title: Clinical usefulness of FDG-PET/CT for the evaluation of various types of adult T-cell leukemia.
abstract: OBJECTIVE
  The aim was to explore undefined useful indices for clinically grading adult T-cell leukemia (ATL) using [18F] 2-fluoro-2-deoxyglucose (FDG) - positron emission tomography/computed tomography (PET/CT).
  
  
  METHODS
  A total of 28 patients with ATL (indolent, 9; aggressive, 19) were enrolled; all patients with aggressive ATL underwent FDG-PET/CT before chemotherapy. Patients with indolent ATL underwent FDG-PET/CT at the time of suspected disease progression and/or transformation; some received lymph node biopsy. The quantitative parameters maximum standardized uptake values (SUVmax), and mean and peak SUV, metabolic tumor volume (MTV), and volume-based total lesion glycolysis were calculated with the margin threshold as 25%, and 50% of the SUVmax for all lesions.
  
  
  RESULTS
  All parameters except for MTV-25% showed significant differences (P ≤ 0.05) in differentiating the aggressive type from the indolent type of ATL. Areas under the curve for receiver-operating characteristic (ROC) analysis regarding the series of parameters investigated ranged from 0.75 to 0.92; this indicated relatively high accuracy in distinguishing the aggressive type from the indolent type. No malignant findings were detected in lymph node biopsies in indolent ATL patients with lymphadenopathy.
  
  
  CONCLUSIONS
  We performed evaluation of a line of parameters of FDG-PET, thereby demonstrating their significantly high accuracy for grading malignancy in ATL patients. In particular, low accumulation of FDG in indolent ATL patients with lymphadenopathy might predict that it is not a sign of disease transformation, but rather a reactive manifestation.
  
  
  CONCLUSIONS
  FDG-PET/CT findings could be useful for clinically grading ATL.
authors.affiliation: a Division of Endocrinology, Diabetes and Metabolism, Hematology and Rheumatology (Second Department of Internal Medicine), Graduate School of Medicine , University of the Ryukyus , Nishihara , Japan.
authors.forename: Sawako
authors.initials: S
authors.lastname: Nakachi
authors.affiliation: b Department of Radiology, Graduate School of Medical Science , University of the Ryukyus , Nishihara , Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Okada
authors.affiliation: a Division of Endocrinology, Diabetes and Metabolism, Hematology and Rheumatology (Second Department of Internal Medicine), Graduate School of Medicine , University of the Ryukyus , Nishihara , Japan.
authors.forename: Satoko
authors.initials: S
authors.lastname: Morishima
authors.affiliation: b Department of Radiology, Graduate School of Medical Science , University of the Ryukyus , Nishihara , Japan.
authors.forename: Yurika
authors.initials: Y
authors.lastname: Agarie
authors.affiliation: a Division of Endocrinology, Diabetes and Metabolism, Hematology and Rheumatology (Second Department of Internal Medicine), Graduate School of Medicine , University of the Ryukyus , Nishihara , Japan.
authors.forename: Sakiko
authors.initials: S
authors.lastname: Kitamura
authors.affiliation: a Division of Endocrinology, Diabetes and Metabolism, Hematology and Rheumatology (Second Department of Internal Medicine), Graduate School of Medicine , University of the Ryukyus , Nishihara , Japan.
authors.forename: Sachie
authors.initials: S
authors.lastname: Uchibori
authors.affiliation: a Division of Endocrinology, Diabetes and Metabolism, Hematology and Rheumatology (Second Department of Internal Medicine), Graduate School of Medicine , University of the Ryukyus , Nishihara , Japan.
authors.forename: Shouhei
authors.initials: S
authors.lastname: Tomori
authors.affiliation: a Division of Endocrinology, Diabetes and Metabolism, Hematology and Rheumatology (Second Department of Internal Medicine), Graduate School of Medicine , University of the Ryukyus , Nishihara , Japan.
authors.forename: Taeko
authors.initials: T
authors.lastname: Hanashiro
authors.affiliation: a Division of Endocrinology, Diabetes and Metabolism, Hematology and Rheumatology (Second Department of Internal Medicine), Graduate School of Medicine , University of the Ryukyus , Nishihara , Japan.
authors.forename: Natsuki
authors.initials: N
authors.lastname: Shimabukuro
authors.affiliation: a Division of Endocrinology, Diabetes and Metabolism, Hematology and Rheumatology (Second Department of Internal Medicine), Graduate School of Medicine , University of the Ryukyus , Nishihara , Japan.
authors.forename: Keita
authors.initials: K
authors.lastname: Tamaki
authors.affiliation: a Division of Endocrinology, Diabetes and Metabolism, Hematology and Rheumatology (Second Department of Internal Medicine), Graduate School of Medicine , University of the Ryukyus , Nishihara , Japan.
authors.forename: Iori
authors.initials: I
authors.lastname: Tedokon
authors.affiliation: a Division of Endocrinology, Diabetes and Metabolism, Hematology and Rheumatology (Second Department of Internal Medicine), Graduate School of Medicine , University of the Ryukyus , Nishihara , Japan.
authors.forename: Kazuho
authors.initials: K
authors.lastname: Morichika
authors.affiliation: a Division of Endocrinology, Diabetes and Metabolism, Hematology and Rheumatology (Second Department of Internal Medicine), Graduate School of Medicine , University of the Ryukyus , Nishihara , Japan.
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Nishi
authors.affiliation: c Internal Medicine , Heart-Life Hospital , Nakagusuku , Japan.
authors.forename: Takeaki
authors.initials: T
authors.lastname: Tomoyose
authors.affiliation: d Department of Pathology and Cell Biology, Graduate School of Medicine , University of the Ryukyus , Nishihara , Japan.
authors.forename: Kennosuke
authors.initials: K
authors.lastname: Karube
authors.affiliation: e Laboratory of Immunohematology, School of Health Sciences, Faculty of Medicine , University of the Ryukyus , Nishihara , Japan.
authors.forename: Takuya
authors.initials: T
authors.lastname: Fukushima
authors.affiliation: b Department of Radiology, Graduate School of Medical Science , University of the Ryukyus , Nishihara , Japan.
authors.forename: Sadayuki
authors.initials: S
authors.lastname: Murayama
authors.affiliation: a Division of Endocrinology, Diabetes and Metabolism, Hematology and Rheumatology (Second Department of Internal Medicine), Graduate School of Medicine , University of the Ryukyus , Nishihara , Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Masuzaki
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers; D001706:Biopsy; D005260:Female; D019788:Fluorodeoxyglucose F18; D005947:Glucose / Q000378:metabolism; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D015459:Leukemia-Lymphoma, Adult T-Cell / Q000000981:diagnostic imaging* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D015588:Observer Variation; D000072078:Positron Emission Tomography Computed Tomography; D012372:ROC Curve; D047368:Tumor Burden
chemical_list: D015415:Biomarkers; D019788:Fluorodeoxyglucose F18; D005947:Glucose
keywords: Adult T-cell leukemia; aggressive type; indolent type; metabolic tumor volume; positron emission tomography; standardized uptake value; total lesion glycolysis; volume-based parameter