone marrow biopsy is no longer indicated for the routine staging of HL and most diffuse large B-cell lymphomas. However, regardless of stage, general practice is to treat patients based on limited (stages I and II, nonbulky) or advanced (stage III or IV) disease, with stage II bulky disease considered as limited or advanced disease based on histology and a number of prognostic factors. PET-CT will be used to assess response in FDG-avid histologies using the 5-point scale. The product of the perpendicular diameters of a single node can be used to identify progressive disease. Routine surveillance scans are discouraged. These recommendations should improve evaluation of patients with lymphoma and enhance the ability to compare outcomes of clinical trials.
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Affiliation(s)
- Bruce D. Cheson
- Bruce D. Cheson, Georgetown University Hospital, Lombardi Comprehensive Cancer Center, Washington, DC; Richard I. Fisher, Fox Chase Cancer Center, Philadelphia, PA; Sally F. Barrington, St Thomas' Hospital; T. Andrew Lister, St Bartholomew's Hospital, London, United Kingdom; Franco Cavalli and Emanuele Zucca, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; and Lawrence H. Schwartz, Columbia University, New York, NY
- Corresponding author: Bruce D. Cheson, MD, Georgetown University Hospital, Lombardi Comprehensive Cancer Center, 3800 Reservoir Rd, NW, Washington, DC 20007; e-mail:
| | - Richard I. Fisher
- Bruce D. Cheson, Georgetown University Hospital, Lombardi Comprehensive Cancer Center, Washington, DC; Richard I. Fisher, Fox Chase Cancer Center, Philadelphia, PA; Sally F. Barrington, St Thomas' Hospital; T. Andrew Lister, St Bartholomew's Hospital, London, United Kingdom; Franco Cavalli and Emanuele Zucca, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; and Lawrence H. Schwartz, Columbia University, New York, NY
| | - Sally F. Barrington
- Bruce D. Cheson, Georgetown University Hospital, Lombardi Comprehensive Cancer Center, Washington, DC; Richard I. Fisher, Fox Chase Cancer Center, Philadelphia, PA; Sally F. Barrington, St Thomas' Hospital; T. Andrew Lister, St Bartholomew's Hospital, London, United Kingdom; Franco Cavalli and Emanuele Zucca, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; and Lawrence H. Schwartz, Columbia University, New York, NY
| | - Franco Cavalli
- Bruce D. Cheson, Georgetown University Hospital, Lombardi Comprehensive Cancer Center, Washington, DC; Richard I. Fisher, Fox Chase Cancer Center, Philadelphia, PA; Sally F. Barrington, St Thomas' Hospital; T. Andrew Lister, St Bartholomew's Hospital, London, United Kingdom; Franco Cavalli and Emanuele Zucca, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; and Lawrence H. Schwartz, Columbia University, New York, NY
| | - Lawrence H. Schwartz
- Bruce D. Cheson, Georgetown University Hospital, Lombardi Comprehensive Cancer Center, Washington, DC; Richard I. Fisher, Fox Chase Cancer Center, Philadelphia, PA; Sally F. Barrington, St Thomas' Hospital; T. Andrew Lister, St Bartholomew's Hospital, London, United Kingdom; Franco Cavalli and Emanuele Zucca, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; and Lawrence H. Schwartz, Columbia University, New York, NY
| | - Emanuele Zucca
- Bruce D. Cheson, Georgetown University Hospital, Lombardi Comprehensive Cancer Center, Washington, DC; Richard I. Fisher, Fox Chase Cancer Center, Philadelphia, PA; Sally F. Barrington, St Thomas' Hospital; T. Andrew Lister, St Bartholomew's Hospital, London, United Kingdom; Franco Cavalli and Emanuele Zucca, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; and Lawrence H. Schwartz, Columbia University, New York, NY
| | - T. Andrew Lister
- Bruce D. Cheson, Georgetown University Hospital, Lombardi Comprehensive Cancer Center, Washington, DC; Richard I. Fisher, Fox Chase Cancer Center, Philadelphia, PA; Sally F. Barrington, St Thomas' Hospital; T. Andrew Lister, St Bartholomew's Hospital, London, United Kingdom; Franco Cavalli and Emanuele Zucca, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; and Lawrence H. Schwartz, Columbia University, New York, NY
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The prognostic value of mid- and post-treatment [18F]fluorodeoxyglucose (FDG) positron emission tomography (PET) in indolent follicular lymphoma. Ann Nucl Med 2014; 28:805-11. [DOI: 10.1007/s12149-014-0874-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2014] [Accepted: 06/20/2014] [Indexed: 10/25/2022]
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Grellier JF, Vercellino L, Leblanc T, Merlet P, Thieblemont C, Weinmann P, Toubert ME, Berenger N, Brière J, Brice P. Performance of FDG PET/CT at initial diagnosis in a rare lymphoma: nodular lymphocyte-predominant Hodgkin lymphoma. Eur J Nucl Med Mol Imaging 2014; 41:2023-30. [PMID: 24965842 DOI: 10.1007/s00259-014-2825-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2014] [Accepted: 05/26/2014] [Indexed: 11/28/2022]
Abstract
PURPOSE Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) is a rare Hodgkin lymphoma distinguished from classical Hodgkin lymphoma (cHL) by the nature of the neoplastic cells which express B-cell markers. We wanted to determine the diagnostic performance of FDG PET/CT in initial assessment and its therapeutic impact on staging. METHODS We retrospectively studied a population of 35 patients with NLPHL (8 previously treated for NLHPL, 27 untreated). All patients underwent an initial staging by pretherapeutic FDG PET/CT. The impact on initial stage or relapse stage was assessed by an independent physician. RESULTS In a per-patient analysis, the sensitivity of the pretherapeutic FDG PET/CT was 100%. In a per-site analysis, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of pretherapeutic FDG PET/CT were 100%, 99%, 97%, 100% and 99%, respectively. Pretherapeutic FDG PET/CT led to a change in the initial stage/relapse stage in 12 of the 35 patients (34%). In contrast to previous results established without FDG PET/CT, 20% of patient had osteomedullary lesions. CONCLUSION Pretherapeutic FDG PET/CT has excellent performance for initial staging or relapse staging of NLPHL.
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Affiliation(s)
- Jean François Grellier
- AP-HP- Hôpital Européen Georges Pompidou, Service de médecine nucléaire, Paris, 75015, France,
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Seymour JF, Trotman J, Hofman MS. Evaluating the place of 18-fluoro-2-deoxy-D-glucose positron emission tomography scanning in primary staging and beyond in patients with follicular lymphoma. Leuk Lymphoma 2014; 54:2093-5. [PMID: 23641872 DOI: 10.3109/10428194.2013.800201] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- John F Seymour
- Peter MacCallum Cancer Centre, East Melbourne, Australia and University of Melbourne , Parkville , Australia
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70
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Kostakoglu L, Cheson BD. Current role of FDG PET/CT in lymphoma. Eur J Nucl Med Mol Imaging 2014; 41:1004-27. [PMID: 24519556 DOI: 10.1007/s00259-013-2686-2] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2013] [Accepted: 12/27/2013] [Indexed: 01/08/2023]
Abstract
The management approach in Hodgkin's (HL) and high-grade non-Hodgkin's lymphomas (NHL) has shifted towards reducing the toxicity and long-term adverse effects associated with treatment while maintaining favorable outcomes in low-risk patients. The success of an individualized treatment strategy depends largely on accurate diagnostic tests both at staging and during therapy. In this regard, positron emission tomography (PET) using fluorodeoxyglucose (FDG) with computed tomography (CT) has proved effective as a metabolic imaging tool with compelling evidence supporting its superiority over conventional modalities, particularly in staging and early evaluation of response. Eventually, this modality was integrated into the routine staging and restaging algorithm of lymphomas. This review will summarize the data on the proven and potential utility of PET/CT imaging for staging, response assessment, and restaging, describing current limitations of this imaging modality.
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Affiliation(s)
- Lale Kostakoglu
- Department of Radiology, Icahn School of Medicine at Mount Sinai, One Gustave Levy Place, Box 1141, New York, NY, 10029, USA,
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71
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Tychyj-Pinel C, Ricard F, Fulham M, Fournier M, Meignan M, Lamy T, Vera P, Salles G, Trotman J. PET/CT assessment in follicular lymphoma using standardized criteria: central review in the PRIMA study. Eur J Nucl Med Mol Imaging 2014; 41:408-15. [DOI: 10.1007/s00259-013-2441-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2013] [Accepted: 04/22/2013] [Indexed: 12/20/2022]
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Araf S, Montoto S. The use of interim (18)F-fluorodeoxyglucose PET to guide therapy in lymphoma. Future Oncol 2013; 9:807-15. [PMID: 23718301 DOI: 10.2217/fon.13.55] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Over the past decade (18)F-fluorodeoxyglucose (FDG)-PET combined with computed tomography has gained a central role in the management of patients with lymphoma. The use of FDG-PET for staging and assessing treatment response in Hodgkin's and 'aggressive' non-Hodgkin's lymphoma is now well established, and the prognostic impact of the response to treatment assessed by FDG-PET is being increasingly recognized. Despite the widespread utilization of FDG-PET in clinical practice, key questions remain on its optimal use in certain contexts. One such area that is generating intense interest is the role of interim FDG-PET (typically performed after two to four cycles of chemotherapy) to guide treatment strategies. The author's will review the current available evidence in this area, highlighting questions in need of further study.
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Affiliation(s)
- Shamzah Araf
- Centre for Haemato-Oncology, Barts Cancer Institute, Queen Mary University of London, London, UK.
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Manohar K, Mittal BR, Bhattacharya A, Malhotra P, Varma S. Fluoro-deoxy-glucose positron emission tomography/computed tomography in lymphoma: A pictorial essay. Indian J Nucl Med 2013; 28:85-92. [PMID: 24163512 PMCID: PMC3800317 DOI: 10.4103/0972-3919.118256] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
F-18 fluoro-deoxy-glucose (FDG) positron emission tomography/computed tomography (PET/CT) has emerged as a powerful imaging modality in the field of oncology. F-18 FDG PET/CT is now an established tool in the management of lymphoma. This has been shown to be useful in staging, detection of bone marrow involvement (BMI), early response assessment and end of therapy response assessment in lymphoma. Interpretation of F-18 FDG PET/CT in lymphoma is carried out by various qualitative response assessment criteria. London criteria are used for interpretation of interim PET/CT and International Harmonization Project (IHP) criteria are used to interpret PET/CT done after the end of chemotherapy. Quantitative analysis is also found to be useful in assessment of response early after two cycles of chemotherapy in patients with diffuse large B cell lymphoma (DLBCL). This pictorial essay provides few images describing the FDG avidity of lymphoma, patterns of bone marrow uptake and their relevance in predicting BMI, role of staging PET/CT, quantitative analysis in response assessment, example images of response according to London criteria and IHP criteria. Few pitfalls in imaging of lymphoma with PET/CT are also discussed in the images legend.
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Affiliation(s)
- Kuruva Manohar
- Department of Nuclear Medicine & PET, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Pyo J, Won Kim K, Jacene HA, Sakellis CG, Brown JR, Van den Abbeele AD. End-Therapy Positron Emission Tomography for Treatment Response Assessment in Follicular Lymphoma: A Systematic Review and Meta-analysis. Clin Cancer Res 2013; 19:6566-77. [DOI: 10.1158/1078-0432.ccr-13-1511] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Kostakoglu L, Cheson BD. State-of-the-Art Research on "Lymphomas: Role of Molecular Imaging for Staging, Prognostic Evaluation, and Treatment Response". Front Oncol 2013; 3:212. [PMID: 24027671 PMCID: PMC3762124 DOI: 10.3389/fonc.2013.00212] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2013] [Accepted: 08/02/2013] [Indexed: 12/11/2022] Open
Abstract
Lymphomas are heterogeneous but potentially curable group of neoplasms. Treatment of lymphomas has rapidly evolved overtime with significant improvement in the cure rate and reductions in treatment-related toxicities. Despite excellent results, treatment programs are continued to be developed to achieve better curative and safety profiles. In these patients individualized therapy schemes can be devised based on a well-defined risk categorization. The therapy efficacy can be increased early during therapy in non-responding patients with escalated therapy protocols or with the addition of radiation therapy, particularly, in advanced-stage or unfavorable risk patients. The increasing availability of positron emission tomography using 18F-fluorodeoxyglucose, particularly fused with computed tomography (FDG-PET/CT) has lead to the integration of this modality into the routine staging and restaging for lymphoma with convincing evidence that it is a more accurate imaging modality compared with conventional imaging techniques. FDG-PET/CT is also is a promising surrogate for tumor chemosensitivity early during therapy. This review will summarize published data on the utility of FDG-PET/CT imaging in the staging, restaging, and predicting therapy response in patients with lymphoma.
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Affiliation(s)
- Lale Kostakoglu
- Department of Radiology, Mount Sinai Medical Center , New York, NY , USA
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Zhu Y, Lu J, Wei X, Song S, Huang G. The predictive value of interim and final [18F] fluorodeoxyglucose positron emission tomography after rituximab-chemotherapy in the treatment of non-Hodgkin's lymphoma: a meta-analysis. BIOMED RESEARCH INTERNATIONAL 2013; 2013:275805. [PMID: 24288671 PMCID: PMC3830841 DOI: 10.1155/2013/275805] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2013] [Revised: 06/13/2013] [Accepted: 07/02/2013] [Indexed: 12/23/2022]
Abstract
BACKGROUND AND PURPOSE The aim of this study is to determine the prognostic value of interim and final FDG-PET in major histotypes of B-cell NHL patients treated with rituximab containing-chemotherapy. METHODS We searched for articles published in English, limited to lymphoma, rituximab, and FDG-PET, and dedicated to deal with the impact on progression and survival. The log hazard ratios (HR) and their variances were estimated. RESULTS A PubMed and Scopus review of published trials identified 13 studies of Progression-free survival (PFS) and overall survival (OS) which were set as the main outcome measures. The combined HRs of I-PET for PFS and OS in DLBCL were 4.4 (P = 0.11) and 3.99 (P = 0.46), respectively. The combined HRs of F-PET for PFS and OS in DLBCL were 5.91 (P = 0.39) and 6.75 (P = 0.92), respectively. Regarding to non-DLBCL with F-PET, the combined HRs of F-PET for PFS and OS were 4.05 (P = 0.79) and 5.1 (P = 0.51), respectively. No publication bias existed. CONCLUSION In DLBCL, both I-PET and F-PET can be performed for survival and progression analysis. But in other B-cell subtypes such as follicular lymphoma (FL) and mantle cell lymphoma (MCL), it would be necessary to perform F-PET for predictive purposes.
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Affiliation(s)
- Yuyuan Zhu
- Department of Nuclear Medicine, Renji Hospital, Jiaotong University, Shanghai 200127, China
- Department of Nuclear Medicine, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200127, China
| | - Jianda Lu
- Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China
| | - Xin Wei
- Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China
| | - Shaoli Song
- Department of Nuclear Medicine, Renji Hospital, Jiaotong University, Shanghai 200127, China
| | - Gang Huang
- Department of Nuclear Medicine, Renji Hospital, Jiaotong University, Shanghai 200127, China
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Luminari S, Biasoli I, Arcaini L, Versari A, Rusconi C, Merli F, Spina M, Ferreri A, Zinzani P, Gallamini A, Mastronardi S, Boccomini C, Gaidano G, D'Arco A, Di Raimondo F, Carella A, Santoro A, Musto P, Federico M. The use of FDG-PET in the initial staging of 142 patients with follicular lymphoma: a retrospective study from the FOLL05 randomized trial of the Fondazione Italiana Linfomi. Ann Oncol 2013; 24:2108-12. [DOI: 10.1093/annonc/mdt137] [Citation(s) in RCA: 109] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
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Lobetti-Bodoni C, Mantoan B, Monitillo L, Genuardi E, Drandi D, Barbero D, Bernocco E, Boccadoro M, Ladetto M. Clinical implications and prognostic role of minimal residual disease detection in follicular lymphoma. Ther Adv Hematol 2013; 4:189-98. [PMID: 23730496 DOI: 10.1177/2040620713480522] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The identification of patients at high risk of relapse is a critical goal of modern translational research in oncohematology. Minimal residual disease (MRD) detection by polymerase chain reaction-based methods is routinely employed in the management of patients with acute lymphoblastic leukemia. Current knowledge indicates that it is also a useful prognostic tool in several mature lymphoproliferative disorders and particularly in follicular lymphoma (FL). Based on this evidence clinical trials employing MRD-based risk stratification are currently ongoing in FL. In this review the 'state of the art' of MRD evaluation in FL is discussed. A short description of technical issues and recent methodological advances is provided. Then, the bulk of the review focuses on critical take-home messages for clinicians working in the field. Finally, we discuss future perspectives of MRD detection and more generally outcome prediction in FL.
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Affiliation(s)
- Chiara Lobetti-Bodoni
- Hematology Division I, Azienda ospedaliera San Giovanni Battista, Città della Salute e della Scienza, Torino, Italy
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79
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Guignard R, Zwarthoed C, Borra A, Darcourt J, Gallamini A. PET scan integration in lymphoma management. Int J Hematol Oncol 2013. [DOI: 10.2217/ijh.13.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
SUMMARY Despite a marked improvement in lymphoma treatment outcome, current prognostic models, relying on a pretreatment set of static clinical variables, appear unable to support a risk-adapted therapeutic strategy. On the other hand, functional imaging with 18F-fluoro-2-deoxy-D-glucose (FDG)-PET proved to be a reliable tool to dynamically assess tumor FDG uptake changes during and after treatment. In this article we aim to review the prognostic value of FDG-PET in all the stages of Hodgkin’s and non-Hodgkin’s lymphoma management, without the intent to address the diagnostic value of PET or to replace available consensus guidelines. In particular we focused on two critical issues: the cost–effectiveness of PET in the overall strategy of lymphoma diagnosis and treatment; and ongoing clinical trials adopting an interim PET-based strategy to modulate treatment intensity based on PET results. Finally, new trends in multimodality imaging, as well as in new radiopharmaceutical tracers, are briefly reviewed.
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Affiliation(s)
- Renaud Guignard
- Nuclear Medicine Department, 33 Avenue Valombrose, 06189 Nice Cedex 2, Centre Antoine Lacassagne, Nice, France.
| | - Colette Zwarthoed
- Nuclear Medicine Department, 33 Avenue Valombrose, 06189 Nice Cedex 2, Centre Antoine Lacassagne, Nice, France
| | - Anna Borra
- Hematology Department, Centre Antoine Lacassagne, Nice, France
| | - Jacques Darcourt
- Nuclear Medicine Department, 33 Avenue Valombrose, 06189 Nice Cedex 2, Centre Antoine Lacassagne, Nice, France
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Ibuka T, Araki H, Sugiyama T, Nakanishi T, Onogi F, Shimizu M, Hara T, Takami T, Tsurumi H, Moriwaki H. Diagnosis of the jejunoileal lymphoma by double-balloon endoscopy. World J Gastrointest Endosc 2013; 5:111-6. [PMID: 23515341 PMCID: PMC3600546 DOI: 10.4253/wjge.v5.i3.111] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2012] [Revised: 08/14/2012] [Accepted: 01/23/2013] [Indexed: 02/05/2023] Open
Abstract
AIM: To investigate the feasibility of double-balloon endoscopy (DBE) to detect jejunoileal lymphoma, compared with fluorodeoxyglucose positron emission tomography (FDG-PET).
METHODS: Between March 2004 and January 2011, we histologically confirmed involvement of malignant lymphoma of the jejunoileum in 31 patients by DBE and biopsy. In 20 patients of them, we performed with FDG-PET. We retrospectively reviewed the records of these 20 patients. Their median age was 64 years (range 50-81). In the 20 patients, the pathological diagnosis of underlying non-Hodgkin’s lymphoma (NHL) comprised follicular lymphoma (FL, n = 12), diffuse large B cell lymphoma (DLBCL, n = 4), mantle cell lymphoma (MCL, n = 2), enteropathy associated T cell lymphoma (ETL, n = 1) and anaplastic large cell lymphoma (ALCL, n = 1).
RESULTS: Ten cases showed accumulation by FDG-PET (50%). FDG-PET was positive in 3 of 12 FL cases (25%) while in 7 of 8 non-FL cases (88%, P < 0.05). Intestinal FL showed a significantly lower rate of positive FDG-PET, in comparison with other types of lymphoma. Cases with endoscopically elevated lesions (n = 10) showed positive FDG-PET in 2 (20%), but those with other type NHL did in 8 of 10 (80%, P < 0.05). When the cases having elevated type was compared with those not having elevated type lesion, the number of cases that showed accumulation of FDG was significantly smaller in the former than in the latter.
CONCLUSION: In a significant proportion, small intestinal involvement cannot be pointed out by FDG-PET. Especially, FL is difficult to evaluate by FDG-PET but essentially requires DBE.
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Affiliation(s)
- Takashi Ibuka
- Takashi Ibuka, Hiroshi Araki, Tomohiko Sugiyama, Takayuki Nakanishi, Fumito Onogi, Masahito Shimizu, Takeshi Hara, Hisashi Tsurumi, Hisataka Moriwaki, First Department of Internal Medicine, Gifu University Graduate School of Medicine, Gifu 501-1194, Japan
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Zinzani PL, Marchetti M, Billio A, Barosi G, Carella AM, Lazzarino M, Martelli M, Rambaldi A, Rigacci L, Tarella C, Vitolo U, Tura S. SIE, SIES, GITMO revised guidelines for the management of follicular lymphoma. Am J Hematol 2013; 88:185-92. [PMID: 23339086 DOI: 10.1002/ajh.23372] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2012] [Revised: 11/15/2012] [Accepted: 11/19/2012] [Indexed: 12/26/2022]
Abstract
By using the GRADE system, we updated the guidelines for management of follicular cell lymphoma issued in 2006 from SIE, SIES, and GITMO group. We confirmed our recommendation to frontline chemoimmunotherapy in patients with Stage III-IV disease and/or high tumor burden. Maintenance rituximab was also recommended in responding patients. In patients relapsing after an interval longer than 12 months from frontline therapy, we recommended chemoimmunotherapy with non cross-resistant regimens followed by rituximab maintenance. High dose chemotherapy followed by hematopoietic stem cell transplant was recommended for young fit patients who achieve a response after salvage chemoimmunotherapy.
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Affiliation(s)
- Pier Luigi Zinzani
- Istituto di Ematologia ed Oncologia Medica “Seragnoli,”; Università di Bologna; Bologna; Italy
| | | | - Atto Billio
- Unità di Ematologia; Ospedale Civile di Bolzano; Bolzano; Italy
| | - Giovanni Barosi
- Laboratory of Clinical Epidemiology and Center of the Study of Myelofibrosis; Fondazione IRCCS Policlinico San Matteo; Pavia; Italy
| | - Angelo Michele Carella
- Divisione di Ematologia I; IRCCS Azienda Ospedaliera Universitaria San Martino; Genova; Italy
| | - Mario Lazzarino
- Divisione di Ematologia; Fondazione IRCCS Policlinico San Matteo; Pavia; Italy
| | - Maurizio Martelli
- Dipartimento di Biotecnologie Cellulari ed Ematologia; Cattedra di Ematologia; Università La Sapienza; Roma
| | | | - Luigi Rigacci
- Unit of Hematology; AOU Careggi; University of Florence; Firenze; Italy
| | | | - Umberto Vitolo
- Divisione di Ematologia; Azienda Ospedaliera San Giovanni Battista; Torino; Italy
| | - Sante Tura
- Department of Hematology; University of Bologna; Bologna; Italy
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Abou-Nassar KE, Vanderplas A, Friedberg JW, Abel GA, Niland J, Rodriguez MA, Czuczman MS, Millenson M, Crosby A, Gordon LI, Zelenetz AD, Kaminski M, Lacasce AS. Patterns of use of 18-fluoro-2-deoxy-D-glucose positron emission tomography for initial staging of grade 1–2 follicular lymphoma and its impact on initial treatment strategy in the National Comprehensive Cancer Network Non-Hodgkin Lymphoma Outcomes database. Leuk Lymphoma 2013; 54:2155-62. [DOI: 10.3109/10428194.2013.770151] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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83
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Oncological Applications of Positron Emission Tomography for Evaluation of the Thorax. J Thorac Imaging 2013; 28:11-24. [DOI: 10.1097/rti.0b013e318279449b] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Dupuis J, Berriolo-Riedinger A, Julian A, Brice P, Tychyj-Pinel C, Tilly H, Mounier N, Gallamini A, Feugier P, Soubeyran P, Colombat P, Laurent G, Berenger N, Casasnovas RO, Vera P, Paone G, Xerri L, Salles G, Haioun C, Meignan M. Impact of [18F]Fluorodeoxyglucose Positron Emission Tomography Response Evaluation in Patients With High–Tumor Burden Follicular Lymphoma Treated With Immunochemotherapy: A Prospective Study From the Groupe d'Etudes des Lymphomes de l'Adulte and GOELAMS. J Clin Oncol 2012; 30:4317-22. [DOI: 10.1200/jco.2012.43.0934] [Citation(s) in RCA: 145] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Purpose [18F]Fluorodeoxyglucose positron emission tomography (PET) is widely used for the staging and restaging of patients with aggressive lymphoma, but less is known about the utility of PET in patients with follicular lymphoma (FL). In a prospective study, we evaluated the prognostic value of PET performed during treatment and at the end of treatment in 121 patients with FL treated with first-line immunochemotherapy. Patients and Methods Patients with previously untreated high–tumor burden FL were treated with six cycles of R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) plus two cycles of rituximab, without rituximab maintenance. PET was performed before treatment, after four cycles of R-CHOP (interim PET), and at the end of treatment (final PET). PET scans were centrally reviewed. Results The total number of patients included was 121. Median age was 57 years. After central review, interim PET (n = 111) was negative in 76% of patients, and final PET (n = 106) was negative in 78%. With a median follow-up of 23 months, 2-year progression-free survival rates were 86% for interim PET–negative versus 61% for interim PET–positive patients (P = .0046) and 87% for final PET–negative versus 51% for final PET–positive patients (P < .001), respectively. Two-year overall survival also significantly differed according to final PET results: 100% versus 88% (P = .0128). Conclusion PET performed either after four cycles of R-CHOP or at the end of therapy was strongly predictive of outcome in this prospective study. Therapeutic intervention based on PET results during or after inductive treatment should be evaluated.
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Affiliation(s)
- Jehan Dupuis
- Jehan Dupuis, Corinne Haioun, and Michel Meignan, Hôpital Henri Mondor, Créteil; Alina Berriolo-Riedinger, Centre Georges Francois Leclerc; Rene-Olivier Casasnovas, Hôpital Le Bocage, Dijon; Anne Julian and Guy Laurent, Hôpital Purpan, Toulouse; Pauline Brice and Nathalie Berenger, Hôpital Saint Louis, Paris; Christelle Tychyj-Pinel and Gilles Salles, Centre Hospitalier Lyon Sud, Pierre Benite; Hervé Tilly and Pierre Vera, Centre Henri Becquerel, Rouen; Nicolas Mounier and Gaetano Paone, Hôpital de
| | - Alina Berriolo-Riedinger
- Jehan Dupuis, Corinne Haioun, and Michel Meignan, Hôpital Henri Mondor, Créteil; Alina Berriolo-Riedinger, Centre Georges Francois Leclerc; Rene-Olivier Casasnovas, Hôpital Le Bocage, Dijon; Anne Julian and Guy Laurent, Hôpital Purpan, Toulouse; Pauline Brice and Nathalie Berenger, Hôpital Saint Louis, Paris; Christelle Tychyj-Pinel and Gilles Salles, Centre Hospitalier Lyon Sud, Pierre Benite; Hervé Tilly and Pierre Vera, Centre Henri Becquerel, Rouen; Nicolas Mounier and Gaetano Paone, Hôpital de
| | - Anne Julian
- Jehan Dupuis, Corinne Haioun, and Michel Meignan, Hôpital Henri Mondor, Créteil; Alina Berriolo-Riedinger, Centre Georges Francois Leclerc; Rene-Olivier Casasnovas, Hôpital Le Bocage, Dijon; Anne Julian and Guy Laurent, Hôpital Purpan, Toulouse; Pauline Brice and Nathalie Berenger, Hôpital Saint Louis, Paris; Christelle Tychyj-Pinel and Gilles Salles, Centre Hospitalier Lyon Sud, Pierre Benite; Hervé Tilly and Pierre Vera, Centre Henri Becquerel, Rouen; Nicolas Mounier and Gaetano Paone, Hôpital de
| | - Pauline Brice
- Jehan Dupuis, Corinne Haioun, and Michel Meignan, Hôpital Henri Mondor, Créteil; Alina Berriolo-Riedinger, Centre Georges Francois Leclerc; Rene-Olivier Casasnovas, Hôpital Le Bocage, Dijon; Anne Julian and Guy Laurent, Hôpital Purpan, Toulouse; Pauline Brice and Nathalie Berenger, Hôpital Saint Louis, Paris; Christelle Tychyj-Pinel and Gilles Salles, Centre Hospitalier Lyon Sud, Pierre Benite; Hervé Tilly and Pierre Vera, Centre Henri Becquerel, Rouen; Nicolas Mounier and Gaetano Paone, Hôpital de
| | - Christelle Tychyj-Pinel
- Jehan Dupuis, Corinne Haioun, and Michel Meignan, Hôpital Henri Mondor, Créteil; Alina Berriolo-Riedinger, Centre Georges Francois Leclerc; Rene-Olivier Casasnovas, Hôpital Le Bocage, Dijon; Anne Julian and Guy Laurent, Hôpital Purpan, Toulouse; Pauline Brice and Nathalie Berenger, Hôpital Saint Louis, Paris; Christelle Tychyj-Pinel and Gilles Salles, Centre Hospitalier Lyon Sud, Pierre Benite; Hervé Tilly and Pierre Vera, Centre Henri Becquerel, Rouen; Nicolas Mounier and Gaetano Paone, Hôpital de
| | - Hervé Tilly
- Jehan Dupuis, Corinne Haioun, and Michel Meignan, Hôpital Henri Mondor, Créteil; Alina Berriolo-Riedinger, Centre Georges Francois Leclerc; Rene-Olivier Casasnovas, Hôpital Le Bocage, Dijon; Anne Julian and Guy Laurent, Hôpital Purpan, Toulouse; Pauline Brice and Nathalie Berenger, Hôpital Saint Louis, Paris; Christelle Tychyj-Pinel and Gilles Salles, Centre Hospitalier Lyon Sud, Pierre Benite; Hervé Tilly and Pierre Vera, Centre Henri Becquerel, Rouen; Nicolas Mounier and Gaetano Paone, Hôpital de
| | - Nicolas Mounier
- Jehan Dupuis, Corinne Haioun, and Michel Meignan, Hôpital Henri Mondor, Créteil; Alina Berriolo-Riedinger, Centre Georges Francois Leclerc; Rene-Olivier Casasnovas, Hôpital Le Bocage, Dijon; Anne Julian and Guy Laurent, Hôpital Purpan, Toulouse; Pauline Brice and Nathalie Berenger, Hôpital Saint Louis, Paris; Christelle Tychyj-Pinel and Gilles Salles, Centre Hospitalier Lyon Sud, Pierre Benite; Hervé Tilly and Pierre Vera, Centre Henri Becquerel, Rouen; Nicolas Mounier and Gaetano Paone, Hôpital de
| | - Andrea Gallamini
- Jehan Dupuis, Corinne Haioun, and Michel Meignan, Hôpital Henri Mondor, Créteil; Alina Berriolo-Riedinger, Centre Georges Francois Leclerc; Rene-Olivier Casasnovas, Hôpital Le Bocage, Dijon; Anne Julian and Guy Laurent, Hôpital Purpan, Toulouse; Pauline Brice and Nathalie Berenger, Hôpital Saint Louis, Paris; Christelle Tychyj-Pinel and Gilles Salles, Centre Hospitalier Lyon Sud, Pierre Benite; Hervé Tilly and Pierre Vera, Centre Henri Becquerel, Rouen; Nicolas Mounier and Gaetano Paone, Hôpital de
| | - Pierre Feugier
- Jehan Dupuis, Corinne Haioun, and Michel Meignan, Hôpital Henri Mondor, Créteil; Alina Berriolo-Riedinger, Centre Georges Francois Leclerc; Rene-Olivier Casasnovas, Hôpital Le Bocage, Dijon; Anne Julian and Guy Laurent, Hôpital Purpan, Toulouse; Pauline Brice and Nathalie Berenger, Hôpital Saint Louis, Paris; Christelle Tychyj-Pinel and Gilles Salles, Centre Hospitalier Lyon Sud, Pierre Benite; Hervé Tilly and Pierre Vera, Centre Henri Becquerel, Rouen; Nicolas Mounier and Gaetano Paone, Hôpital de
| | - Pierre Soubeyran
- Jehan Dupuis, Corinne Haioun, and Michel Meignan, Hôpital Henri Mondor, Créteil; Alina Berriolo-Riedinger, Centre Georges Francois Leclerc; Rene-Olivier Casasnovas, Hôpital Le Bocage, Dijon; Anne Julian and Guy Laurent, Hôpital Purpan, Toulouse; Pauline Brice and Nathalie Berenger, Hôpital Saint Louis, Paris; Christelle Tychyj-Pinel and Gilles Salles, Centre Hospitalier Lyon Sud, Pierre Benite; Hervé Tilly and Pierre Vera, Centre Henri Becquerel, Rouen; Nicolas Mounier and Gaetano Paone, Hôpital de
| | - Philippe Colombat
- Jehan Dupuis, Corinne Haioun, and Michel Meignan, Hôpital Henri Mondor, Créteil; Alina Berriolo-Riedinger, Centre Georges Francois Leclerc; Rene-Olivier Casasnovas, Hôpital Le Bocage, Dijon; Anne Julian and Guy Laurent, Hôpital Purpan, Toulouse; Pauline Brice and Nathalie Berenger, Hôpital Saint Louis, Paris; Christelle Tychyj-Pinel and Gilles Salles, Centre Hospitalier Lyon Sud, Pierre Benite; Hervé Tilly and Pierre Vera, Centre Henri Becquerel, Rouen; Nicolas Mounier and Gaetano Paone, Hôpital de
| | - Guy Laurent
- Jehan Dupuis, Corinne Haioun, and Michel Meignan, Hôpital Henri Mondor, Créteil; Alina Berriolo-Riedinger, Centre Georges Francois Leclerc; Rene-Olivier Casasnovas, Hôpital Le Bocage, Dijon; Anne Julian and Guy Laurent, Hôpital Purpan, Toulouse; Pauline Brice and Nathalie Berenger, Hôpital Saint Louis, Paris; Christelle Tychyj-Pinel and Gilles Salles, Centre Hospitalier Lyon Sud, Pierre Benite; Hervé Tilly and Pierre Vera, Centre Henri Becquerel, Rouen; Nicolas Mounier and Gaetano Paone, Hôpital de
| | - Nathalie Berenger
- Jehan Dupuis, Corinne Haioun, and Michel Meignan, Hôpital Henri Mondor, Créteil; Alina Berriolo-Riedinger, Centre Georges Francois Leclerc; Rene-Olivier Casasnovas, Hôpital Le Bocage, Dijon; Anne Julian and Guy Laurent, Hôpital Purpan, Toulouse; Pauline Brice and Nathalie Berenger, Hôpital Saint Louis, Paris; Christelle Tychyj-Pinel and Gilles Salles, Centre Hospitalier Lyon Sud, Pierre Benite; Hervé Tilly and Pierre Vera, Centre Henri Becquerel, Rouen; Nicolas Mounier and Gaetano Paone, Hôpital de
| | - Rene-Olivier Casasnovas
- Jehan Dupuis, Corinne Haioun, and Michel Meignan, Hôpital Henri Mondor, Créteil; Alina Berriolo-Riedinger, Centre Georges Francois Leclerc; Rene-Olivier Casasnovas, Hôpital Le Bocage, Dijon; Anne Julian and Guy Laurent, Hôpital Purpan, Toulouse; Pauline Brice and Nathalie Berenger, Hôpital Saint Louis, Paris; Christelle Tychyj-Pinel and Gilles Salles, Centre Hospitalier Lyon Sud, Pierre Benite; Hervé Tilly and Pierre Vera, Centre Henri Becquerel, Rouen; Nicolas Mounier and Gaetano Paone, Hôpital de
| | - Pierre Vera
- Jehan Dupuis, Corinne Haioun, and Michel Meignan, Hôpital Henri Mondor, Créteil; Alina Berriolo-Riedinger, Centre Georges Francois Leclerc; Rene-Olivier Casasnovas, Hôpital Le Bocage, Dijon; Anne Julian and Guy Laurent, Hôpital Purpan, Toulouse; Pauline Brice and Nathalie Berenger, Hôpital Saint Louis, Paris; Christelle Tychyj-Pinel and Gilles Salles, Centre Hospitalier Lyon Sud, Pierre Benite; Hervé Tilly and Pierre Vera, Centre Henri Becquerel, Rouen; Nicolas Mounier and Gaetano Paone, Hôpital de
| | - Gaetano Paone
- Jehan Dupuis, Corinne Haioun, and Michel Meignan, Hôpital Henri Mondor, Créteil; Alina Berriolo-Riedinger, Centre Georges Francois Leclerc; Rene-Olivier Casasnovas, Hôpital Le Bocage, Dijon; Anne Julian and Guy Laurent, Hôpital Purpan, Toulouse; Pauline Brice and Nathalie Berenger, Hôpital Saint Louis, Paris; Christelle Tychyj-Pinel and Gilles Salles, Centre Hospitalier Lyon Sud, Pierre Benite; Hervé Tilly and Pierre Vera, Centre Henri Becquerel, Rouen; Nicolas Mounier and Gaetano Paone, Hôpital de
| | - Luc Xerri
- Jehan Dupuis, Corinne Haioun, and Michel Meignan, Hôpital Henri Mondor, Créteil; Alina Berriolo-Riedinger, Centre Georges Francois Leclerc; Rene-Olivier Casasnovas, Hôpital Le Bocage, Dijon; Anne Julian and Guy Laurent, Hôpital Purpan, Toulouse; Pauline Brice and Nathalie Berenger, Hôpital Saint Louis, Paris; Christelle Tychyj-Pinel and Gilles Salles, Centre Hospitalier Lyon Sud, Pierre Benite; Hervé Tilly and Pierre Vera, Centre Henri Becquerel, Rouen; Nicolas Mounier and Gaetano Paone, Hôpital de
| | - Gilles Salles
- Jehan Dupuis, Corinne Haioun, and Michel Meignan, Hôpital Henri Mondor, Créteil; Alina Berriolo-Riedinger, Centre Georges Francois Leclerc; Rene-Olivier Casasnovas, Hôpital Le Bocage, Dijon; Anne Julian and Guy Laurent, Hôpital Purpan, Toulouse; Pauline Brice and Nathalie Berenger, Hôpital Saint Louis, Paris; Christelle Tychyj-Pinel and Gilles Salles, Centre Hospitalier Lyon Sud, Pierre Benite; Hervé Tilly and Pierre Vera, Centre Henri Becquerel, Rouen; Nicolas Mounier and Gaetano Paone, Hôpital de
| | - Corinne Haioun
- Jehan Dupuis, Corinne Haioun, and Michel Meignan, Hôpital Henri Mondor, Créteil; Alina Berriolo-Riedinger, Centre Georges Francois Leclerc; Rene-Olivier Casasnovas, Hôpital Le Bocage, Dijon; Anne Julian and Guy Laurent, Hôpital Purpan, Toulouse; Pauline Brice and Nathalie Berenger, Hôpital Saint Louis, Paris; Christelle Tychyj-Pinel and Gilles Salles, Centre Hospitalier Lyon Sud, Pierre Benite; Hervé Tilly and Pierre Vera, Centre Henri Becquerel, Rouen; Nicolas Mounier and Gaetano Paone, Hôpital de
| | - Michel Meignan
- Jehan Dupuis, Corinne Haioun, and Michel Meignan, Hôpital Henri Mondor, Créteil; Alina Berriolo-Riedinger, Centre Georges Francois Leclerc; Rene-Olivier Casasnovas, Hôpital Le Bocage, Dijon; Anne Julian and Guy Laurent, Hôpital Purpan, Toulouse; Pauline Brice and Nathalie Berenger, Hôpital Saint Louis, Paris; Christelle Tychyj-Pinel and Gilles Salles, Centre Hospitalier Lyon Sud, Pierre Benite; Hervé Tilly and Pierre Vera, Centre Henri Becquerel, Rouen; Nicolas Mounier and Gaetano Paone, Hôpital de
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Iwamuro M, Okada H, Takata K, Shinagawa K, Fujiki S, Shiode J, Imagawa A, Araki M, Morito T, Nishimura M, Mizuno M, Inaba T, Suzuki S, Kawai Y, Yoshino T, Kawahara Y, Takaki A, Yamamoto K. Diagnostic role of 18F-fluorodeoxyglucose positron emission tomography for follicular lymphoma with gastrointestinal involvement. World J Gastroenterol 2012; 18:6427-6436. [PMID: 23197888 PMCID: PMC3508637 DOI: 10.3748/wjg.v18.i44.6427] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To investigate the capacity for 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) to evaluate patients with gastrointestinal lesions of follicular lymphoma.
METHODS: This retrospective case series consisted of 41 patients with follicular lymphoma and gastrointestinal involvement who underwent 18F-FDG-PET and endoscopic evaluations at ten different institutions between November 1996 and October 2011. Data for endoscopic, radiological, and biological examinations performed were retrospectively reviewed from clinical records. A semi-quantitative analysis of 18F-FDG uptake was performed for each involved area by calculating the maximum standardized uptake value (SUVmax). Based on the positivity of 18F-FDG uptake in the gastrointestinal lesions analyzed, patients were subdivided into two groups. To identify potential predictive factors for 18F-FDG positivity, these two groups were compared with respect to gender, age at diagnosis of lymphoma, histopathological grade, pattern of follicular dendritic cells, mitotic rate, clinical stage, soluble interleukin-2 receptor levels detected by 18F-FDG-PET, lactate dehydrogenase (LDH) levels, hemoglobin levels, bone marrow involvement, detectability of gastrointestinal lesions by computed tomography (CT) scanning, and follicular lymphoma international prognostic index (FLIPI) risk.
RESULTS: Involvement of follicular lymphoma in the stomach, duodenum, jejunum, ileum, cecum, colon, and rectum was identified in 1, 34, 6, 3, 2, 3, and 6 patients, respectively. No patient had esophageal involvement. In total, 19/41 (46.3%) patients exhibited true-positive 18F-FDG uptake in the lesions present in their gastrointestinal tract. In contrast, false-negative 18F-FDG uptake was detected in 24 patients (58.5%), while false-positive 18F-FDG uptake was detected in 5 patients (12.2%). In the former case, 2/19 patients had both 18F-FDG-positive lesions and 18F-FDG-negative lesions in the gastrointestinal tract. In patients with 18F-FDG avidity, the SUVmax value of the involved gastrointestinal tract ranged from 2.6 to 17.4 (median: 4.7). For the 18F-FDG-negative (n = 22) and -positive (n = 19) groups, there were no differences in the male to female ratios (10/12 vs 4/15, P = 0.186), patient age (63.6 ± 2.4 years vs 60.1 ± 2.6 years, P = 0.323), presence of histopathological grade 1 vs 2 (20/2 and 17/2, P = 1.000), follicular dendritic cell pattern (duodenal/nodal: 13/5 vs 10/3, P = 1.000), mitotic rate (low/partly high, 14/1 vs 10/3, P = 0.311), clinical stage according to the Ann Arbor system (stages IE and IIE/other, 15/7 vs 15/4, P = 0.499), clinical stage according to the Lugano system (stages I and II-1/other, 14/8 vs 14/5, P = 0.489), soluble interleukin-2 receptor levels (495 ± 78 vs 402 ± 83, P = 0.884), LDH levels (188 ± 7 vs 183 ± 8, P = 0.749), hemoglobin levels (13.5 ± 0.3 vs 12.8 ± 0.4, P = 0.197), bone marrow involvement (positive/negative, 1/8 vs 1/10, P = 1.000), detectability by CT scanning (positive/negative, 1/16 vs 4/13, P = 0.335), and FLIPI risk (low risk/other, 16/6 vs 13/6, P = 0.763), respectively in each case.
CONCLUSION: These findings indicate that it is not feasible to predict 18F-FDG-avidity. Therefore, 18F-FDG-PET scans represent a complementary modality for the detection of gastrointestinal involvements in follicular lymphoma patients, and surveillance of the entire gastrointestinal tract by endoscopic examinations is required.
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86
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Barrington SF, Mikhaeel NG. Imaging follicular lymphoma using positron emission tomography with [(18)F]fluorodeoxyglucose: to what purpose? J Clin Oncol 2012; 30:4285-7. [PMID: 23109690 DOI: 10.1200/jco.2012.45.4082] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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El-Najjar I, Barwick T, Avril N, Montoto S. The role of FDG-PET and bone marrow examination in lymphoma staging. Ann Oncol 2012; 23 Suppl 10:x89-91. [DOI: 10.1093/annonc/mds316] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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FDG-PET in Follicular Lymphoma Management. JOURNAL OF ONCOLOGY 2012; 2012:370272. [PMID: 22899920 PMCID: PMC3413977 DOI: 10.1155/2012/370272] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2012] [Accepted: 06/26/2012] [Indexed: 11/23/2022]
Abstract
18-Fluoro-deoxyglucose positron emission tomography/computerised tomography (FDG PET/CT) is commonly used in the management of patients with lymphomas and is recommended for both initial staging and response assessment after treatment in patients with diffuse large B-cell lymphoma and Hodgkin lymphoma. Despite the FDG avidity of follicular lymphoma (FL), FDG PET/CT is not yet applied in standard clinical practice for patients with FL. However, FDG PET/CT is more accurate than conventional imaging for initial staging, often prompting significant management change, and allows noninvasive characterization to guide assessment of high-grade transformation. For restaging, FDG PET/CT assists in distinguishing between scar tissue and viable tumors in residual masses and a positive PET after induction treatment would seem to predict a shorter progression-free survival.
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Shelly MJ, McDermott S, O'Connor OJ, Blake MA. 18-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in the Management of Aggressive Non-Hodgkin's B-Cell Lymphoma. ISRN HEMATOLOGY 2012; 2012:456706. [PMID: 22474590 PMCID: PMC3313577 DOI: 10.5402/2012/456706] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2011] [Accepted: 12/29/2011] [Indexed: 12/13/2022]
Abstract
18-Fluorodeoxyglucose (FDG-PET/CT) is an established imaging modality that has been proven to be of benefit in the management of aggressive B-cell non-Hodgkin's lymphoma, such as diffuse large B-cell lymphoma and advanced stage follicular lymphoma. The combination of anatomic and functional imaging afforded by FDG-PET/CT has led to superior sensitivity and specificity in the primary staging, restaging, and assessment of response to treatment of hematological malignancies when compared to FDG-PET and CT alone. The use of FDG-PET/CT for posttreatment surveillance imaging remains controversial, and further study is needed to ascertain whether this modality is cost effective and appropriate for use in this setting.
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Affiliation(s)
- M J Shelly
- Department of Radiology, Massachusetts General Hospital, Boston, MA 02114, USA
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FDG PET/CT predictive role in follicular lymphoma. Eur J Nucl Med Mol Imaging 2012; 39:864-71. [PMID: 22354449 DOI: 10.1007/s00259-012-2079-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2011] [Accepted: 01/26/2012] [Indexed: 10/28/2022]
Abstract
PURPOSE We present findings concerning (18)F-fluorodeoxyglucose (FDG) positron emission tomography (PET) at end-treatment evaluation in follicular lymphoma (FL) in order to establish possible predictive factors for progression-free survival (PFS) and patient outcome. METHODS We retrospectively analysed data from 91 consecutive FL patients (M:F = 51:40, mean age 61) referred to our PET Unit at therapy completion: 38 with an indolent form (grade 1-2) and 53 with an aggressive FL (grade 3a and b) according to the World Health Organization (WHO) classification. A total of 148 FDG PET/CT scans were analysed and findings reported as positive or negative for disease. The overall response to treatment was assessed according to the revised International Workshop Criteria (IWC). The final outcome was defined as remission or disease by taking clinical, instrumental and histological data as standards of reference, with a mean follow-up period of 3 years (range 1-8). A statistical analysis was performed with respect to PFS and patient outcome for FDG PET result, tumour grading, Follicular Lymphoma International Prognostic Index (FLIPI), disease stage and number of relapses, on uni- and multivariate analyses, with p < 0.05 considered as significant. RESULTS Overall patients presented a mean PFS of 35 months (range 3-86), with a relapse rate of 42%. At final outcome, remission was achieved in 67 of 91 patients (74%). Of the different predictive factors, only FDG PET result significantly correlated with patient outcome (p = 0.0002). PET/CT performance at the end of treatment was as follows: 100% sensitivity, 99% specificity, 89% positive predictive value and 100% negative predictive value. The Kaplan-Meier analysis demonstrated a statistically significant correlation with PFS for FDG PET (p < 0.0001), FLIPI score (0-1 versus ≥ 2) (p = 0.0451) and number of relapses (none versus ≥ 1) (p = 0.0058). These findings were confirmed at the univariate analysis, whereas at the multivariate analysis only FDG PET (p = 0.0006892) and number of relapses (p = 0.01947) were independent predictive factors for PFS. CONCLUSION End-treatment PET/CT in FL has high accuracy and appears to be a good predictor of PFS and patient outcome, irrespective of grading. As expected, patients facing more than one relapse seem to have significantly shorter PFS in the presence of a positive FDG PET.
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Cornec D, Tempescul A, Querellou S, Hutin P, Pers JO, Jamin C, Bendaoud B, Berthou C, Renaudineau Y, Youinou P. Identification of patients with indolent B cell lymphoma sensitive to rituximab monotherapy. Ann Hematol 2011; 91:715-721. [DOI: 10.1007/s00277-011-1369-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2011] [Accepted: 11/02/2011] [Indexed: 12/27/2022]
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Spira D, Sökler M, Vogel W, Löffler S, Spira SM, Brodoefel H, Fenchel M, Horger M. Volume and attenuation computed tomography measurements for interim evaluation of Hodgkin and follicular lymphoma as an additional surrogate parameter for more confident response monitoring: a pilot study. Cancer Imaging 2011; 11:155-62. [PMID: 22042236 PMCID: PMC3205764 DOI: 10.1102/1470-7330.2011.0022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Purpose: To retrospectively determine the potential role of additional computed tomography (CT) attenuation measurements for interim response evaluation in residual masses of patients with Hodgkin disease (HD) and follicular non-Hodgkin lymphoma (NHL). Materials and methods: In this retrospective study, 39 patients with HD and 35 patients with NHL presented with residual masses at mid-treatment CT (after 2–4 cycles of chemotherapy) and were assessed via contrast-enhanced CT at baseline, mid-treatment and post-treatment. Volume was recorded as whole-tumour volume. A tumour attenuation ratio (TAR) was calculated as the quotient of attenuation between tumour and muscle at the respective point in time versus baseline. The standard deviation of attenuation values within the tumour volume was recorded to estimate tumour heterogeneity. Results were correlated with relapse-free survival determined at a minimum of 12 months after end-treatment CT. Results: Tumour volume and TAR at interim versus baseline control were significantly reduced in responders compared with non-responders, even after controlling for age, stage, treatment regimen, and baseline tumour volume. No significant differences with respect to the standard deviation of attenuation values within the tumour volumes (tumour heterogeneity) were observed. The volume and attenuation CT (VACT) criteria yielded the highest sensitivities and specificities for the identification of non-response at a threshold of a >20% increase in volume and an increase in TAR at interim control, i.e. 88% (NHL 80%, HD 100%) and 98% (NHL 97%, HD 100%), respectively. The negative predictive values reached by VACT analysis were ≥97%, according to both parameters. Conclusion: Mid-treatment response assessment of residual masses in patients with HD and NHL using VACT may aid in the risk stratification as an additional surrogate parameter.
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Affiliation(s)
- Daniel Spira
- Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University, Hoppe-Seyler-Strasse 3, 72076 Tübingen, Germany.
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Meignan M. Place de la tomographie par émission de positons au F18-fluorodéoxyglucose couplée au scanner (TEP/TDM) dans le bilan initial des lymphomes de l’adulte. ONCOLOGIE 2011. [DOI: 10.1007/s10269-011-2066-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Trotman J, Fournier M, Lamy T, Seymour JF, Sonet A, Janikova A, Shpilberg O, Gyan E, Tilly H, Estell J, Forsyth C, Decaudin D, Fabiani B, Gabarre J, Salles B, Van Den Neste E, Canioni D, Garin E, Fulham M, Vander Borght T, Salles G. Positron Emission Tomography–Computed Tomography (PET-CT) After Induction Therapy Is Highly Predictive of Patient Outcome in Follicular Lymphoma: Analysis of PET-CT in a Subset of PRIMA Trial Participants. J Clin Oncol 2011; 29:3194-200. [DOI: 10.1200/jco.2011.35.0736] [Citation(s) in RCA: 152] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose The utility of [18F]fluorodeoxyglucose (FDG) positron emission tomography–computed tomography (PET-CT) in assessing response at the end of induction therapy is well documented in Hodgkin's and diffuse large B-cell lymphomas, but its role in follicular lymphoma (FL) remains undetermined. We investigated the prognostic significance of PET-CT performed after first-line therapy in patients with FL treated in the prospective Primary Rituximab and Maintenance (PRIMA) study. Patients and Methods Results of PET-CT scans performed after induction immunochemotherapy were recorded retrospectively. Patients went on to either observation or rituximab maintenance per protocol independent of the PET-CT result. Patient characteristics and outcomes were then evaluated. Results Of 122 PET-CT scans performed at the end of the induction immunochemotherapy, 32 (26%) were reported as positive by the local investigator. Initial demographic or disease characteristics did not differ between PET-CT–positive (PET-positive) and PET-CT–negative (PET-negative) patients. PET status correlated with conventional response criteria (P < .001). Patients remaining PET positive had a significantly (P < .001) inferior progression-free survival at 42 months of 32.9% (95% CI, 17.2% to 49.5%) compared with 70.7% (95% CI, 59.3% to 79.4%) in those who became PET negative. PET status, but not conventional response (complete response or complete response unconfirmed v partial response) according to IWC 1999, was an independent predictive factor for lymphoma progression. The risk of death was also increased in PET-positive patients (hazard ratio 7.0; P = .0011). Conclusion [18F]FDG PET-CT status at the end of immunochemotherapy induction in patients with FL is strongly predictive of outcome and should be considered a meaningful clinical end point in future studies.
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Affiliation(s)
- Judith Trotman
- Judith Trotman and Jane Estell, Concord Hospital; Michael Fulham, Royal Prince Alfred Hospital and Sydney Medical School, University of Sydney, Sydney; John Francis Seymour, Peter MacCallum Cancer Center and University of Melbourne, Melbourne; Cecily Forsyth, Wyong Hospital, Kanwal, Australia; Marion Fournier, Hospices Civils de Lyon, Groupe d'Etude des Lymphomes de l'Adulte, Recherche Clinique, Hôpital Lyon sud, Pierre-Bénite; Thierry Lamy, Centre Hospitalier Universitaire (CHU) de Rennes, L'Institut
| | - Marion Fournier
- Judith Trotman and Jane Estell, Concord Hospital; Michael Fulham, Royal Prince Alfred Hospital and Sydney Medical School, University of Sydney, Sydney; John Francis Seymour, Peter MacCallum Cancer Center and University of Melbourne, Melbourne; Cecily Forsyth, Wyong Hospital, Kanwal, Australia; Marion Fournier, Hospices Civils de Lyon, Groupe d'Etude des Lymphomes de l'Adulte, Recherche Clinique, Hôpital Lyon sud, Pierre-Bénite; Thierry Lamy, Centre Hospitalier Universitaire (CHU) de Rennes, L'Institut
| | - Thierry Lamy
- Judith Trotman and Jane Estell, Concord Hospital; Michael Fulham, Royal Prince Alfred Hospital and Sydney Medical School, University of Sydney, Sydney; John Francis Seymour, Peter MacCallum Cancer Center and University of Melbourne, Melbourne; Cecily Forsyth, Wyong Hospital, Kanwal, Australia; Marion Fournier, Hospices Civils de Lyon, Groupe d'Etude des Lymphomes de l'Adulte, Recherche Clinique, Hôpital Lyon sud, Pierre-Bénite; Thierry Lamy, Centre Hospitalier Universitaire (CHU) de Rennes, L'Institut
| | - John Francis Seymour
- Judith Trotman and Jane Estell, Concord Hospital; Michael Fulham, Royal Prince Alfred Hospital and Sydney Medical School, University of Sydney, Sydney; John Francis Seymour, Peter MacCallum Cancer Center and University of Melbourne, Melbourne; Cecily Forsyth, Wyong Hospital, Kanwal, Australia; Marion Fournier, Hospices Civils de Lyon, Groupe d'Etude des Lymphomes de l'Adulte, Recherche Clinique, Hôpital Lyon sud, Pierre-Bénite; Thierry Lamy, Centre Hospitalier Universitaire (CHU) de Rennes, L'Institut
| | - Anne Sonet
- Judith Trotman and Jane Estell, Concord Hospital; Michael Fulham, Royal Prince Alfred Hospital and Sydney Medical School, University of Sydney, Sydney; John Francis Seymour, Peter MacCallum Cancer Center and University of Melbourne, Melbourne; Cecily Forsyth, Wyong Hospital, Kanwal, Australia; Marion Fournier, Hospices Civils de Lyon, Groupe d'Etude des Lymphomes de l'Adulte, Recherche Clinique, Hôpital Lyon sud, Pierre-Bénite; Thierry Lamy, Centre Hospitalier Universitaire (CHU) de Rennes, L'Institut
| | - Andrea Janikova
- Judith Trotman and Jane Estell, Concord Hospital; Michael Fulham, Royal Prince Alfred Hospital and Sydney Medical School, University of Sydney, Sydney; John Francis Seymour, Peter MacCallum Cancer Center and University of Melbourne, Melbourne; Cecily Forsyth, Wyong Hospital, Kanwal, Australia; Marion Fournier, Hospices Civils de Lyon, Groupe d'Etude des Lymphomes de l'Adulte, Recherche Clinique, Hôpital Lyon sud, Pierre-Bénite; Thierry Lamy, Centre Hospitalier Universitaire (CHU) de Rennes, L'Institut
| | - Ofer Shpilberg
- Judith Trotman and Jane Estell, Concord Hospital; Michael Fulham, Royal Prince Alfred Hospital and Sydney Medical School, University of Sydney, Sydney; John Francis Seymour, Peter MacCallum Cancer Center and University of Melbourne, Melbourne; Cecily Forsyth, Wyong Hospital, Kanwal, Australia; Marion Fournier, Hospices Civils de Lyon, Groupe d'Etude des Lymphomes de l'Adulte, Recherche Clinique, Hôpital Lyon sud, Pierre-Bénite; Thierry Lamy, Centre Hospitalier Universitaire (CHU) de Rennes, L'Institut
| | - Emmanuel Gyan
- Judith Trotman and Jane Estell, Concord Hospital; Michael Fulham, Royal Prince Alfred Hospital and Sydney Medical School, University of Sydney, Sydney; John Francis Seymour, Peter MacCallum Cancer Center and University of Melbourne, Melbourne; Cecily Forsyth, Wyong Hospital, Kanwal, Australia; Marion Fournier, Hospices Civils de Lyon, Groupe d'Etude des Lymphomes de l'Adulte, Recherche Clinique, Hôpital Lyon sud, Pierre-Bénite; Thierry Lamy, Centre Hospitalier Universitaire (CHU) de Rennes, L'Institut
| | - Hervé Tilly
- Judith Trotman and Jane Estell, Concord Hospital; Michael Fulham, Royal Prince Alfred Hospital and Sydney Medical School, University of Sydney, Sydney; John Francis Seymour, Peter MacCallum Cancer Center and University of Melbourne, Melbourne; Cecily Forsyth, Wyong Hospital, Kanwal, Australia; Marion Fournier, Hospices Civils de Lyon, Groupe d'Etude des Lymphomes de l'Adulte, Recherche Clinique, Hôpital Lyon sud, Pierre-Bénite; Thierry Lamy, Centre Hospitalier Universitaire (CHU) de Rennes, L'Institut
| | - Jane Estell
- Judith Trotman and Jane Estell, Concord Hospital; Michael Fulham, Royal Prince Alfred Hospital and Sydney Medical School, University of Sydney, Sydney; John Francis Seymour, Peter MacCallum Cancer Center and University of Melbourne, Melbourne; Cecily Forsyth, Wyong Hospital, Kanwal, Australia; Marion Fournier, Hospices Civils de Lyon, Groupe d'Etude des Lymphomes de l'Adulte, Recherche Clinique, Hôpital Lyon sud, Pierre-Bénite; Thierry Lamy, Centre Hospitalier Universitaire (CHU) de Rennes, L'Institut
| | - Cecily Forsyth
- Judith Trotman and Jane Estell, Concord Hospital; Michael Fulham, Royal Prince Alfred Hospital and Sydney Medical School, University of Sydney, Sydney; John Francis Seymour, Peter MacCallum Cancer Center and University of Melbourne, Melbourne; Cecily Forsyth, Wyong Hospital, Kanwal, Australia; Marion Fournier, Hospices Civils de Lyon, Groupe d'Etude des Lymphomes de l'Adulte, Recherche Clinique, Hôpital Lyon sud, Pierre-Bénite; Thierry Lamy, Centre Hospitalier Universitaire (CHU) de Rennes, L'Institut
| | - Didier Decaudin
- Judith Trotman and Jane Estell, Concord Hospital; Michael Fulham, Royal Prince Alfred Hospital and Sydney Medical School, University of Sydney, Sydney; John Francis Seymour, Peter MacCallum Cancer Center and University of Melbourne, Melbourne; Cecily Forsyth, Wyong Hospital, Kanwal, Australia; Marion Fournier, Hospices Civils de Lyon, Groupe d'Etude des Lymphomes de l'Adulte, Recherche Clinique, Hôpital Lyon sud, Pierre-Bénite; Thierry Lamy, Centre Hospitalier Universitaire (CHU) de Rennes, L'Institut
| | - Bettina Fabiani
- Judith Trotman and Jane Estell, Concord Hospital; Michael Fulham, Royal Prince Alfred Hospital and Sydney Medical School, University of Sydney, Sydney; John Francis Seymour, Peter MacCallum Cancer Center and University of Melbourne, Melbourne; Cecily Forsyth, Wyong Hospital, Kanwal, Australia; Marion Fournier, Hospices Civils de Lyon, Groupe d'Etude des Lymphomes de l'Adulte, Recherche Clinique, Hôpital Lyon sud, Pierre-Bénite; Thierry Lamy, Centre Hospitalier Universitaire (CHU) de Rennes, L'Institut
| | - Jean Gabarre
- Judith Trotman and Jane Estell, Concord Hospital; Michael Fulham, Royal Prince Alfred Hospital and Sydney Medical School, University of Sydney, Sydney; John Francis Seymour, Peter MacCallum Cancer Center and University of Melbourne, Melbourne; Cecily Forsyth, Wyong Hospital, Kanwal, Australia; Marion Fournier, Hospices Civils de Lyon, Groupe d'Etude des Lymphomes de l'Adulte, Recherche Clinique, Hôpital Lyon sud, Pierre-Bénite; Thierry Lamy, Centre Hospitalier Universitaire (CHU) de Rennes, L'Institut
| | - Bruno Salles
- Judith Trotman and Jane Estell, Concord Hospital; Michael Fulham, Royal Prince Alfred Hospital and Sydney Medical School, University of Sydney, Sydney; John Francis Seymour, Peter MacCallum Cancer Center and University of Melbourne, Melbourne; Cecily Forsyth, Wyong Hospital, Kanwal, Australia; Marion Fournier, Hospices Civils de Lyon, Groupe d'Etude des Lymphomes de l'Adulte, Recherche Clinique, Hôpital Lyon sud, Pierre-Bénite; Thierry Lamy, Centre Hospitalier Universitaire (CHU) de Rennes, L'Institut
| | - Eric Van Den Neste
- Judith Trotman and Jane Estell, Concord Hospital; Michael Fulham, Royal Prince Alfred Hospital and Sydney Medical School, University of Sydney, Sydney; John Francis Seymour, Peter MacCallum Cancer Center and University of Melbourne, Melbourne; Cecily Forsyth, Wyong Hospital, Kanwal, Australia; Marion Fournier, Hospices Civils de Lyon, Groupe d'Etude des Lymphomes de l'Adulte, Recherche Clinique, Hôpital Lyon sud, Pierre-Bénite; Thierry Lamy, Centre Hospitalier Universitaire (CHU) de Rennes, L'Institut
| | - Danielle Canioni
- Judith Trotman and Jane Estell, Concord Hospital; Michael Fulham, Royal Prince Alfred Hospital and Sydney Medical School, University of Sydney, Sydney; John Francis Seymour, Peter MacCallum Cancer Center and University of Melbourne, Melbourne; Cecily Forsyth, Wyong Hospital, Kanwal, Australia; Marion Fournier, Hospices Civils de Lyon, Groupe d'Etude des Lymphomes de l'Adulte, Recherche Clinique, Hôpital Lyon sud, Pierre-Bénite; Thierry Lamy, Centre Hospitalier Universitaire (CHU) de Rennes, L'Institut
| | - Etienne Garin
- Judith Trotman and Jane Estell, Concord Hospital; Michael Fulham, Royal Prince Alfred Hospital and Sydney Medical School, University of Sydney, Sydney; John Francis Seymour, Peter MacCallum Cancer Center and University of Melbourne, Melbourne; Cecily Forsyth, Wyong Hospital, Kanwal, Australia; Marion Fournier, Hospices Civils de Lyon, Groupe d'Etude des Lymphomes de l'Adulte, Recherche Clinique, Hôpital Lyon sud, Pierre-Bénite; Thierry Lamy, Centre Hospitalier Universitaire (CHU) de Rennes, L'Institut
| | - Michael Fulham
- Judith Trotman and Jane Estell, Concord Hospital; Michael Fulham, Royal Prince Alfred Hospital and Sydney Medical School, University of Sydney, Sydney; John Francis Seymour, Peter MacCallum Cancer Center and University of Melbourne, Melbourne; Cecily Forsyth, Wyong Hospital, Kanwal, Australia; Marion Fournier, Hospices Civils de Lyon, Groupe d'Etude des Lymphomes de l'Adulte, Recherche Clinique, Hôpital Lyon sud, Pierre-Bénite; Thierry Lamy, Centre Hospitalier Universitaire (CHU) de Rennes, L'Institut
| | - Thierry Vander Borght
- Judith Trotman and Jane Estell, Concord Hospital; Michael Fulham, Royal Prince Alfred Hospital and Sydney Medical School, University of Sydney, Sydney; John Francis Seymour, Peter MacCallum Cancer Center and University of Melbourne, Melbourne; Cecily Forsyth, Wyong Hospital, Kanwal, Australia; Marion Fournier, Hospices Civils de Lyon, Groupe d'Etude des Lymphomes de l'Adulte, Recherche Clinique, Hôpital Lyon sud, Pierre-Bénite; Thierry Lamy, Centre Hospitalier Universitaire (CHU) de Rennes, L'Institut
| | - Gilles Salles
- Judith Trotman and Jane Estell, Concord Hospital; Michael Fulham, Royal Prince Alfred Hospital and Sydney Medical School, University of Sydney, Sydney; John Francis Seymour, Peter MacCallum Cancer Center and University of Melbourne, Melbourne; Cecily Forsyth, Wyong Hospital, Kanwal, Australia; Marion Fournier, Hospices Civils de Lyon, Groupe d'Etude des Lymphomes de l'Adulte, Recherche Clinique, Hôpital Lyon sud, Pierre-Bénite; Thierry Lamy, Centre Hospitalier Universitaire (CHU) de Rennes, L'Institut
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95
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Lanic H, Mareschal S, Mechken F, Picquenot JM, Cornic M, Maingonnat C, Bertrand P, Clatot F, Bohers E, Stamatoullas A, Leprêtre S, Rainville V, Ruminy P, Bastard C, Tilly H, Becker S, Vera P, Jardin F. Interim positron emission tomography scan associated with international prognostic index and germinal center B cell-like signature as prognostic index in diffuse large B-cell lymphoma. Leuk Lymphoma 2011; 53:34-42. [PMID: 21806349 DOI: 10.3109/10428194.2011.600482] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
[(18)F]-fluorodeoxyglucose positron emission tomography (FDG-PET) imaging is essential to optimize the initial staging and to predict the prognosis of diffuse large B-cell lymphoma (DLBCL). To assess the relationship between the germinal center B cell-like/activated B cell-like (GCB/ABC) classification and PET scan features in DLBCL, 57 cases treated with rituximab and a cyclophosphamide, doxorubicin, vincristine and prednisone (CHOP)/CHOP-like regimen were analyzed. The expression profile of 18 GCB/ABC related genes and five genes coding for glucose transporters (GLUTs) was determined from frozen tissues using DASL (cDNA-mediated Annealing, Selection, Ligation and extension) technology. According to the gene expression profile (GEP), 30 cases of DLBCL were classified as GCB subtype (2-year progression-free survival [PFS] 76%) and 27 cases as ABC subtype (2-year PFS 51%, p = 0.03). Using a semiquantitative assessment of the decrease in standard uptake value (SUV) at interim PET performed after 3-4 cycles of chemotherapy, we defined fast (n = 36) and slow (n = 9) metabolic responders. In multivariate analysis, GCB/ABC subtype, age-adjusted international prognostic index (aaIPI) and slow/fast metabolic response were independent variables that predicted outcome. A score incorporating aaIPI, fast/slow metabolic response and GCB/ABC classification was used to define two groups with highly significantly distinct outcomes. Our study suggests that the combination of GEP, aaIPI and interim PET more accurately predicts DLBCL prognosis and is therefore suitable for tailoring therapeutic strategies.
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Affiliation(s)
- Hélène Lanic
- UMR INSERM U918, Centre Henri Becquerel, Rouen, France
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96
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[Non-Hodgkin's lymphoma staging with PET-CT scan]. Med Clin (Barc) 2011; 137:402-4. [PMID: 21696781 DOI: 10.1016/j.medcli.2011.04.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2011] [Revised: 04/06/2011] [Accepted: 04/07/2011] [Indexed: 01/05/2023]
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97
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Bachy E, Salles G. Marrow-ablative treatment and autologous stem cell transplantation in follicular NHL. Best Pract Res Clin Haematol 2011; 24:257-70. [DOI: 10.1016/j.beha.2011.03.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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98
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PROGNOSTIC FACTORS IN FOLLICULAR LYMPHOMA IN THE RITUXIMAB ERA: HOW TO IDENTIFY A HIGH-RISK PATIENT? Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2011; 155:99-108. [DOI: 10.5507/bp.2011.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
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