¹⁸F-FDG-PET/CT for detection of extramedullary acute myeloid leukemia

Abstract

Myeloid sarcoma in acute myeloid leukemia has been clearly defined by the World Health Organization but studies regarding the prevalence and the prognostic impact of extramedullary acute myeloid leukemia have not been conducted. We performed (18)Fluoro-deoxy-Glucose Positron Emission Tomography/Computed Tomography scans in 10 patients with de novo and relapsed acute myeloid leukemia and histologically proven extramedullary disease. The scans were able to detect the known extramedullary lesions in 9 out of 10 patients (90%). Furthermore, additional extramedullary sites were detected in 6 patients (60%). Thus, it is possible to identify known and clinically undetectable extramedullary manifestations of acute myeloid leukemia. Since most of these patients relapsed within a short period of time after initiation of therapy or had refractory disease, the detection of extramedullary disease with (18)Fluoro-deoxy-Glucose Positron Emission Tomography/Computed Tomography might be helpful in the development of individual treatment algorithms for these high-risk patients.

Trial registration: ClinicalTrials.gov NCT01278069.

Figure 1.

(A) ¹⁸F-FDG-PET scan of patient UPN 1 at diagnosis of extramedullary AML. (B) Coronal and transversal ¹⁸F-FDG-PET/CT fusion images of the EM in the left mammary gland at diagnosis. (C) ¹⁸F-FDG-PET scan of the same patient after salvage chemotherapy (note: higher bone marrow ¹⁸F-FDG uptake due to higher bone marrow activity). (D) Coronal and transversal ¹⁸F-FDG-PET/CT fusion images of the EM in the left mammary gland after salvage chemotherapy (note: higher bone marrow ¹⁸F-FDG uptake due to higher bone marrow activity).