title: Prognostic Value of FDG PET/CT before Allogeneic and Autologous Stem Cell Transplantation for Aggressive Lymphoma.
abstract: OBJECTIVE
  To determine the prognostic value of performing fluorine-18 fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) before allogeneic and autologous stem cell transplantation (SCT) in patients with aggressive lymphoma.
  
  
  METHODS
  A HIPAA-compliant retrospective review was performed under institutional review board waiver. Patients with aggressive lymphoma underwent allogeneic or autologous SCT between January 2005 and December 2010. FDG PET/CT was performed within the 3 months prior to transplantation. PET/CT images were evaluated for lesions with FDG avidity greater than that of the background liver. The relationship between pretransplantation PET and progression-free survival (PFS), disease-specific survival (DSS), and overall survival (OS) was assessed with Kaplan-Meier curves and a corresponding log-rank test for categorical variables and Cox regression for continuous variables.
  
  
  RESULTS
  A total of 175 patients were identified, of whom 73 underwent FDG PET/CT before allogeneic SCT and 102 underwent FDG PET/CT before autologous SCT. Before allogeneic SCT, 23 of 73 patients (32%) had FDG-avid lesions, and before autologous SCT, 11 of 102 patients (11%) had FDG-avid lesions. For allogeneic SCT, the 2-year PFS estimate was 68% (95% confidence interval [CI]: 56%, 82%) in patients without FDG-avid lesions, but only 35% (95% CI: 20%, 61%) for patients with FDG-avid lesions (P = .014). For autologous SCT, the 2-year PFS was 72% (95% CI: 64%, 82%) in patients without FDG-avid lesions, but only 18% (95% CI: 5%, 64%) for patients with FDG-avid lesions (P < .0001). Similar differences were seen in OS and DSS. The risk for posttransplantation recurrence correlated with higher lesional maximum standardized uptake values: for PFS, P < .0001 to P = .01; for DSS, P < .0001 to P = .002; and for OS, P < .0001 to P = .015.
  
  
  CONCLUSIONS
  Performing FDG PET/CT before SCT in patients with aggressive lymphoma has prognostic value. For patients with aggressive lymphomas, the presence of FDG-avid lesions at PET/CT performed before allogeneic and autologous SCT indicates a lower likelihood of SCT success.
authors.affiliation: From the Departments of Radiology (G.A.U., J.L., H.S.), Epidemiology and Biostatistics (D.A.G., M.G.), and Medicine (C.S.S., J.M., C.H.M., A.D.Z.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10065; and Departments of Radiology (G.A.U., H.S.) and Medicine (C.S.S., C.H.M., A.D.Z.), Weill Cornell Medical College, New York, NY.
authors.forename: Gary A
authors.initials: GA
authors.lastname: Ulaner
authors.affiliation: From the Departments of Radiology (G.A.U., J.L., H.S.), Epidemiology and Biostatistics (D.A.G., M.G.), and Medicine (C.S.S., J.M., C.H.M., A.D.Z.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10065; and Departments of Radiology (G.A.U., H.S.) and Medicine (C.S.S., C.H.M., A.D.Z.), Weill Cornell Medical College, New York, NY.
authors.forename: Debra A
authors.initials: DA
authors.lastname: Goldman
authors.affiliation: From the Departments of Radiology (G.A.U., J.L., H.S.), Epidemiology and Biostatistics (D.A.G., M.G.), and Medicine (C.S.S., J.M., C.H.M., A.D.Z.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10065; and Departments of Radiology (G.A.U., H.S.) and Medicine (C.S.S., C.H.M., A.D.Z.), Weill Cornell Medical College, New York, NY.
authors.forename: Craig S
authors.initials: CS
authors.lastname: Sauter
authors.affiliation: From the Departments of Radiology (G.A.U., J.L., H.S.), Epidemiology and Biostatistics (D.A.G., M.G.), and Medicine (C.S.S., J.M., C.H.M., A.D.Z.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10065; and Departments of Radiology (G.A.U., H.S.) and Medicine (C.S.S., C.H.M., A.D.Z.), Weill Cornell Medical College, New York, NY.
authors.forename: Jocelyn
authors.initials: J
authors.lastname: Migliacci
authors.affiliation: From the Departments of Radiology (G.A.U., J.L., H.S.), Epidemiology and Biostatistics (D.A.G., M.G.), and Medicine (C.S.S., J.M., C.H.M., A.D.Z.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10065; and Departments of Radiology (G.A.U., H.S.) and Medicine (C.S.S., C.H.M., A.D.Z.), Weill Cornell Medical College, New York, NY.
authors.forename: Joshua
authors.initials: J
authors.lastname: Lilienstein
authors.affiliation: From the Departments of Radiology (G.A.U., J.L., H.S.), Epidemiology and Biostatistics (D.A.G., M.G.), and Medicine (C.S.S., J.M., C.H.M., A.D.Z.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10065; and Departments of Radiology (G.A.U., H.S.) and Medicine (C.S.S., C.H.M., A.D.Z.), Weill Cornell Medical College, New York, NY.
authors.forename: Mithat
authors.initials: M
authors.lastname: Gönen
authors.affiliation: From the Departments of Radiology (G.A.U., J.L., H.S.), Epidemiology and Biostatistics (D.A.G., M.G.), and Medicine (C.S.S., J.M., C.H.M., A.D.Z.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10065; and Departments of Radiology (G.A.U., H.S.) and Medicine (C.S.S., C.H.M., A.D.Z.), Weill Cornell Medical College, New York, NY.
authors.forename: Heiko
authors.initials: H
authors.lastname: Schöder
authors.affiliation: From the Departments of Radiology (G.A.U., J.L., H.S.), Epidemiology and Biostatistics (D.A.G., M.G.), and Medicine (C.S.S., J.M., C.H.M., A.D.Z.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10065; and Departments of Radiology (G.A.U., H.S.) and Medicine (C.S.S., C.H.M., A.D.Z.), Weill Cornell Medical College, New York, NY.
authors.forename: Craig H
authors.initials: CH
authors.lastname: Moskowitz
authors.affiliation: From the Departments of Radiology (G.A.U., J.L., H.S.), Epidemiology and Biostatistics (D.A.G., M.G.), and Medicine (C.S.S., J.M., C.H.M., A.D.Z.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10065; and Departments of Radiology (G.A.U., H.S.) and Medicine (C.S.S., C.H.M., A.D.Z.), Weill Cornell Medical College, New York, NY.
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Zelenetz
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D049268:Positron-Emission Tomography; D011379:Prognosis; D011859:Radiography; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D033581:Stem Cell Transplantation; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18