Onkologie. 2009:3(3):164-169

The current position of positron emission tomography and combined positron emission tomography with computed tomography in initial staging and response assessment in patients with non-Hodgkin´s lymphoma

MUDr. Tomáš Papajík CSc¹, Miroslav Mysliveček², Magdalena Skopalová³, Alaxander Malán⁴, Vladimír Koza⁵, Marek Trněný⁶, Karel Indrák¹

¹ Hemato-onkologická klinika FN a LF UP v Olomouci

² Klinika nukleární medicíny FN a LF UP v Olomouci

³ PET centrum, Nemocnice Na Homolce, Praha

⁴ Oddělení nukleární medicíny FN Plzeň

⁵ Hematologicko-onkologické oddělení, FN Plzeň

⁶ I. interní klinika 1. LF UK a VFN Praha

2-[fluorin-18] fluoro-2-deoxy-D-glucose (18F-FDG) positron emission tomography (PET) is a modern imaging modality reliable for the initial

diagnosis, staging and for the evaluation of therapeutic response of non-Hodgkin´s lymphoma (NHL). 18F-FDG PET has been demonstrated

more sensitive and specific than either 67gallium scintigraphy or computed tomography (CT). However, 18F-FDG PET may not accurately

localize pathological lesions. Actually, the integration of PET and CT (PET/CT) provides more precise anatomic localization of the lesions

on the 18F-FDG PET scans, thereby increasing specificity of the examination. All major NHL subtypes are usually 18F-FDG-avid, but some

indolent lymphoma and T-cell lymphoma have low 18F-FDG uptake and the PET results may not be reliable in such cases. 18F-FDG PET has

been shown to be important in response assessment of NHL, especially in diffuse large B-cell lymphoma (DLBCL) and the method has been

recently incorporated in the revised response criteria for malignant lymphoma. The independent prognostic value of early or interim 18F-FDG

PET for DLBCL has been established and should be a useful tool to modify ineffective therapy in high-risk patients. Some non-neoplastic

conditions (sarcoidosis, tuberculosis, fungal infections, inflammation, tissue reparation, etc.) may be a source of “false-positive” 18F-FDG PET

scans. Integrated PET-CT system can help improve the specificity of the findings and may contribute to better lesion characterization.

Keywords: 18F- FDG PET, PET/CT, non-Hodgkin´s lymphoma, staging, restaging.

Published: June 15, 2009  Show citation