title: Role of 18F-FDG-PET/CT in the management of Burkitt lymphoma.
abstract: Burkitt lymphoma (BL) is highly FDG-avid even though its usefulness in the management of these patients is still controversial.
  
  
  OBJECTIVE
  We analyzed the role of positron emission tomography/computerized tomography (PET/CT) in staging newly diagnosed patients with BL and evaluating disease after first-line chemotherapy.
  
  
  METHODS
  Fifty-two PET/CTs were performed in 32 patients (20 at diagnosis, 27 after treatment, five to monitor residual disease). Involved areas were retrospectively compared with those observed in contrast-enhanced CT.
  
  
  RESULTS
  Discrepancies were found in 64.7% of patients for whom results of both tests at diagnosis were available (n = 17), most of them involving extranodal sites. Regarding response assessment, discrepancies were observed in 38% of patients with both tests (5/13): residual masses detected by CT with negative PET/CT. Of 27 patients with post-treatment PET/CT, 22 were in complete remission whereas one true-positive and four false-positive lesions (two nodal and two extranodal) were detected. With a median follow-up of 27 months, 22 patients with negative PET/CT did not relapse. Thus, negative predictive value (NPV) was 100%. With respect to positive predictive value (PPV), one of five patients with positive assays after treatment died due to progression while the remaining four had false-positive lesions. Nevertheless, for these four patients, mean SUVmax at nodal sites was 4.1 vs. 14.9 at diagnosis, while mean SUVmax at extranodal sites was 3.8 vs. 12.1. Thus, with a cutoff value for SUVmax < 66% of that observed at diagnosis, PPV was also 100%.
  
  
  CONCLUSIONS
  More accurate staging can be achieved using PET/CT. NPV reaches 100%, and using a ΔSUV < 66%, a high PPV is also observed.
authors: Department of Hematology, Hospital Universitario Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBIS)/CSIC/Universidad de Sevilla, Seville, Spain.
authors: Estrella
authors: E
authors: Carrillo-Cruz
authors: Víctor A
authors: VA
authors: Marín-Oyaga
authors: María
authors: M
authors: Solé Rodríguez
authors: Isabel
authors: I
authors: Borrego-Dorado
authors: Fátima
authors: F
authors: de la Cruz Vicente
authors: Eduardo
authors: E
authors: Quiroga Cantero
authors: Marina
authors: M
authors: Manzanares Pérez
authors: Francisco J
authors: FJ
authors: Capote
authors: María J
authors: MJ
authors: Ramírez Sánchez
authors: Ildefonso
authors: I
authors: Espigado Tocino
authors: Herminia
authors: H
authors: Pérez-Vega
authors: Ricardo
authors: R
authors: Vázquez-Albertino
authors: Jose A
authors: JA
authors: Pérez-Simón
mesh_terms: D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002051:Burkitt Lymphoma / Q000175:diagnosis* / Q000188:drug therapy / Q000401:mortality; D002648:Child; D002675:Child, Preschool; D019468:Disease Management; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D019788:Fluorodeoxyglucose F18
keywords: Burkitt lymphoma; [18F]-2-deoxy-D-glucose-positron emission tomography/computerized tomography; positron emission tomography/computerized tomography; response assessment; staging