title: Prognostic value of early 18 fluorodeoxyglucose positron emission tomography and gallium-67 scintigraphy in aggressive lymphoma: a prospective comparative study.
abstract: The prognostic value of fluorodeoxyglucose positron emission tomography (FDG-PET) and gallium-67 scan (GS) performed early after chemotherapy was assessed in 40 patients with newly diagnosed aggressive lymphoma. FDG-PET and GS were performed before and after three cycles of CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone) or two cycles of ACVBP (doxorubicin, cyclophosphamide, vindesine, bleomycin, prednisone), with or without rituximab. Thirty-five patients had diffuse large B-cell lymphoma (DLBCL), two had mantle-cell lymphoma and three had T-cell lymphoma. Four patients relapsed despite early negative FDG-PET and GS including all three patients with T-cell lymphoma. Nine patients stayed in remission despite positive FDG-PET and/or GS of whom five showed moderate intensity residual bone uptake. Seven of these nine early false positives had a negative exam at the end of treatment. In patients with DLBCL, the 2-year event-free survival was 85% for negative versus 30% for positive FDG-PET patients (P = 0.003) whereas it was 78% for negative versus 33% for positive GS patients (P = 0.018). Sensitivity, specificity and diagnostic accuracy of FDG-PET and GS were not significantly different: 90% versus 70%, 76 versus 80% and 80 versus 77%, respectively. We conclude that both FDG-PET and GS are valuable tools to early predict outcome in patients with DLBCL.
authors.affiliation: Department of Haematology, François Baclesse Center, Caen, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Fruchart
authors.forename: Oumedaly
authors.initials: O
authors.lastname: Reman
authors.forename: Nolwenn
authors.initials: N
authors.lastname: Le Stang
authors.forename: Dada
authors.initials: D
authors.lastname: Musafiri
authors.forename: Stéphane
authors.initials: S
authors.lastname: Cheze
authors.forename: Margaret
authors.initials: M
authors.lastname: Macro
authors.forename: Odile
authors.initials: O
authors.lastname: Switsers
authors.forename: Nicolas
authors.initials: N
authors.lastname: Aide
authors.forename: Mélanie
authors.initials: M
authors.lastname: Liegard
authors.forename: Xavier
authors.initials: X
authors.lastname: Levaltier
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Peny
authors.forename: Michel
authors.initials: M
authors.lastname: Leporrier
authors.forename: Stéphane
authors.initials: S
authors.lastname: Bardet
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000494:pharmacology*; D005710:Gallium Radioisotopes / Q000494:pharmacology*; D006801:Humans; D008223:Lymphoma / Q000175:diagnosis* / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography / Q000379:methods*; D011379:Prognosis; D011446:Prospective Studies; D019275:Radiopharmaceuticals / Q000494:pharmacology*; D012680:Sensitivity and Specificity; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods
chemical_list: D005710:Gallium Radioisotopes; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18