title: Prognostic impact of 18F-fluoro-deoxyglucose positron emission tomography in untreated mantle cell lymphoma: a retrospective study from the GOELAMS group.
abstract: OBJECTIVE
  (18)F-fluorodeoxyglucose (FDG) PET is a non-invasive imaging technique recommended for the management of both diffuse large B-cell and Hodgkin's lymphomas. This retrospective study investigated the value of FDG PET for initial staging and its prognostic impact on patients with mantle cell lymphoma (MCL).
  
  
  METHODS
  A total of 44 untreated MCL patients assessed by both conventional evaluations (CE) and FDG PET for initial staging were included. The maximum standardized uptake value (SUV(max)) in the most intense pathological area was recorded for each patient. Disease status after chemotherapy completion was assessed according to the International Workshop Criteria (IWC) for non-Hodgkin's lymphoma (NHL) response and IWC+PET.
  
  
  RESULTS
  FDG PET uptakes at diagnosis were abnormal in all cases. Compared to CT scan, nodal and extranodal sites were only detected by FDG PET. Due to insufficient sensibility for bone marrow (BM) and gastrointestinal (GI) involvement, FDG PET did not modify initial staging. Positive and negative predictive values of IWC+PET for relapse at 1 year were 62.5 and 100%. With a median follow-up of 21 months, only the International Prognostic Index (IPI) and IWC+PET modified both event-free survival (EFS) (p = .02 and .0001, respectively) and overall survival (p = .03 and .05, respectively) duration. When combining IPI and SUV(max) at diagnosis, we were able to identify patients with low (29%; no relapse/progression), intermediate (42%; median EFS: 37 months) and high risk (29%, median EFS: 22 months) (p = .004).
  
  
  CONCLUSIONS
  In MCL, FDG PET at diagnosis is complementary to CE, but BM and GI biopsies remain mandatory. IWC+PET criteria are highly efficient to identify patients with high risk for early relapse. Combining IPI and SUV(max) may predict patient outcome and warrant further prospective investigations towards designing risk-adapted strategies.
authors.affiliation: Service de médecine nucléaire, CHU de Nantes, Nantes, France.
authors.forename: Caroline
authors.initials: C
authors.lastname: Bodet-Milin
authors.forename: Cyrille
authors.initials: C
authors.lastname: Touzeau
authors.forename: Christophe
authors.initials: C
authors.lastname: Leux
authors.forename: Mehmet
authors.initials: M
authors.lastname: Sahin
authors.forename: Anne
authors.initials: A
authors.lastname: Moreau
authors.forename: Hervé
authors.initials: H
authors.lastname: Maisonneuve
authors.forename: Nadine
authors.initials: N
authors.lastname: Morineau
authors.forename: Henry
authors.initials: H
authors.lastname: Jardel
authors.forename: Philippe
authors.initials: P
authors.lastname: Moreau
authors.forename: Céline
authors.initials: C
authors.lastname: Gallazini-Crépin
authors.forename: Pascal
authors.initials: P
authors.lastname: Gries
authors.forename: Rémy
authors.initials: R
authors.lastname: Gressin
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Harousseau
authors.forename: Mohamad
authors.initials: M
authors.lastname: Mohty
authors.forename: Philippe
authors.initials: P
authors.lastname: Moreau
authors.forename: Françoise
authors.initials: F
authors.lastname: Kraeber-Bodere
authors.forename: Steven
authors.initials: S
authors.lastname: Le Gouill
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D020522:Lymphoma, Mantle-Cell / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D019788:Fluorodeoxyglucose F18