The role of FDG-PET/CT in the evaluation of residual disease in paediatric non-Hodgkin lymphoma.
(18) F-labelled-fluorodeoxyglucose positron emission tomography (FDG-PET) findings are challenging to interpret for residual disease versus complete response in paediatric patients with non-Hodgkin lymphoma (NHL). A biopsy is often warranted to confirm the presence or absence of viable tumour if there is clinical or radiographic evidence of residual disease. In this study, we compared conventional imaging and FDG-PET/computerized tomography (CT) findings with biopsy results in 18 children with NHL. Our goal was to provide additional data to establish more reliable criteria for response evaluation. Residual disease was suspected after conventional imaging alone in eight patients, after FDG-PET/CT alone in three and after both modalities in seven patients. Biopsy confirmed the presence of viable tumour in two patients. Two additional patients experienced progressive disease or relapse. The sensitivity and negative predictive value of FDG-PET/CT using the London criteria to indicate residual tumour detectable by biopsy were 100%, but specificity was low (60%), as was the positive predictive value (25%). Thus, in this study, a negative FDG-PET/CT finding was a good indicator of complete remission. However, because false-positive FDG-PET/CT findings are common, biopsy and close monitoring are required for accurate determination of residual disease in individual patients.
Department of Oncology, St Jude Children's Research Hospital, Memphis, TN, USA; Department of Pediatrics, University of Tennessee Health Science Center, College of Medicine, Memphis, TN, USA.
Deepa
D
Bhojwani
Mary B
MB
McCarville
John K
JK
Choi
Jennifer
J
Sawyer
Monika L
ML
Metzger
Hiroto
H
Inaba
Andrew M
AM
Davidoff
Robert
R
Gold
Barry L
BL
Shulkin
John T
JT
Sandlund
D000293:Adolescent; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000175:diagnosis* / Q000473:pathology; D064847:Multimodal Imaging / Q000379:methods; D018365:Neoplasm, Residual; D049268:Positron-Emission Tomography / Q000379:methods; D011237:Predictive Value of Tests; D011379:Prognosis; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods; D055815:Young Adult
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
biopsy; neoplasm; non-Hodgkin lymphoma; positron-emission tomography; residual