title: Can Interim 18F-FDG PET or Diffusion-Weighted MRI Predict End-of-Treatment Outcome in FDG-Avid MALT Lymphoma After Rituximab-Based Therapy?: A Preliminary Study in 15 Patients.
abstract: OBJECTIVE
  To determine whether interim F-FDG PET or interim diffusion-weighted magnetic resonance imaging (DWI) can predict the end-of-treatment (EOT) outcome after immunotherapy in patients with FDG-avid extranodal marginal zone B-cell lymphoma of the mucosa-associated lymphoid tissue (MALT).
  
  
  METHODS
  Patients with untreated MALT lymphoma prospectively underwent whole-body F-FDG PET/CT and DWI before treatment (baseline), and after three cycles (interim) of rituximab-based immunotherapy. Maximum and mean standardized uptake values (SUVmax, SUVmean), and minimum and mean apparent diffusion coefficients (ADCmin, ADCmean), were measured for up to three target lesions per patient. Rates of change between baseline and interim examinations (ΔSUVmax, ΔSUVmean, ΔADCmin, and ΔADCmean) were compared, using ANOVAs, between the four end-of-treatment (EOT, after six cycles of immunotherapy) outcomes: complete remission (CR), partial remission (PR), stable disease (SD), or progressive disease (PD).
  
  
  RESULTS
  Fifteen patients with 25 lesions were included. Lesion-based post hoc tests showed significant differences between CR and PR for ΔSUVmax (P < 0.001), ΔSUVmean (P < 0.001), and ΔADCmin (P = 0.044), and between CR and SD for ΔSUVmax (P < 0.001), ΔSUVmean (P < 0.001), ΔADCmin (P = 0.021), and ΔADCmean (P = 0.022). No lesion showed PD at EOT.
  
  
  CONCLUSIONS
  Both quantitative interim F-FDG PET and interim DWI may possibly be useful to predict complete remission at end-of-treatment in MALT lymphoma patients after immunotherapy.
authors.affiliation: From the *Department of Biomedical Imaging and Image-guided Therapy, †Department of Internal Medicine I, ‡Centre for Medical Physics and Biomedical Engineering, §Institute of Pathology, ∥Department of Internal Medicine III, and #Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria.
authors.forename: Marius E
authors.initials: ME
authors.lastname: Mayerhoefer
authors.forename: Georgios
authors.initials: G
authors.lastname: Karanikas
authors.forename: Kurt
authors.initials: K
authors.lastname: Kletter
authors.forename: Barbara
authors.initials: B
authors.lastname: Kiesewetter
authors.forename: Michael
authors.initials: M
authors.lastname: Weber
authors.forename: Ivo
authors.initials: I
authors.lastname: Rausch
authors.forename: Matthias
authors.initials: M
authors.lastname: Pones
authors.forename: Ingrid
authors.initials: I
authors.lastname: Simonitsch-Klupp
authors.forename: Leonhard
authors.initials: L
authors.lastname: Müllauer
authors.forename: Werner
authors.initials: W
authors.lastname: Dolak
authors.forename: Julius
authors.initials: J
authors.lastname: Lukas
authors.forename: Markus
authors.initials: M
authors.lastname: Raderer
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy; D038524:Diffusion Magnetic Resonance Imaging; D005134:Eye Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007167:Immunotherapy; D007766:Lacrimal Apparatus Diseases / Q000000981:diagnostic imaging* / Q000188:drug therapy; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy; D008198:Lymph Nodes / Q000000981:diagnostic imaging*; D018442:Lymphoma, B-Cell, Marginal Zone / Q000000981:diagnostic imaging* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D000072078:Positron Emission Tomography Computed Tomography; D049268:Positron-Emission Tomography; D011379:Prognosis; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D012074:Remission Induction; D000069283:Rituximab / Q000627:therapeutic use; D012983:Soft Tissue Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy; D013160:Splenic Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy; D013274:Stomach Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D000069283:Rituximab