title: Utility of the PET-CT in the evaluation of early response to treatment in the diffuse large B-cell lymphoma. Preliminary results.
abstract: OBJECTIVE
  To assess the role of FDG-PET/CT performed after the first cycles of chemotherapy in the prediction of response to treatment in patients with diffuse large B-cell lymphoma.
  
  
  METHODS
  Twenty patients (mean age: 48 years) were included, 16 initial staging and 4 relapse. All patients underwent PET/CT at 3 times: 1) Baseline, 2) After 1-3 cycles of chemotherapy (early response assessment), and 3) End of treatment (evaluation of final response). Early PET/CT findings were correlated to the end-treatment PET/CT and follow-up. The evaluation of the response was established according to the decrease in uptake of the lesions (SUVmax). In the early assessment, a good response indicator (GRI) was obtained when the lesion disappeared or had more than 50% reduction in SUVmax. At the end of the treatment, a complete metabolic response (CMR) was determined in negative PET scans. Follow-up was superior to 19 months and final outcome was established as progression/relapse or no evidence of disease (NED).
  
  
  RESULTS
  At the early treatment evaluation, 16/16 patients of initial staging (100%) and 2/4 of relapse (50%) achieved GRI. At the end of treatment evaluation, 14/16 patients of initial staging with GRI achieved CMR and 1/16 PMR: 14 were alive with NED in the follow-up while 1 relapsed. In the second group, 2/2 patients with GRI achieved CMR (100%): 1 continued with NED in the follow-up and another relapsed.
  
  
  CONCLUSIONS
  FDG-PET/CT after the first cycles of chemotherapy is useful to monitor treatment due to its high negative predictive value (87.5%), using it to modify treatment early in the non-responders.
authors.affiliation: Unitat PET, Institut de Diagnòstic per la Imatge (IDI), Hospital Universitari de Bellvitge, IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain. mcortes@bellvitgehospital.cat
authors.forename: M
authors.initials: M
authors.lastname: Cortés Romera
authors.forename: C
authors.initials: C
authors.lastname: Gámez Cenzano
authors.forename: A P
authors.initials: AP
authors.lastname: Caresia Aróztegui
authors.forename: J
authors.initials: J
authors.lastname: Martín-Comín
authors.forename: E
authors.initials: E
authors.lastname: González-Barca
authors.forename: Y
authors.initials: Y
authors.lastname: Ricart Brulles
authors.forename: A
authors.initials: A
authors.lastname: Palacios Abufón
authors.forename: J
authors.initials: J
authors.lastname: Robles Barba
authors.forename: L
authors.initials: L
authors.lastname: Rodríguez-Bel
authors.forename: S
authors.initials: S
authors.lastname: Rossi Seoane
authors.forename: A
authors.initials: A
authors.lastname: Fernández de Sevilla
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D058846:Antibodies, Monoclonal, Murine-Derived / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage; D003520:Cyclophosphamide / Q000008:administration & dosage; D003561:Cytarabine / Q000008:administration & dosage; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D004317:Doxorubicin / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D005462:Fluorine Radioisotopes / Q000493:pharmacokinetics; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000473:pathology; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage; D008875:Middle Aged; D064847:Multimodal Imaging; D009367:Neoplasm Staging; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D010865:Pilot Projects; D049268:Positron-Emission Tomography; D011241:Prednisone / Q000008:administration & dosage; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D012074:Remission Induction; D000069283:Rituximab; D014018:Tissue Distribution; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014750:Vincristine / Q000008:administration & dosage; D055815:Young Adult
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D005462:Fluorine Radioisotopes; D009944:Organoplatinum Compounds; D019275:Radiopharmaceuticals; D003561:Cytarabine; D003841:Deoxycytidine; D019788:Fluorodeoxyglucose F18; D000069283:Rituximab; D014750:Vincristine; D005047:Etoposide; D004317:Doxorubicin; D003520:Cyclophosphamide; D002945:Cisplatin; D011241:Prednisone; D008775:Methylprednisolone