title: (18)F-FDG avidity in lymphoma readdressed: a study of 766 patients.
abstract: PET/CT with (18)F-FDG is an important noninvasive diagnostic tool for management of patients with lymphoma, and its use may surpass current guideline recommendations. The aim of the present study is to enlarge the growing body of evidence concerning (18)F-FDG avidity of lymphoma to provide a basis for future guidelines.
  
  
  METHODS
  The reports from (18)F-FDG PET/CT studies performed in a single center for staging of 1,093 patients with newly diagnosed Hodgkin disease and non-Hodgkin lymphoma between 2001 and 2008 were reviewed for the presence of (18)F-FDG avidity. Of these patients, 766 patients with a histopathologic diagnosis verified according to the World Health Organization classification were included in the final analysis. (18)F-FDG avidity was defined as the presence of at least 1 focus of (18)F-FDG uptake reported as a disease site. Nonavidity was defined as disease proven by clinical examination, conventional imaging modalities, and histopathology with no (18)F-FDG uptake in any of the involved sites.
  
  
  RESULTS
  At least one (18)F-FDG-avid lymphoma site was reported for 718 patient studies (94%). Forty-eight patients (6%) had lymphoma not avid for (18)F-FDG. (18)F-FDG avidity was found in all patients (100%) with Hodgkin disease (n = 233), Burkitt lymphoma (n = 18), mantle cell lymphoma (n = 14), nodal marginal zone lymphoma (n = 8), and lymphoblastic lymphoma (n = 6). An (18)F-FDG avidity of 97% was found in patients with diffuse large B-cell lymphoma (216/222), 95% for follicular lymphoma (133/140), 85% for T-cell lymphoma (34/40), 83% for small lymphocytic lymphoma (24/29), and 55% for extranodal marginal zone lymphoma (29/53).
  
  
  CONCLUSIONS
  The present study indicated that with the exception of extranodal marginal zone lymphoma and small lymphocytic lymphoma, most lymphoma subtypes have high (18)F-FDG avidity. The cumulating evidence consistently showing high (18)F-FDG avidity in the potentially curable Burkitt, natural killer/T-cell, and anaplastic large T-cell lymphoma subtypes justifies further investigations of the utility of (18)F-FDG PET in these diseases at presentation.
authors.affiliation: Department of Nuclear Medicine, Rambam Health Care Campus, Haifa, Israel. m_weiler@rambam.health.gov.il
authors.forename: Michal
authors.initials: M
authors.lastname: Weiler-Sagie
authors.forename: Olga
authors.initials: O
authors.lastname: Bushelev
authors.forename: Ron
authors.initials: R
authors.lastname: Epelbaum
authors.forename: Eldad J
authors.initials: EJ
authors.lastname: Dann
authors.forename: Nissim
authors.initials: N
authors.lastname: Haim
authors.forename: Irit
authors.initials: I
authors.lastname: Avivi
authors.forename: Ayelet
authors.initials: A
authors.lastname: Ben-Barak
authors.forename: Yehudit
authors.initials: Y
authors.lastname: Ben-Arie
authors.forename: Rachel
authors.initials: R
authors.lastname: Bar-Shalom
authors.forename: Ora
authors.initials: O
authors.lastname: Israel
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics*; D006801:Humans; D008223:Lymphoma / Q000145:classification / Q000000981:diagnostic imaging* / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics*; D055815:Young Adult
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18