title: 18F-FDG-PET/CT in the surveillance of patients with lymphoma: detection of asymptomatic recurrences.
abstract: OBJECTIVE
  To assess the diagnostic accuracy of (18)F-FDG-PET/CT in detecting asymptomatic recurrences in patients with lymphoma. To define uptake patterns of recurrence indicative of recurrence.
  
  
  METHODS
  Those patients with lymphoma who fulfilled the following inclusion criteria of clinical complete remission and negative PET/CT study were included retrospectively and longitudinally. Conventional surveillance of these patients was performed only by (18)F-FDG PET/CT following a standardized procedure. Pathologic locations (supra- and infradiaphragmatic) and their character (single or multiple) were analyzed in order to determine reliable metabolic patterns of recurrence. The final diagnosis was established by histopathological analysis or clinical follow-up greater than 8 months.
  
  
  RESULTS
  A total of 199 explorations belonging to 106 patients with lymphoma were included. Of these patients, 59 had Hodgkin's lymphoma and 47 non-Hodgkin's lymphoma. There was suspicion of relapse from the metabolic point of view in 27 of the PET/CT scans. Of these, 14 (10 patients) were false positive (FP), and 13 (8 patients) true positive. The remaining studies were true negative, no false negatives being detected. The pattern most frequently related to recurrence was infradiaphragmatic lymph node involvement while most of the FP had isolated supradiaphragmatic involvement. Sensitivity, specificity, PPV, NPV and diagnostic accuracy of PET/CT parameters for the study were 100%, 92%, 48%, 100% and 93%, respectively.
  
  
  CONCLUSIONS
  (18)F-FDG-PET/CT is a sensitive technique in the detection of asymptomatic recurrences in patients with lymphoma during their follow-up. Multiple character and infradiaphragmatic locations were the patterns that best correlated to the diagnosis of recurrence.
authors: Servicio de Medicina Nuclear, Hospital General Universitario, Ciudad Real, España. amgarcia@sescam.jccm.es
authors: A M
authors: AM
authors: García Vicente
authors: M
authors: M
authors: Bellón Guardia
authors: A
authors: A
authors: Soriano Castrejón
authors: C
authors: C
authors: Calle Primo
authors: J M
authors: JM
authors: Cordero García
authors: A
authors: A
authors: Palomar Muñoz
authors: J P
authors: JP
authors: Pilkington Woll
authors: M P
authors: MP
authors: Talavera Rubio
authors: B
authors: B
authors: Hernández Ruiz
mesh_terms: D000328:Adult; D058070:Asymptomatic Diseases; D005260:Female; D019788:Fluorodeoxyglucose F18; D006689:Hodgkin Disease / Q000000981:diagnostic imaging*; D006801:Humans; D008137:Longitudinal Studies; D008228:Lymphoma, Non-Hodgkin / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging*; D011159:Population Surveillance; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18