The utility and limitations of (18)F-fluorodeoxyglucose positron emission tomography with computed tomography in patients with primary mediastinal B-cell lymphoma: single institution experience and literature review.
There are limited data regarding the role of (18)F-fluorodeoxyglucose positron emission tomography with computed tomography (FDG PET-CT) scanning in primary mediastinal B-cell lymphoma (PMBL). We analyzed 28 patients with PMBL treated with chemotherapy, of whom 25 (89%) also received rituximab and 17 (61%) radiotherapy. PET-CT scans were interpreted using visual analysis and a 5-point scale. After a median follow-up of 2.6 years, four patients relapsed and two died. The 2-year progression-free survival and overall survival were 86% and 94%. PET-CT has excellent negative predictive value (interim, 86-87%; end of treatment, 95%) but limited positive predictive value due to the high frequency of positive scans. Several patients with persistent metabolically active masses underwent biopsies, which showed necrosis but no lymphoma. Thus a negative PET-CT is an excellent predictor of subsequent outcome. However, residual metabolically active masses after treatment should be biopsied to confirm viable lymphoma prior to salvage therapy.
Department of Haematology, Peter MacCallum Cancer Centre , East Melbourne, Victoria , Australia.
Chan Y
CY
Cheah
Michael S
MS
Hofman
John F
JF
Seymour
David S
DS
Ritchie
Michael
M
Dickinson
Andrew
A
Wirth
H Miles
HM
Prince
Max
M
Wolf
Elchanan H
EH
Januszcewicz
Dennis A
DA
Carney
Kirsten E
KE
Herbert
Simon J
SJ
Harrison
Kate L
KL
Burbury
Constantine S
CS
Tam
D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D016393:Lymphoma, B-Cell / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D008297:Male; D008479:Mediastinal Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D063868:Patient Outcome Assessment; D049268:Positron-Emission Tomography; D011379:Prognosis; D011878:Radiotherapy; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D055815:Young Adult
D019788:Fluorodeoxyglucose F18
PET-CT; Primary mediastinal B-cell lymphoma; interim PET-CT; non-Hodgkin lymphoma; prognostic factors; risk adapted therapy