title: Diagnostic and prognostic role of PET/CT in patients with chronic lymphocytic leukemia and progressive disease.
abstract: In order to evaluate the predictive value of positron emission tomography-computed tomography (PET/CT) in discriminating the presence of a Richter's syndrome (RS) or a second malignancy (SM), as well as to evaluate its prognostic value in patients with chronic lymphocytic leukemia (CLL), we retrospectively analyzed the data of 90 patients who, in the suspicion of a RS or a SM, underwent PET/CT followed by the biopsy of the involved tissue. The median maximum Standardized Uptake Value (SUV max) in the presence of a CLL/small lymphocytic lymphoma, a diffuse large B-cell lymphoma (DLBCL), a Hodgkin lymphoma (HL), a SM were 3.5, 14.6, 7.0 and 6.3, respectively (P ⩽ 0.0001). A SUV max cutoff value ⩾ 5 showed a sensitivity, specificity, positive and negative predictive values of 88.2, 71.2, 51.3 and 94%, respectively, for the presence of a more aggressive disease (DLBCL, HL and SM). A SUV max ⩾ 5 identified also a subset of treatment naive patients with an inferior progression-free survival (P = 0.011) and overall survival (P = 0.067). These findings suggest that PET/CT may helpfully integrate the biologically-based prognostic stratification of CLL. Prospective clinical trials including larger cohorts of patients are needed to conclusively define the role and prognostic impact of PET/CT in the routine management of CLL patients.
authors: Department of Cellular Biotechnologies and Hematology, Sapienza University, Rome, Italy.
authors: F R
authors: FR
authors: Mauro
authors: Department of Medical Physics, Azienda Ospedaliera S. Croce e Carle, Cuneo, Italy.
authors: S
authors: S
authors: Chauvie
authors: Italian Group for Adult Hematologic Diseases (GIMEMA), Rome, Italy.
authors: F
authors: F
authors: Paoloni
authors: Department of Medical Physics, Azienda Ospedaliera S. Croce e Carle, Cuneo, Italy.
authors: A
authors: A
authors: Biggi
authors: Department of Cellular Biotechnologies and Hematology, Sapienza University Polo Pontino, Rome, Italy.
authors: G
authors: G
authors: Cimino
authors: Department of Cellular Biotechnologies and Hematology, Sapienza University Polo Pontino, Rome, Italy.
authors: A
authors: A
authors: Rago
authors: Hematology Section, Cosenza Hospital, Cosenza, Italy.
authors: M
authors: M
authors: Gentile
authors: Hematology Section, Cosenza Hospital, Cosenza, Italy.
authors: F
authors: F
authors: Morabito
authors: Department of Hematology, University of Turin, Turin, Italy.
authors: M
authors: M
authors: Coscia
authors: Department of Hematology, University of Turin, Turin, Italy.
authors: M
authors: M
authors: Bellò
authors: Amedeo Avogadro University of Eastern Piedmont, Novara, Italy.
authors: G M
authors: GM
authors: Sacchetti
authors: Amedeo Avogadro University of Eastern Piedmont, Novara, Italy.
authors: D
authors: D
authors: Rossi
authors: Department of Hematology, Catholic University, Rome, Italy.
authors: L
authors: L
authors: Laurenti
authors: Department of Hematology, Catholic University, Rome, Italy.
authors: F
authors: F
authors: Autore
authors: Department of Cellular Biotechnologies and Hematology, Sapienza University, Rome, Italy.
authors: M
authors: M
authors: Campanelli
authors: Department of Cellular Biotechnologies and Hematology, Sapienza University, Rome, Italy.
authors: F
authors: F
authors: Trastulli
authors: SDN Foundation, Institute of Diagnostic and Nuclar Development, Naples, Italy.
authors: E
authors: E
authors: Nicolai
authors: Department of Molecular Medicine, Sapienza University, Rome, Italy.
authors: M
authors: M
authors: Riminucci
authors: Amedeo Avogadro University of Eastern Piedmont, Novara, Italy.
authors: G
authors: G
authors: Gaidano
authors: Department of Cellular Biotechnologies and Hematology, Sapienza University, Rome, Italy.
authors: A
authors: A
authors: Guarini
authors: Department of Research and Medical Innovation, Antoine-Lacassagne Cancer Center, Nice, France.
authors: A
authors: A
authors: Gallamini
authors: Department of Cellular Biotechnologies and Hematology, Sapienza University, Rome, Italy.
authors: R
authors: R
authors: Foà
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006689:Hodgkin Disease / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D016403:Lymphoma, Large B-Cell, Diffuse / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D016609:Neoplasms, Second Primary / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D049268:Positron-Emission Tomography / Q000379:methods*; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D014057:Tomography, X-Ray Computed / Q000379:methods*
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