[Positron emission tomography combined with computed tomography in the initial evaluation and response assessment in primary central nervous system lymphoma]

Abstract

Objective: To evaluate the role of positron emission tomography combined with computed tomography (PET-CT) in the initial evaluation and response assessment in primary central nervous system lymphoma (PCNSL).

Material and method: Fourteen patients (8 males) with a median age 59.5 years diagnosed of PCNSL. A brain PET-CT and magnetic resonance imaging (MRI) were performed in the initial evaluation. In 7 patients a PET-CT after treatment was performed.

Results: PET-CT showed at diagnosis 31 hypermetabolic focuses and MRI showed 47 lesions, with a good grade of concordance between both (k = 0.61; P = .005). In the response assessment, correlation between both techniques was good, and PET-CT was helpful in the appreciation of residual MRI lesions. Overall survival at 2 years of negative vs. positive PET-CT at the end of treatment was 100 vs. 37.5%, respectively (P = .045).

Conclusions: PET-CT can be useful in the initial evaluation of PCNSL, and especially in the assessment of response. Despite the fact that PET-CT detects less small lesions than MRI, a good correlation between MRI and PET-CT was observed. It is effective in the evaluation of residual lesions. Prospective studies are needed to confirm their possible prognostic value.

Keywords: Linfoma cerebral primario; Magnetic resonance; Positron emission tomography combined with computed tomography; Primary central nervous system lymphoma; Prognosis; Pronóstico; Resonancia magnética; Tomografía por emisión de positrones combinada con tomografía computarizada.