engleski

FDG-PET in patients with lymphoma: What follows in follow-up?

Purpose: to asses the role of FDG-PET as a predictor of prognosis in patients with Hodgkin’ s disease (HD) and non-Hodgkin lymphoma (NHL) during a long-term follow-up period. In this investigation we continue with the follow up of the patients that entered the previous study several years ago. In the first study we evaluated the accuracy of PET in early detection of residual or recurrent disease after the completion of therapy. Methods: The single centre study comprised 31 consecutive patients (median age 35 years ; range 16-66 years) with primary or recurrent biopsy confirmed lymphoma and follow-up of at least 48 months (median 57 months ; range 48-75 months). PET studies were performed using IRIX hybrid PET camera with triple head coincidence imaging capability. The long-term follow-up data after treatment and PET studies were extracted from the patients’ medical files. Results: Fifteen patients (5 NHL, 10 HD) were negative on PET scan. They did not receive any therapy after FDG-PET, and no one relapsed in the short- (median 20, range 12-39 months) nor long-term (median 57, range 48-75 months) follow-up. Twelve patients presented with clear FDG pathological accumulation in one or more sites previously shown to be involved by lymphoma. Ten patients received further therapy. Six of them never achieved complete remission (CR). Three patients entered CR but relapsed (5, 17, and 28 months after FDG-PET) despite of additional therapy. Two patients were noted as false- positive. In four patients only slightly increased FDG uptake was observed (equivocal findings). Conclusions: FDG PET enables reliable prognosis in short and long-term follow-up of patients with HD and NHL, especially in patients without pathological uptake of FDG. False positive FDG uptake seems to be a problem. No one of our 15 FDG negative patients relapsed. Our results show that FDG negative patients usually have good prognosis and stay in complete remission for a long time. Therefore, results of PET are predictive of immediate success of therapy as well as of disease-free survival. Negative PET scan is an important contribution in the management of these patients due to its prognostic value and may reassure patients and their doctors that disease is not active.

FDG-PET; lymphoma; follow-up

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