The role of positron emission tomography and combined positron emission tomography with computed tomography in staging and response assessment in patients with non-Hodgkin’s lymphoma. Part II: Response evaluation

Czech version

Authors: T. Papajík ¹; M. Mysliveček ²; E. Buriánková ²; M. Skopalová ³; A. Malán ⁴; V. Koza ⁵; H. Mociková ⁶; M. Trněný ⁶; P. Koranda ²; K. Indrák ¹
Authors‘ workplace: Hemato-onkologická klinika FNO a LF UP v Olomouci ¹; Klinika nukleární medicíny FNOL a LF UP v Olomouci ²; PET centrum Nemocnice na Homolce ³; Oddělení nukleární medicíny FN Plzeň ⁴; Hematologicko-onkologické oddělení FN Plzeň ⁵; I. interní klinika VFN Praha ⁶
Published in: Transfuze Hematol. dnes,15, 2009, No. 3, p. 158-168.
Category: Comprehensive Reports, Original Papers, Case Reports

Overview

2-[fluorin-18] fluoro-2-deoxy-D-glucose (¹⁸F-FDG) positron emission tomography (PET) and combined ¹⁸F-FDG PET and computed tomography (CT) scanning have emerged as a promising imaging modality in the evaluation of lymphoma. Both modalities have been shown to be important in response assessment of non-Hodgkin’s lymphoma (NHL), especially in diffuse large B-cell lymphoma (DLBCL). ¹⁸F-FDG PET and ¹⁸F-FDG PET/CT improves the accuracy of restaging of NHL over that of CT alone and ¹⁸F-FDG PET has been recently incorporated in the revised response criteria for malignant lymphoma. The independent prognostic value of early or interim ¹⁸F-FDG PET for DLBCL has been established and should be a useful tool to modify ineffective therapy in high-risk PET-positive cases. The role and prognostic impact of ¹⁸F-FDG PET therapy response evaluation in other types of lymphomas is unclear. Some non-neoplastic conditions (sarcoidosis, tuberculosis, fungal infections, inflammation, tissue reparation, etc.) may be a source of “false-positive” ¹⁸F-FDG PET scans and integrated PET-CT system can help to improve the specificity of the findings and may contribute to better lesion characterization.

Key words:
¹⁸F-FDG PET, PET/CT, lymphoma, response to therapy

Sources

1. Villela L, Lopez-Guillermo A, Montoto S, et al. Prognostic features and outcome in patients with diffuse large B-cell lymphoma who do not achieve a complete response to first-line regimens. Cancer 2001; 91: 1557–1562.

2. Armitage JO, Weisenburger DD, Hutchins M, et al. Chemotherapy for diffuse large-cell lymphoma - rapidly responding patients have more durable remissions. J Clin Oncol 1986; 4: 160–164.

3. Haw R, Sawka CA, Franseen E, Berinstein NL. Significance of a partial or slow response to front-line chemotherapy in the management of intermediate-grade or high-grade non-Hodgkin’s lymphoma: a literature review. J Clin Oncol 1994; 12: 1074–1084.

4. Cheson BD, Horning SJ, Coiffier B, et al. Report of an international workshop to standardize response criteria for non-Hodgkin’s lymphomas. J Clin Oncol 1999; 17: 1244–1253.

5. Coiffier B, Gisselbrecht C, Herbrecht R, et al. LNH-84 regimen: a multicenter study of intensive chemotherapy in 737 patients with aggressive malignant lymphoma. J Clin Oncol 1989; 7: 1018–1026.

6. Kaplan WD, Jochelson MS, Herman TS, et al. Gallium-67 imaging: a predictor of residual tumor viability and clinical outcome in patients with diffuse large-cell lymphoma. J Clin Oncol 1990; 8: 1966–1970.

7. Gasparini M, Bombardieri E, Castellani M, et al. Gallium-67 scintigraphy evaluation of therapy in non-Hodgkin’s lymphoma. J Nucl Med 1998; 39: 1586–1590.

8. Zinzani PL, Magagnoli M, Chierichetti F, et al. The role of positron emission tomography (PET) in the management of lymphoma patients. Ann Oncol 1999; 10: 1181–1184.

9. Spaepen K, Stroobants S, Dupont P, et al. Prognostic value of positron emission tomography (PET) with fluorine-18 fluorodeoxyglucose ([18F]FDG) after first-line chemotherapy in non-Hodgkin’s lymphoma: is [18F]FDG-PET a valid alternative to conventional diagnostic methods? J Clin Oncol 2001; 19: 414–419.

10. Cremerius U, Fabry U, Neuerburg J, et al. Positron emission tomography with 18F-FDG to detect residual disease after therapy for malignant lymphoma. Nucl Med Commun 1998; 19: 1055–1063.

11. Mikhaeel NG, Timothy AR, O’Doherty MJ, Hain S, Maisey MN. 18-FDG-PET as a prognostic indicator in the treatment of aggressive Non-Hodgkin’s Lymphoma-comparison with CT. Leuk Lymphoma 2000; 39: 543–553.

12. Juweid ME, Wiseman GA, Vose JM, et al. Response assessment of aggressive non-Hodgkin’s lymphoma by integrated International Workshop Criteria and fluorine-18-fluorodeoxyglucose positron emission tomography. J Clin Oncol 2005; 23: 4652–4661.

13. Reinhardt MJ, Herkel C, Altehoefer C, Finke J, Moser E. Computed tomography and 18F-FDG positron emission tomography for therapy control of Hodgkin’s and non-Hodgkin’s lymphoma patients: when do we really need FDG-PET? Ann Oncol 2005; 16: 1524–1529.

14. Trneny M, Jaeger U, Belohlavek O, et al. Early whole body F18-FDG positron emission tomography (PET) restaging has significant prognostic impact in diffuse large cell lymphomas (DLCL-B). Ann Oncol 2005; 16 (Suppl.5): 122–122.

15. Juweid ME, Stroobants S, Hoekstra OS, et al. Use of positron emission tomography for response assessment of lymphoma: consensus of the Imaging Subcommittee of International Harmonization Project in Lymphoma. J Clin Oncol 2007; 25: 571–578.

16. Cheson BD, Pfistner B, Juweid ME, et al. Revised response criteria for malignant lymphoma. J Clin Oncol 2007; 25: 579–586.

17. Reske SN. FDG-PET and PET/CT in malignant lymphoma. Recent Results Cancer Res 2008; 170: 93 –107.

18. Zijlstra JM, Lindauer-van der Werf G, Hoekstra OS, et al. 18F-fluoro-deoxyglucose positron emission tomography for post-treatment evaluation of malignant lymphoma: a systematic review. Haematologica 2006; 91: 522–529.

19. Terasawa T, Nihashi T, Hotta T, Nagai H. 18F-FDG PET for posttherapy assessment of Hodgkin’s disease and aggressive Non-Hodgkin’s lymphoma: a systematic review. J Nucl Med 2008; 49:13–21.

20. Zinzani PL, Tani M, Trisolini R, et al. Histological verification of positive positron emission tomography findings in the follow-up of patients with mediastinal lymphoma. Haematologica 2007; 92: 771–777.

21. Han HS, Escalon MP, Serafini A, Losos IS. High Incidence of False Positive PET Scans in Patients with Aggressive Non-Hodgkins Lymphoma Treated with Rituximab-Containing Regimens. Blood 2006; 108: 2401a.

22. Kahn ST, Flowers C, Lechowicz MJ, Hollenbach K, Johnstone PA. Value of PET restaging after chemotherapy for non-Hodgkin’s lymphoma: implications for consolidation radiotherapy. Int J Radiat Oncol Biol Phys 2006; 66: 961–965.

23. Filmont JE, Czernin J, Yap C, et al. Value of F-18 fluorodeoxyglucose positron emission tomography for predicting the clinical outcome of patients with aggressive lymphoma prior to and after autologous stem-cell transplantation. Chest 2003; 124: 608–613.

24. Spaepen K, Stroobants S, Dupont P, et al. Prognostic value of pretransplantation positron emission tomography using fluorine 18-fluorodeoxyglucose in patients with aggressive lymphoma treated with high-dose chemotherapy and stem cell transplantation. Blood 2003; 102: 53–59.

25. Schot BW, Pruim J, van Imhoff GW, et al. The role of serial pre-transplantation positron emission tomography in predicting progressive disease in relapsed lymphoma. Haematologica 2006; 91: 490–495.

26. Derenzini E, Musuraca G, Fanti S, et al. Pretransplantation positron emission tomography scan is the main predictor of autologous stem cell transplantation outcome in aggressive B-cell non-Hodgkin lymphoma. Cancer 2008; 113: 2496–2503.

27. Bishu S, Quigley JM, Bishu SR, et al. Predictive value and diagnostic accuracy of F-18-fluoro-deoxy-glucose positron emission tomography treated grade 1 and 2 follicular lymphoma. Leuk Lymphoma 2007; 48: 1548–1555.

28. Janikova A, Bolcak K, Pavlik T, Mayer J, Kral Z. Value of [18F]fluorodeoxyglucose positron emission tomography in the management of follicular lymphoma: the end of a dilemma? Clin Lymphoma Myeloma 2008; 8: 287–293.

29. Gill S, Wolf M, Prince HM, et al. [18F]fluorodeoxyglucose positron emission tomography scanning for staging, response assessment, and disease surveillance in patients with mantle cell lymphoma. Clin Lymphoma Myeloma 2008; 8: 159–165.

30. Brepoels L, Stroobants S, De Wever W, et al. Positron emission tomography in mantle cell lymphoma. Leuk Lymphoma 2008; 49: 1693–1701.

31. Pro B, Nunez R. F, Romaguera J, et al. Achievement of FDG-PET negativity does not predict durale response in T-cell lymphoma. Blood 2006; 108: 2404a.

32. Cahu X, Bodet-Milin C, Gastinne T, et al. Interest and Prognosis Value of Fluorine-18-Fluoro-2-Deoxy-D-Glucose Positron Emission Tomography ([18F] FDG-PET/CT) in Aggressive T-Cell Lymphomas. Blood 2008; 112: 2835a.

33. Römer W, Hanauske AR, Ziegler S, et al. Positron emission tomography in non-Hodgkin’s lymphoma: assessment of chemotherapy with fluorodeoxyglucose. Blood 1998; 91: 4464–4471.

34. Jerusalem G, Beguin Y, Fassotte MF, et al. Persistent tumor 18F-FDG uptake after a few cycles of polychemotherapy is predictive of treatment failure in non-Hodgkin’s lymphoma. Haematologica 2000; 85: 613–618.

35. Kostakoglu L, Coleman M, Leonard JP, et al. PET predicts prognosis after 1 cycle of chemotherapy in aggressive lymphoma and Hodgkin’s disease. J Nucl Med 2002; 43: 1018–1027.

36. Spaepen K, Stroobants S, Dupont P, et al. Early restaging positron emission tomography with (18)F-fluorodeoxyglucose predicts outcome in patients with aggressive non-Hodgkin’s lymphoma. Ann Oncol 2002; 13: 1356–1363.

37. Haioun C, Itti E, Rahmouni A, et al. [18F]fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) in aggressive lymphoma: an early prognostic tool for predicting patient outcome. Blood 2005; 106: 1376–1381.

38. Mikhaeel NG, Hutchings M, Fields PA, O’Doherty MJ, Timothy AR. FDG-PET after two to three cycles of chemotherapy predicts progression-free and overall survival in high-grade non-Hodgkin lymphoma. Ann Oncol 2005; 16: 1514–1523.

39. Querellou S, Valette F, Bodet-Milin C, et al. FDG-PET/CT predicts outcome in patients with aggressive non-Hodgkin’s lymphoma and Hodgkin’s disease. Ann Hematol 2006; 85: 759–767.

40. Ng AP, Wirth A, Seymour JF, et al. Early therapeutic response assessment by (18)FDG-positron emission tomography during chemotherapy in patients with diffuse large B-cell lymphoma: isolated residual positivity involving bone is not usually a predictor of subsequent treatment failure. Leuk Lymphoma 2007; 48: 596–600.

41. Dupuis J, Gaulard P, Hemery F, et al. Respective prognostic values of germinal center phenotype and early (18)fluorodeoxyglucose-positron emission tomography scanning in previously untreated patients with diffuse large B-cell lymphoma. Haematologica 2007; 92: 778–783.

42. Kasamon YL, Wahl RL, Ziessman HA, et al. Risk-Adapted Therapy of Aggressive Lymphoma Based on FDG-PET Performed after 2 or 3 Cycles of Initial Chemotherapy. Blood 2007; 110: 1894a.

43. Moskowitz C, Hamlin PA, Horwitz SM, et al. Phase II Trial of Dose-Dense R-CHOP Followed by Risk-Adapted Consolidation with Either ICE or ICE and ASCT, Based upon the Results of Biopsy Confirmed Abnormal Interim Restaging PET Scan, Improves Outcome in Patients with Advanced Stage DLBCL. Blood 2006; 108: 532a.

44. Sehn LH, Sabate KJ, Hoskins P, et al. Limited-Stage Diffuse Large B-Cell Lymphoma (DLBCL) Patients with a Negative Pet Scan Following Three Cycles of R-CHOP Can Be Effectively Treated with Abbreviated Chemoimmunotherapy Alone. Blood 2007; 110: 787a.

45. Lin C, Itti E, Hamoun C, et al. Early 18F-FDG PET for prediction of prognosis in patients with diffuse large B-cell lymphoma: SUV-based assessment versus visual analysis. J Nucl Med 2007; 48: 1626–1632.

46. Moulin-Romsee G, Spaepen K, Stroobants S, Mortelmans L. Non-Hodgkin lymphoma: retrospective study on the cost-effectiveness of early treatment response assessment by FDG-PET. Eur J Nucl Med Mol Imaging 2008; 35: 1074–1080.

47. Papajík T, Mysliveček M, Buriánková E, et al. Pozitronová emisní tomografie a integrovaná pozitronová emisní tomografie s počítačovou tomografií ve stážování a hodnocení léčebné odpovědi u nehodgkinských lymfomů. Část I. Určení stadia a postižení jednotlivých orgánů. Transfuze Hematol dnes 2008; 14: 55–61.

48. Castellucci P, Nanni C, Farsad M, et al. Potential pitfalls of 18F-FDG PET in a large series of patients treated for malignant lymphoma: prevalence and scan interpretation. Nucl Med Commun 2005; 26: 689–694.

49. Sonet A, Graux C, Nollevaux MC, et al. Unsuspected FDG-PET findings in the follow-up of patients with lymphoma. Ann Hematol 2007; 86: 9–15.

50. Han HS, Escalón MP, Hsiao B, Serafini A, Lossos IS. High incidence of false-positive PET scans in patients with aggressive non-Hodgkin’s lymphoma treated with rituximab-containing regimens. Ann Oncol 2008; October 7. (Epub ahead of print).

51. Šedová Z, Mysliveček M, Papajík T, et al. Zajímavé 18FDG-PET-pozitivní vedlejší nálezy při PET/CT vyšetření u nemocných léčených pro ne-hodgkinův lymfom. Vnitřní lék 2008; 54 (Suppl. 5): P34.

52. Freudenberg LS, Antoch G, Schütt P, et al. FDG-PET/CT in re-staging of patients with lymphoma. Eur J Nucl Med Mol Imaging 2004; 31: 325–329.

53. Elstrom RL, Leonard JP, Coleman M, Brown RK. Combined PET and low-dose, noncontrast CT scanning obviates the need for additional diagnostic contrast-enhanced CT scans in patients undergoing staging or restaging for lymphoma. Ann Oncol 2008;19:1770–1773.

54. Yang DH, Min JJ, Jeong YY, et al. The combined evaluation of interim contrast-enhanced computerized tomography (CT) and FDG-PET/CT predicts the clinical outcomes and may impact on the therapeutic plans in patients with aggressive non-Hodgkin’s lymphoma. Ann Hematol 2008; November 12. (Epub ahead of print).

Labels

Haematology Internal medicine Clinical oncology

Vascular endothelial growth factor in persons with type 2 diabetes

Warfarin-induced skin necrosis, case report and survey of resources

Activities of hospital-based blood transfusion service in the Czech Republic in 2008

Detection of the JAK2V617F mutation in myeloproliferative disorders - an overview and own experiences

Successful treatment of early molecular relapse of variant form of secondary acute promyelocytic leukemia with arsenic trioxide

Article was published in

Transfusion and Haematology Today

2009 Issue 3