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. 2012:2012:370272.
doi: 10.1155/2012/370272. Epub 2012 Jul 30.

FDG-PET in Follicular Lymphoma Management

C Bodet-Milin  1 , T Eugène, T Gastinne, E Frampas, S Le Gouill, F Kraeber-Bodéré
Affiliations

FDG-PET in Follicular Lymphoma Management

C Bodet-Milin et al. J Oncol. 2012.

Abstract

18-Fluoro-deoxyglucose positron emission tomography/computerised tomography (FDG PET/CT) is commonly used in the management of patients with lymphomas and is recommended for both initial staging and response assessment after treatment in patients with diffuse large B-cell lymphoma and Hodgkin lymphoma. Despite the FDG avidity of follicular lymphoma (FL), FDG PET/CT is not yet applied in standard clinical practice for patients with FL. However, FDG PET/CT is more accurate than conventional imaging for initial staging, often prompting significant management change, and allows noninvasive characterization to guide assessment of high-grade transformation. For restaging, FDG PET/CT assists in distinguishing between scar tissue and viable tumors in residual masses and a positive PET after induction treatment would seem to predict a shorter progression-free survival.

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Figures

Figure 1
Figure 1
The FDG PET/CT images of a patient with rapidly progressive cutaneous follicular lymphoma presenting general signs (a). CT scans showed cutaneous nodes and hilar lymph nodes. Bone marrow biopsy was negative. FDG PET/CT was realised in order to detect systemic lymphoma and to guide biopsy to detect aggressive transformation. FDG PET/CT shows high levels of fixation in subcutaneous nodes, especially in presternal area (with maximal SUV of 25) (b), in supra-and infradiaphragmatic lymph nodes (c) and in focalized bone foci (d). Biopsy realised in presternal area confirmed aggressive transformation of FL.
Figure 2
Figure 2
FDG PET/CT imaging of a patient with a stage 2 FL in relapse, treated by RAIT in a phase I/II protocol using fractioned 90Y-epratuzumab with a partial metabolic response at 6 weeks and 3 months after RIT and who experienced relapse 6 months after RAIT. Figure 1(a) shows the FDG PET/CT image before RAIT with accumulation of FDG in lomboaortic, iliac, and inguinal nodes. Figures 1(b) and 1(c) show the FDG PET/CT images realised 6 weeks and 3 months after RIT, showing a residual uptake of FDG in left iliac nodes. Figure 1(d) shows the FDG-PET images realised 6 months after RIT with pathologic accumulation of FDG in lombo-aortic, iliac and inguinal nodes confirming clinical suspicion of relapse.
See this image and copyright information in PMC

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