title: The use of FDG-PET in the initial staging of 142 patients with follicular lymphoma: a retrospective study from the FOLL05 randomized trial of the Fondazione Italiana Linfomi.
abstract: BACKGROUND
  The role of [¹⁸F] fluorodeoxyglucose (FDG)-positron emission tomography (PET) in follicular lymphoma (FL) staging is not yet determined.
  
  
  METHODS
  The aim of the present study was to investigate the role of PET in the initial staging of FL patients enrolled in the FOLL05-phase-III trial that compared first-line regimens (R-CVP, R-CHOP and R-FM). Patients should have undergone conventional staging and have available PET baseline to be included.
  
  
  RESULTS
  A total of 142 patients were analysed. PET identified a higher number of nodal areas in 32% (46 of 142) of patients and more extranodal (EN) sites than computed tomography (CT) scan. Also, the Follicular Lymphoma International Prognostic Index (FLIPI) score increased in 18% (26 of 142) and decreased in 6% (9 of 142) of patients. Overall, the impact of PET on modifying the stage was highest in patients with limited stage. Actually, 62% (15 of 24) of cases with limited disease were upstaged with PET.
  
  
  CONCLUSIONS
  The inclusion of PET among staging procedures makes the evaluation of patients with FL more accurate and has the potential to modify therapy decision and prognosis in a moderate proportion of patients. Further prospective clinical trials on FL should incorporate PET at different moments, and the therapeutic criteria to start therapy should be re-visited in the views of this new tool.
authors.affiliation: Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy. sluminari@unimore.it
authors.forename: S
authors.initials: S
authors.lastname: Luminari
authors.forename: I
authors.initials: I
authors.lastname: Biasoli
authors.forename: L
authors.initials: L
authors.lastname: Arcaini
authors.forename: A
authors.initials: A
authors.lastname: Versari
authors.forename: C
authors.initials: C
authors.lastname: Rusconi
authors.forename: F
authors.initials: F
authors.lastname: Merli
authors.forename: M
authors.initials: M
authors.lastname: Spina
authors.forename: A J M
authors.initials: AJ
authors.lastname: Ferreri
authors.forename: P L
authors.initials: PL
authors.lastname: Zinzani
authors.forename: A
authors.initials: A
authors.lastname: Gallamini
authors.forename: S
authors.initials: S
authors.lastname: Mastronardi
authors.forename: C
authors.initials: C
authors.lastname: Boccomini
authors.forename: G
authors.initials: G
authors.lastname: Gaidano
authors.forename: A M
authors.initials: AM
authors.lastname: D'Arco
authors.forename: F
authors.initials: F
authors.lastname: Di Raimondo
authors.forename: A M
authors.initials: AM
authors.lastname: Carella
authors.forename: A
authors.initials: A
authors.lastname: Santoro
authors.forename: P
authors.initials: P
authors.lastname: Musto
authors.forename: M
authors.initials: M
authors.lastname: Federico
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D003520:Cyclophosphamide / Q000627:therapeutic use; D004317:Doxorubicin / Q000627:therapeutic use; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007558:Italy; D008224:Lymphoma, Follicular / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis / Q000175:diagnosis; D009367:Neoplasm Staging / Q000379:methods*; D049268:Positron-Emission Tomography; D011241:Prednisone / Q000627:therapeutic use; D011379:Prognosis; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014750:Vincristine / Q000627:therapeutic use
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone
keywords: CT scan; FDG-PET; follicular lymphoma; staging