title: Prognostic value of pretreatment 18F-FDG PET in patients with primary central nervous system lymphoma: SUV-based assessment.
abstract: The purpose of this retrospective study was to evaluate the prognostic value of 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) in immunocompetent patients with primary central nervous system lymphoma (PCNSL). We also investigated whether FDG uptake was related to angiogenesis in the tumors. Seventeen patients with newly diagnosed and histologically confirmed PCNSL were investigated with FDG-PET before the treatment. FDG uptake was assessed by standardized uptake value of the tumor showing the maximum uptake (SUVmax). The Kaplan–Meier method was used to estimate the overall and the progression-free survival times. The difference of the survival curves between the low to moderate FDG uptake (SUVmax < 12) and high FDG uptake (SUVmax ≥ 12) groups was statistically analyzed. The relationship between FDG SUVmax and microvessel density (MVD) in the tumor specimens determined by CD34 immunohistochemical staining was examined. Finally, the difference of the overall survival curve between the low MVD (<20) and high MVD (≥ 20) groups was statistically analyzed. After the completion of initial treatment, 7 of the 8 low to moderate FDG uptake patients showed complete response (CR) and 1 showed partial response (PR). On the other hand, 5 of the 9 high FDG uptake patients showed CR and 4 showed PR. However, the difference of treatment response (CR vs PR) between the low to moderate and high FDG uptake groups was not statistically significant (P = 0.36). Median survival time was more than 26 months in low to moderate FDG uptake patients and 12 months in high FDG uptake patients. The overall survival time of patients with low to moderate FDG uptake was significantly longer than that of patients with high FDG uptake (P < 0.05). The progression free survival (PFS) was also significantly longer in patients with low to moderate FDG uptake compared to the patients with high FDG uptake (P < 0.05). There was no significant relationship between FDG SUVmax and MVD in the tumors. The survival time tended to be longer in patients with high MVD than in low MVD, but the difference was not statistically significant (P = 0.15). Pretreatment FDG uptake may have a prognostic value in newly diagnosed PCNSL.
authors.affiliation: Department of Neurological Surgery, Faculty of Medicine, Kagawa University, Kita-gun, Kagawa, Japan. nobu@med.kagawa-u.ac.jp
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Kawai
authors.forename: Hai-Ning
authors.initials: HN
authors.lastname: Zhen
authors.forename: Keisuke
authors.initials: K
authors.lastname: Miyake
authors.forename: Yuka
authors.initials: Y
authors.lastname: Yamamaoto
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Nishiyama
authors.forename: Takashi
authors.initials: T
authors.lastname: Tamiya
mesh_terms: D000368:Aged; D018952:Antigens, CD34; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D016543:Central Nervous System Neoplasms / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000628:therapy; D003131:Combined Modality Therapy; D016371:Cranial Irradiation; D018572:Disease-Free Survival; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000378:metabolism*; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D008223:Lymphoma / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000628:therapy; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography; D011379:Prognosis; D019275:Radiopharmaceuticals / Q000378:metabolism*; D012189:Retrospective Studies
chemical_list: D018952:Antigens, CD34; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
references.citation: J Clin Oncol. 2003 Jan 15;21(2):266-72
references.pmid: 12525518
references.citation: J Comput Assist Tomogr. 2002 Mar-Apr;26(2):185-90
references.pmid: 11884771
references.citation: Int J Radiat Oncol Biol Phys. 1992;23(1):9-17
references.pmid: 1572835
references.citation: Nucl Med Commun. 2007 Nov;28(11):834-41
references.pmid: 17901765
references.citation: Eur J Radiol. 2006 Jun;58(3):394-403
references.pmid: 16527438
references.citation: J Nucl Med. 2002 Aug;43(8):1018-27
references.pmid: 12163626
references.citation: J Nucl Med. 1992 Nov;33(11):1972-80
references.pmid: 1432158
references.citation: J Neurooncol. 1999 Jul;43(3):231-6
references.pmid: 10563428
references.citation: J Nucl Med. 1997 Oct;38(10):1575-83
references.pmid: 9379195
references.citation: Neurosci Lett. 2003 Feb 27;338(2):119-22
references.pmid: 12566167
references.citation: Eur J Nucl Med Mol Imaging. 2005 Jan;32(1):52-9
references.pmid: 15309332
references.citation: J Neurooncol. 2003 Sep;64(3):227-37
references.pmid: 14558598
references.citation: J Clin Oncol. 2002 Dec 15;20(24):4643-8
references.pmid: 12488408
references.citation: J Clin Oncol. 2006 Oct 1;24(28):4570-4
references.pmid: 17008697
references.citation: Int J Radiat Oncol Biol Phys. 1998 Jun 1;41(3):615-20
references.pmid: 9635710
references.citation: J Nucl Med. 1992 Apr;33(4):532-6
references.pmid: 1552337
references.citation: J Clin Oncol. 2000 Feb;18(3):519-26
references.pmid: 10653867
references.citation: AJNR Am J Neuroradiol. 2006 Aug;27(7):1432-7
references.pmid: 16908552
references.citation: J Neurooncol. 2007 Sep;84(2):141-5
references.pmid: 17406788
references.citation: Neuro Oncol. 2008 Aug;10(4):560-8
references.pmid: 18559969
references.citation: J Neurooncol. 1999 Jul;43(3):259-68
references.pmid: 10563432
references.citation: Cancer. 2005 Dec 15;104(12):2775-83
references.pmid: 16284993
references.citation: Int J Radiat Oncol Biol Phys. 1999 May 1;44(2):265-72
references.pmid: 10760418
references.citation: J Nucl Med. 2007 Oct;48(10):1626-32
references.pmid: 17873129
references.citation: Eur J Nucl Med Mol Imaging. 2004 Jan;31(1):22-8
references.pmid: 14574514
references.citation: Acta Radiol. 2009 Mar;50(2):217-25
references.pmid: 19096950
references.citation: Neurology. 1982 Dec;32(12):1323-9
references.pmid: 6983044
references.citation: Eur J Nucl Med Mol Imaging. 2008 Nov;35(11):2009-17
references.pmid: 18542957
references.citation: Blood. 2005 Aug 15;106(4):1376-81
references.pmid: 15860666
references.citation: Eur J Nucl Med Mol Imaging. 2007 Jan;34(1):78-86
references.pmid: 16896670
references.citation: Eur J Nucl Med Mol Imaging. 2003 Jun;30(6):868-73
references.pmid: 12692687
references.citation: Eur J Nucl Med Mol Imaging. 2006 Feb;33(2):164-8
references.pmid: 16220304
references.citation: Clin Adv Hematol Oncol. 2008 Nov;6(11):818-20, 840
references.pmid: 19194366
references.citation: Ann Nucl Med. 2005 Dec;19(8):685-90
references.pmid: 16444994
references.citation: AJNR Am J Neuroradiol. 2009 Apr;30(4):744-51
references.pmid: 19164442