FDG positron emission tomography/computed tomography scan may identify mantle cell lymphoma patients with unusually favorable outcome.
OBJECTIVE
Patients diagnosed with mantle cell lymphoma (MCL) have generally poor prognosis, but a minority have a longer survival. There are no markers to identify this group and no generally established prognostic index for MCL. Our objective was to assess the prognostic value of the staging FDG PET/computed tomography (CT) scan.


METHODS
We retrospectively analyzed initial scans performed at three institutions on biopsy-proven, cyclin D (+) MCL patients. The association of the SUVmax of the 'hottest focus' with overall survival (OS) and failure-free survival (FFS) was evaluated. Receiver operating characteristic analysis of SUVmax versus survival was used to establish a cut-off point of 4.83. In addition, PET findings were compared with contrast-enhanced CT performed within 3 weeks in patients from one institution.


RESULTS
Both the OS and FFS for patients with SUVmax greater than 5 were significantly decreased (P<0.01 and <0.001, respectively) as compared with the patients with SUV < or = 5. The 5-year OS for group with SUVmax < or = 5 was 87.7% and for SUVmax greater than 5 it was 34%. For SUVmax < or = 5, the median FFS was 45.3 months as compared with 10.6 months for SUVmax greater than 5. PET changed the stage as compared with CT alone in 45% of patients.


CONCLUSIONS
Staging FDG PET/CT is superior to CT and may be used in the future for identification of a subset of MCL patients with a better outcome than otherwise expected.
Karam
Maroun
M
Department of Radiology, Albany Medical College, Albany, New York 12208, USA. karamm@mail.amc.edu
Ata
Ashar
A
Irish
Kevin
K
Feustel
Paul J
PJ
Mottaghy
Felix M
FM
Stroobants
Sigrid G
SG
Verhoef
Gregor E
GE
Chundru
Surya
S
Douglas-Nikitin
Vonda
V
Oliver Wong
Ching-yee
CY
Brepoels
Lieselot M
LM
D001530:Belgium / Q000453:epidemiology; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D020522:Lymphoma, Mantle-Cell / Q000175:diagnosis* / Q000401:mortality*; D008297:Male; D049268:Positron-Emission Tomography / Q000379:methods*; D015995:Prevalence; D011379:Prognosis; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D012680:Sensitivity and Specificity; D016019:Survival Analysis; D015996:Survival Rate; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014481:United States / Q000453:epidemiology
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18