Positron Emission Tomography (PET) for Staging Low-Grade Non-Hodgkin s Lymphomas (NHL)

Size: px
Start display at page:

Download "Positron Emission Tomography (PET) for Staging Low-Grade Non-Hodgkin s Lymphomas (NHL)"

Transcription

1 CANCER BIOTHERAPY & RADIOPHARMACEUTICALS Volume 16, Number 4, 2001 Mary Ann Liebert, Inc. Positron Emission Tomography (PET) for Staging Low-Grade Non-Hodgkin s Lymphomas (NHL) F. Najjar, R. Hustinx, G. Jerusalem, G. Fillet, and P. Rigo Divisions of Nuclear Medicine and Onco-Hematology, University Hospital, Liege, Belgium Part of this manuscript was presented at the annual meeting of the European Association Congress of Nuclear Medicine (September 3, 2000, Paris, France). Although positron emission tomography (PET) imaging is now recognized as a useful tool for staging intermediate and high-grade non-hodgkin s lymphoma (NHL), few data are available regarding its accuracy in low grade NHL. We therefore studied 36 patients with histologically proven low-grade NHL. Whole-body 2-(fluorine-18) fluoro-2-deoxy-d-glucose (FDG) PET was performed at the time of initial diagnosis (n 5 21) or for disease recurrence (n 5 15) prior to any treatment. PET results were compared to those of physical examination and computed tomography (CT). PET studies were read without knowledge of any clinical data. Any focus of increased activity was described and given a probability of malignancy using a 5 point-scale (0: normal to 4: definitively malignant). An individual biopsy was available for a total of 31 lesions. The sensitivity and specificity were 87% and 100% for FDG-PET, 100% and 100% for physical examination and 90% and 100% for CT respectively. In addition, 42 of 97 peripheral lymph node lesions observed by FDG-PET were clinically undetected, whereas the physical examination detected 23 additional nodal lesions. PET and CT both indicated 12 extranodal lymphomatous localizations. FDG-PET showed 7 additional extranodal lesions while 5 additional unconfirmed lesions were observed on CT. Regarding bone marrow infiltration, PET and biopsy were concordant in 24 patients with 11 true positive (TP) and 13 true negative (TN). However PET was FN in 11 patients and no biopsy was performed in one patient. The combination PET/CT/physical examination seems to be more sensitive than the conventional approach for staging low grade NHL. Its sensitivity however is unacceptably low for diagnosing bone marrow infiltration. Key words: FDG-PET, Fluorine-18 fluorodeoxyglucose, Non-Hodgkin s lymphoma, Positron emission tomography INTRODUCTION Metabolic imaging with positron emission tomography using FDG provides information on the functional characterization of tissues without dependence on morphologic criteria. It allows Address reprint requests to R. Hustinx, MD, PhD, CHU Sart-Tilman, B 35, B-4000 Liege 1, Belgium Tel. : Fax: one to detect foci of increased glycolysis, 1 which is an important sign of tumor metabolism. 2 Malignant tumors can be imaged by PET using FDG as it accumulates intracellularly as a result of the increase in the glucose transporter proteins at the tumor cell surface as well as increased hexokinase activity. 3 FDG-PET is now established as a valuable method for staging various malignancies. 4,5 In particular, its ability to image lymphomatous involvement in Hodgkin s disease (HD) and NHL 297

2 was demonstrated by several groups Although the difference between high-grade and low-grade NHL is clinically important, few data are available regarding the usefulness of FDG- PET in the evaluation of patients with low-grade NHL. 6,9,11 In addition, various histological subtypes exist within low-grade NHL corresponding to different clinical outcome. The prognosis for low-grade NHL is variable as it may transform into high-grade NHL. Rodriguez et al 12 suggested a significant difference in FDG uptake between high-grade and low-grade NHL, but these data have yet to be confirmed by other groups. A correlation between FDG uptake, prognosis and proliferative activity in NHL has also been suggested. 13 The aim of this study was to compare the accuracy of FDG-PET with that of physical examination and CT for the identification of nodal and extranodal lymphomatous involvement in lowgrade non-hodgkin s lymphoma. MATERIALS AND METHODS Population Thirty-six patients were retrospectively included in this study. Twenty-one patients were studied at initial diagnosis (I) and 15 patients at disease recurrence (R). All the 15 patients who relapsed were initially in complete remission after the first line treatment. All had low-grade NHL proved by biopsy. PET was performed prior to treatment. In the group of relapsing patients, transformation to high grade NHL was excluded by a new biopsy. The population consisted of 13 female and 23 male patients aged 38 to 76 years (mean 62.4). The histopathological analysis revealed 9 patients with small diffuse lymphocytic lymphoma, 7 patients with follicular lymphoma predominantly small cleaved cell, 14 patients with follicular lymphoma mixed small and large cell and 6 patients with unclassable pathological types of NHL according to Working Formulation classification for clinical use: 3 patients with mantle cell lymphoma and 3 patients with Mucosa-Associated Lymphoid Tissue (MALT type). All patients were submitted to physical examination, CT and PET study within one week before starting the treatment. Following the Ann-Arbor classification for clinical staging of patients, there were 4 stage I, 3 stage II, 5 stage III and 24 stage IV (Table 1). PET Imaging Whole-body PET was performed using the PENN PET scanner 240H (UGM, Philadelphia, PA). All 298

3 patients were requested to fast at least 6 hours prior to intravenous injection of 222 to 296 MBQ (6 8 mci) FDG. Emission scans were recorded minutes later. Whole-body acquisitions were performed from the cervical to the inguinal regions and consisted of 10 to 12 separate overlapping bed positions each covering 12.8 cm. The total time for image acquisition was about 50 minutes. The images were reconstructed using filtered back-projection and a hanning filter and reoriented in the transverse, coronal and sagittal planes. As attenuation correction was performed in only 10 patients, attenuation corrected images were not considered in this study. PET images were interpreted by one nuclear physician who was unaware of any clinical data. Any focus of increased FDG uptake that was not located in areas of physiologic FDG uptake and/or excretion was noted and given a probability of malignancy using a 5 point-scale depending on their aspect, size, location and intensity: 0: definitively benign. 1: probably benign or normal. 2: possibly benign or normal. 3: probably malignant. 4: definitively malignant. As attenuation corrected images were not always available, measurements of standard uptake value (SUV) were not considered for image analysis. Computed Tomography (CT) and Physical Examination (PE) CT studies of the thorax and abdomen or pelvis were performed separately in 30 and 35 patients respectively. The CT of the thorax was not always realized in our study because the clinician felt sometimes that the chest X-ray was sufficient. However, the PET results were not included in data analysis for thoracic lesions when the CT of thorax was not performed. Intravenous contrast enhancement was performed in every case. The cervical, axillary, supra-clavicular and inguinal regions were clinically explored, while the intrathoracic and intra-abdominopelvic lymph node regions were evaluated by FDG-PET and CT findings. Thoracic and abdominopelvic CT were realized using a PQ 5000 scanner (Picker, Cleveland, OH). All patients had an automated injection of 120 ml of 30% iodine (Xenetix, Guerbet, Aulnay sous-bois, France) for thoracic studies or 170 ml of 30% iodine for abdominopelvic studies with a flow rate of 2 and 3 cc/sec for thoracic and abdominal studies respectively. The first phase of acquisition started (15 20) or 30 seconds after the injection for thoracic or abdominal studies respectively. The second phase of acquisition started after 60 or 90 seconds. The resolution was The enhanced contrast images were only reviewed in thoracic studies while non-enhanced and enhanced were read and compared in the abdominopelvic studies. The slice thickness was 5 10 mm and 10 mm in thoracic and abdominopelvic studies, respectively. CT scans were interpreted by a senior radiologist, as part of his routine clinical work. Each lymph node of 1 cm or greater in diameter was considered as pathological on CT. 14 Similarly, an isolated lymph node greater than 1 cm or multiple lymph nodes of 1 cm in diameter observed by physical examination were suspected to be infiltrated by lymphoma. Data Analysis We examined the concordance between PET images and the presence of enlarged lymph nodes according to physical examination or CT imaging. In case of discordance, the standard of reference was the biopsy whenever available. For ethical considerations a systematic biopsy of the various lesions was not performed for staging NHL but only when it was considered clinically necessary. Eight peripheral lymph node regions (bilateral cervical, axillary, supraclavicular and inguinal) were evaluated by physical examination and FDG-PET, whereas 7 intra-thoracic and abdominopelvic nodal regions (mediastinal, bilateral hilar and iliac, intra- and retroperitoneal) were explored by CT and FDG-PET. Overall 89 pathological samples were available. Pathological examinations were available for lymph node biopsies (n 5 23), digestive tract (n 5 23), bone marrow (n 5 35) and other extranodal localization (n 5 8). Lesions observed at PET, CT or physical examination but without pathological correlation were considered as unconfirmed and thus reported separately from the confirmed results. RESULTS Excluding bone marrow and digestive tract lesions, a total of 31 lesions were biopsied in 26 patients. There were 23 lymph node sites (20 peripheral, 3 abdominopelvic) and 8 extranodal lo- 299

4 calizations. Using an ROC methodology, 87% sensitivity and 100% specificity were reached when considering positive those lesions described as probably or definitively malignant (score 3 and 4). Using this threshold, there were 4 FN results for PET imaging (2 nodal, 1 pulmonary and 1 pleural) (Table 2). For all the 31 biopsy-proven lesions, the sensitivity and specificity were both 100% for physical examination versus 90% and 100% respectively for CT. a) Peripheral Lymph Nodes Both physical examination and FDG-PET showed 55 pathological lymph node regions. 300

5 FDG-PET showed 42 additional nodal lesions. Conversely, 23 lymph node lesions were only observed at physical examination (Table 3). Pathological analysis revealed 20 TP for physical examination and 18 TP and 2 FN for FDG-PET. b) Thoracic and Abdominopelvic Lymph Nodes There were 38 lesions identified by both FDG- PET and CT findings. FDG-PET indicated 24 additional lesions, whereas 21 additional lesions were observed by CT (Table 4). There were only 3 available biopsies, which showed 3 TP findings for both methods. Overall Results Completely identical results were obtained in 6 patients (I: 4 pts., R: 2 pts.) by both methods (conventional procedures and FDG-PET). Conventional procedures (PE and CT) indicated 31 additional involvement in 9 patients (I: 6 pts., R: 3 pts.). Conversely PET imaging showed 44 additional lesions in 14 patients (I: 8 pts., R: 6 pts.). However, completely discordant lesions were observed in 7 patients (I: 3 pts., R: 4 pts.), in whom conventional procedures and FDG-PET demonstrated 13 and 23 additional lesions respectively (Figs. 1,2). Extra-nodal Localization a) Spleen and Liver Concordant results between CT and PET scans for spleen infiltration were obtained in 5 patients (I: 3 pts., R: 2 pts.). These infiltrations were diffuse in 4 patients and focal in one. PET showed splenic involvement with negative CT findings in 3 patients (I: 1 pt., R: 2 pts.). CT demonstrated splenomegaly in one patient at initial presentation with normal FDG uptake of the spleen. Diffuse liver infiltration was demonstrated by both PET and CT imaging in one patient at disease recurrence. FDG-PET illustrated a diffuse hepatic involvement in 2 patients (I: 1 pt., R: 1 pt.) with negative CT findings. The histopathological analysis was available in 3 cases and indicated (2 TP, 1 TN) for both methods. b) Lungs and Pleura Both FDG-PET and CT showed lymphomatous infiltration of the lungs in 2 patients studied at disease recurrence. There were additional pulmonary lesions observed by CT in 3 patients (I: Figure 1. FDG-PET (coronal view) showing widespread lymph node involvement in a 37-year-old patient with a follicular lymphoma at initial diagnosis. Increased activity is clearly seen on the cervical, axillary, mediastinal, retroperitoneal and inguinal regions. 301

6 and confirmed by biopsy. One of them was also demonstrated by CT in one patient at disease recurrence. Overall Results (excluding bone marrow) A total of 12 extranodal lymphomatous infiltrations were concordantly detected with FDG-PET and CT. The most common site was the splenic involvement (n 5 5). FDG-PET depicted 7 additional extranodal lymphomatous involvements (3 splenic, 2 hepatic, 1 pleural and 1 digestive). CT demonstrated 5 additional extranodal localizations (3 pulmonary, 1 pleural and one splenic) (Table 5). Figure 2. Recurrent follicular lymphoma in a 42-year-old man. Multiple lesions are seen in the axillary, cervical and retroperitoneal areas as well as an extensive splenic involvement. 1 pt., R: 2 pts.). These lesions were less than 1 cm in diameter in one case and the two other lesions were observed in two patients with small lymphocytic and MALT subtypes NHL. Bilateral pathological FDG uptake of the pleura with negative CT findings was identified in one patient at disease recurrence, whereas additional unilateral pleural involvement was demonstrated on CT in a patient at initial diagnosis. The biopsy results, which were available in 3 patients, indicated 3 TP for CT and (1 TP, 2 FN) for FDG-PET. c) Head and Neck Localizations Both CT and FDG-PET indicated 3 lymphomatous lesions (2 tonsilar and 1 pharyngeal) in 3 patients studied at initial presentation. One of these lesions was confirmed by biopsy. d) Digestive Tract FDG-PET correctly identified a digestive infiltration in 2 patients (I: 1 pt., R: 1 pt.). These lesions were located in the colic and rectal regions e) Bone Marrow Infiltration Concordant findings between bone marrow biopsies and PET images were observed in 24 patients (70% of patient population) with 13 TN and 11 TP. On the other hand, FDG-PET failed to detect medullar infiltration identified at biopsy in 11 patients. Additionally, no biopsy was performed before the treatment in one patient. However, an incorrect downstaging with FDG-PET was suggested by their FN results in 6 patients (17% of patient population). DISCUSSION High and intermediate grade lymphomas demonstrate high FDG uptake, which allows PET imaging to detect disease involvement or disease recurrences. Previous studies confirmed that overall FDG-PET is at least as sensitive as CT, and more specific, in staging and restaging of HD and lymphoma. 7,15,16 In particular, FDG-PET appears to be more accurate for detecting nodal involvement than CT in primary untreated HD and NHL. 8 PET scanning also provided important additional information for detecting extranodal malignant lymphoma. 16 Previous studies also suggest that FDG-PET is able to evaluate treatment response and to detect residual masses after chemotherapy. 17,18 Although an increased FDG uptake was found in both high-grade and low-grade NHL, 15,16 the sensitivity of the technique for detecting individual nodal lesions appeared lower in low-grade NHL than in aggressive lymphoma. 7 Additionally, there were discouraging results for FDG- PET in staging of MALT-type lymphomas. 19 Low-grade lymphoma PET data published to 302

7 date are still limited and concern heterogeneous populations with small numbers of patients. 6,9,13 The present study is the first one dedicated to a fairly high number of patients with untreated lowgrade non-hodgkin s lymphoma. We found that FDG-PET detected more abnormal lymph node areas than conventional procedures especially in the axillary and supra-clavicular regions. This may be due to the size of the lesions, but it is not precisely known since no biopsy was taken. More likely, these regions are imperfectly investigated by physical examination especially in overweight patients. Regarding extra-nodal involvement, FDG-PET was as efficient as CT imaging. Some lymphomatous infiltrations were only detected by PET and others only by CT. Excluding bone-marrow involvement, 2 of the 4 FN encountered at FDG-PET were smaller than 1 cm. A pleural effusion was also missed. The last FN result for PET imaging was a 2 cm lymph node lesion in a patient with small cell type lymphoma. In our study, the sensitivity of PET for diagnosing bone-marrow involvement in lowgrade NHL is lower than that reported by Moog et al. 20 They studied both low and high-grade NHL. In addition, attenuation correction was performed in their study. Although we investigated a relatively large number of patients with low-grade NHL, limitations of this retrospective study include: 1. The inability to sample all sites of suspected lesions detected by FDG-PET and/or conventional procedures in order to confirm them (limitation in lymphoma imaging). 2. The SUV measurements were not realized for the suspected lesions observed by PET. 3. The attenuation correction was not often available in the PET study. The clinical impact of attenuation correction remains debated. Regarding its usefulness in clinical oncology, there was high agreement between diagnostic accuracy yield of uncorrected and attenuation correction images. 21 Kotzerke et al 22 studied 51 patients in order to evaluate the impact of the technique with and without attenuation correction in staging primary lymphoma. They found very similar clinical results with both techniques and concluded that attenuation correction was not absolutely necessary. However in a recent study, the accuracy of PET for staging abdominal malignancies was significantly improved by the combination of attenuation corrected and unattenuation corrected images compared to unattenuation correction images. 23 As for the SUV, the fact is that using an ROC methodology in our study, the sensitivity did not increase when a lower threshold for malignancy was used. This suggests that on average, lowgrade lymphoma lesions display significantly increased FDG uptake. Overall, our results suggest that FDG-PET provides additional information, but the clinical impact remains to be assessed by large prospective studies. In conclusion, the combination of PET/CT/ physical examination appears to be more sensitive than conventional staging in low-grade NHL. However, unacceptably low sensitivity of non-attenuation corrected PET imaging was observed in the detection of bone-marrow involvement. Further prospective studies are needed in order to determine the usefulness of quantitative analysis of FDG uptake in the evaluation of patients with low-grade NHL. The impact of FDG-PET on patient management and outcome remains to be evaluated by further investigations. ACKNOWLEDGMENTS The author thanks the Syrian Atomic Energy Commission (AECS) for its financial support. 303

8 REFERENCES 1. Som P, Atkims HL, Bandophadhayah D. A fluorinated glucose analog, 2 f-fluoro-deoxy-glucose (F-18). J Nucl Med 1980;21: Warburg O. On the origin of cancer cells. Science 1956;123: Warburg O, Wind F, Neglers E. On the metabolism of tumors in the body. In: Metabolism of tumors (Warburg O, ed). Constable, London, 1930: Rigo P, Paulus P, Kaschten BJ et al. Oncological applications of positron emission tomography with fluorine-18 fluorodeoxyglucose. Eur J Nucl Med 1996;23: Conti PS, Lilien DL, Hawley K et al. PET and (18F)- FDG in oncology: A clinical update. Nucl Med Biol 1996;23: Moog F, Bangerter M, Diederichs CG et al. Lymphoma: role of whole-body 2-deoxy-2-(F-18) fluoro-d-glucose positron emission tomography (FDG) PET in nodal staging. Radiology 1997;302: Hoh CK, Glapsy J, Rosen P et al. Whole-body FDG- PET imaging for staging of Hodgkin s and lymphoma. J Nucl Med 1997;38: Bangerter M, Moog F, Buchmann I et al. Whole-body 2-deoxy-2-(F-18) fluoro-d-glucose positron emission tomography (FDG-PET) for accurate staging of Hodgkin s disease. Ann Oncol 1998;9: Jerusalem G, Warland V, Najjar F et al. Whole-body 18-FDG PET for the evaluation of patients with Hodgkin s disease and non-hodgkin s lymphoma. Nucl Med Com 1999;20: Najjar F, Jerusalem G, Paulus P et al. Whole-body FDG- PET for the evaluation of patients with aggressive non- Hodgkin s lymphoma. Méd Nucl Imag Fonc Mét 1999; 23: Newman JS, Francis IR, Kamiski MS, Wahl RL. Imaging of lymphoma with PET with 2-(F-18)-fluoro-D-glucose: correlation with CT. Radiology 1994;190: Rodriguez M, Rehn S, Ahlström H et al. Predicting malignancy grade with PET in non-hodgkin s lymphoma. J Nucl Med 1995;36: Okada J, Yoshikawa K, Imazcki K et al. The use of FDG-PET in the detection and management of malignant lymphoma: Correlation of uptake with prognosis. J Nucl Med 1991;32: Castellino RA, Blank N, Hoppe RT et al. Hodgkin s disease: contribution of chest CT in the initial staging evaluation. Radiology 1986;27: Stumpe KD M, Urbinelli M, Steinert HC et al. Wholebody positron emission tomography using fluorodeoxyglucose for staging of lymphoma: Effectiveness and comparison with computed tomography. Eur J Nucl Med 1998;25: Moog F, Bangerter M, Diederichs CG et al. Extranodal malignant lymphoma: detection with FDG-PET versus CT. Radiology 1998;206: Jerusalem G, Beguin Y, Fassotte MF et al. Persistant tumor 18F-FDG uptake after few cycles of polychemotherapy is predictive of treatment failure in non- Hodgkin s lymphoma. Haematologica 2000;85: Jerusalem G, Beguin Y, Fassotte MF et al. Positron emission tomography using 18-FDG for post-treatment evaluation of Hodgkin s disease and non-hodgkin s lymphoma has higher diagnostic and prognostic values than classical CT-scan imaging. Blood 1999;94,2: Hoffmann M, Kletter K, Diemling M et al. Positron emission tomography using fluorine-18-fluoro-deoxy- D-glucose (F18-FDG) does not visualise extranodal B- cell lymphoma of the mucosa-associated lymphoid tissue (MALT)-type. Ann Oncol 1999;10: Moog F, Bangerter M, Kotzerk J et al. 18-F-Fluorodeoxyglucose Positron Emission Tomography as a new approach to detect lymphomatous bone marrow. J Clin Oncol 1998;16: Bengel FM, Ziegler SI, Avril N, et al. Whole-body positron emission tomography in clinical oncology: Comparaison between attenuation-corrected and uncorrected images. Eur J Nucl Med 1997;24: Kotzerke J, Guhlmann A, Moog F et al. Role of attenuation correction for fluorine-18-fluorodeoxyglucose positron emission tomography in primary staging of malignant lymphoma. Eur J Nucl Med 1999;26: Hustinx R, Dolin RJ, Bénard F et al. Impact of attenuation correction on the accuracy of FDG-PET in patients with abdominal tumors: A free-response ROC analysis. Eur J Nucl Med 2000;27:

Dr Sneha Shah Tata Memorial Hospital, Mumbai.

Dr Sneha Shah Tata Memorial Hospital, Mumbai. Dr Sneha Shah Tata Memorial Hospital, Mumbai. Topics covered Lymphomas including Burkitts Pediatric solid tumors (non CNS) Musculoskeletal Ewings & osteosarcoma. Neuroblastomas Nasopharyngeal carcinomas

More information

Zurich Open Repository and Archive. Non-Hodgkin lymphoma and Hodgkin disease: coregistered FDG PET and CT at staging and restaging--do we need

Zurich Open Repository and Archive. Non-Hodgkin lymphoma and Hodgkin disease: coregistered FDG PET and CT at staging and restaging--do we need University of Zurich Zurich Open Repository and Archive Winterthurerstr. 190 CH-8057 Zurich http://www.zora.uzh.ch Year: 2004 Non-Hodgkin lymphoma and Hodgkin disease: coregistered FDG PET and CT at staging

More information

Los Angeles Radiological Society 62 nd Annual Midwinter Radiology Conference January 31, 2010

Los Angeles Radiological Society 62 nd Annual Midwinter Radiology Conference January 31, 2010 Los Angeles Radiological Society 62 nd Annual Midwinter Radiology Conference January 31, 2010 Self Assessment Module on Nuclear Medicine and PET/CT Case Review FDG PET/CT IN LYMPHOMA AND MELANOMA Submitted

More information

Lugano classification: Role of PET-CT in lymphoma follow-up

Lugano classification: Role of PET-CT in lymphoma follow-up CAR Educational Exhibit: ID 084 Lugano classification: Role of PET-CT in lymphoma follow-up Charles Nhan 4 Kevin Lian MD Charlotte J. Yong-Hing MD FRCPC Pete Tonseth 3 MD FRCPC Department of Diagnostic

More information

Update in Lymphoma Imaging

Update in Lymphoma Imaging Update in Lymphoma Imaging Victorine V. Muse, MD Lymphoma Update in Lymphoma Imaging Victorine V Muse, MD Heterogeneous group of lymphoid neoplasms divided into two broad histological categories Hodgkin

More information

PET-imaging: when can it be used to direct lymphoma treatment?

PET-imaging: when can it be used to direct lymphoma treatment? PET-imaging: when can it be used to direct lymphoma treatment? Luca Ceriani Nuclear Medicine and PET-CT centre Oncology Institute of Southern Switzerland Bellinzona Disclosure slide I declare no conflict

More information

The lymphomas are a group of related diseases for which

The lymphomas are a group of related diseases for which Initial Staging of Lymphoma With Positron Emission Tomography and Computed Tomography Rodney J. Hicks, MBBS (Hons), MD, FRACP,*, Michael P. Mac Manus, MD, FRCR, and John F. Seymour, MBBS, FRACP Lymphomas

More information

Research Article Revisiting the Marrow Metabolic Changes after Chemotherapy in Lymphoma: A Step towards Personalized Care

Research Article Revisiting the Marrow Metabolic Changes after Chemotherapy in Lymphoma: A Step towards Personalized Care International Molecular Imaging Volume 2011, Article ID 942063, 6 pages doi:10.1155/2011/942063 Research Article Revisiting the Marrow Metabolic Changes after Chemotherapy in Lymphoma: A Step towards Personalized

More information

Positron Emission Tomography in the Evaluation of Lymphoma

Positron Emission Tomography in the Evaluation of Lymphoma Positron Emission Tomography in the Evaluation of Lymphoma Ora Israel, Zohar Keidar, and Rachel Bar-Shalom Positron emission tomography (PET) using 18 F-fluorodeoxyglucose (FDG) has emerged in recent years

More information

Clinical impact of whole body FDG-PET on the staging and therapeutic decision making for malignant lymphoma

Clinical impact of whole body FDG-PET on the staging and therapeutic decision making for malignant lymphoma ORIGINAL ARTICLE Annals of Nuclear Medicine Vol. 16, No. 5, 337 345, 2002 Clinical impact of whole body FDG-PET on the staging and therapeutic decision making for malignant lymphoma Masayuki SASAKI, Yasuo

More information

Testicular relapse of non-hodgkin Lymphoma noted on FDG-PET

Testicular relapse of non-hodgkin Lymphoma noted on FDG-PET Testicular relapse of non-hodgkin Lymphoma noted on FDG-PET Stephen D. Scotti 1*, Jennifer Laudadio 2 1. Department of Radiology, North Carolina Baptist Hospital, Winston-Salem, NC, USA 2. Department of

More information

ACHIEVING EXCELLENCE IN ABSTRACTING: LYMPHOMA

ACHIEVING EXCELLENCE IN ABSTRACTING: LYMPHOMA ACHIEVING EXCELLENCE IN ABSTRACTING: LYMPHOMA ACHIEVING EXCELLENCE IN ABSTRACTING LYMPHOMA Recoding Audit Performed in 2009 260 cases audited 17 data items audited per case 4420 possible discrepancies

More information

FDG-PET/CT for cancer management

FDG-PET/CT for cancer management 195 REVIEW FDG-PET/CT for cancer management Hideki Otsuka, Naomi Morita, Kyo Yamashita, and Hiromu Nishitani Department of Radiology, Institute of Health Biosciences, The University of Tokushima, Graduate

More information

/S

/S CLINICAL SCIENCE Positron emission tomography with 2-[18f]- fluoro-2-deoxy-d-glucose for initial staging of hodgkin lymphoma: a single center experience in brazil Juliano Julio Cerci, I Luís Fernando Pracchia,

More information

Lymphoma Read with the experts

Lymphoma Read with the experts Lymphoma Read with the experts Marc Seltzer, MD Associate Professor of Radiology Geisel School of Medicine at Dartmouth Director, PET-CT Course American College of Radiology Learning Objectives Recognize

More information

SWOG ONCOLOGY RESEARCH PROFESSIONAL (ORP) MANUAL RESPONSE ASSESSMENT LYMPHOMA CHAPTER 11B REVISED: SEPTEMBER 2016

SWOG ONCOLOGY RESEARCH PROFESSIONAL (ORP) MANUAL RESPONSE ASSESSMENT LYMPHOMA CHAPTER 11B REVISED: SEPTEMBER 2016 LYMPHOMA Definitions of Response According to Non Hodgkin s Lymphoma (NHL) Criteria Listed below is the new NCI Lymphoma criteria for evaluation and endpoint definitions for Non Hodgkin s Lymphoma response

More information

Sarajevo (Bosnia Hercegivina) Monday June :30-16:15. PET/CT in Lymphoma

Sarajevo (Bosnia Hercegivina) Monday June :30-16:15. PET/CT in Lymphoma Sarajevo (Bosnia Hercegivina) Monday June 16 2013 15:30-16:15 PET/CT in Lymphoma FDG-avidity Staging (nodal & extra nodal) Response evaluation Early assessment during treatment / interim (ipet) Remission

More information

1. Define the role of diagnostic PET in the staging of patients with lymphoma.

1. Define the role of diagnostic PET in the staging of patients with lymphoma. The Oncologist PET Scans in the Staging of Lymphoma: Current Status JONATHAN W. FRIEDBERG, VASEEM CHENGAZI Lymphoma Program, James P. Wilmot Cancer Center, University of Rochester, Rochester, New York,

More information

Whole-body 18 FDG positron emission tomography in the staging of non-small cell lung cancer

Whole-body 18 FDG positron emission tomography in the staging of non-small cell lung cancer Eur Respir J 1997; 10: 2529 2534 DOI: 10.1183/09031936.97.10112529 Printed in UK - all rights reserved Copyright ERS Journals Ltd 1997 European Respiratory Journal ISSN 0903-1936 Whole-body 18 FDG positron

More information

Role of PET in Lymphoma

Role of PET in Lymphoma Special Section 315 Role of PET in Lymphoma Markus Schwaiger, MD; Hinrich Wieder, MD In Hodgkin's lymphoma (HL), PET imaging should be performed in all patients, particularly in stage I or II disease where

More information

L hyperfixation dans le suivi des lymphomes représente-t-elle toujours une maladie active?

L hyperfixation dans le suivi des lymphomes représente-t-elle toujours une maladie active? L hyperfixation dans le suivi des lymphomes représente-t-elle toujours une maladie active? Thierry Vander Borght UCL Mont-Godinne, Belgique FDG-PET in Lymphoma: Mont-Godinne Experience 03/2000 10/2002:

More information

LYMPHOMA Joginder Singh, MD Medical Oncologist, Mercy Cancer Center

LYMPHOMA Joginder Singh, MD Medical Oncologist, Mercy Cancer Center LYMPHOMA Joginder Singh, MD Medical Oncologist, Mercy Cancer Center Lymphoma is cancer of the lymphatic system. The lymphatic system is made up of organs all over the body that make up and store cells

More information

Evaluation of Lung Cancer Response: Current Practice and Advances

Evaluation of Lung Cancer Response: Current Practice and Advances Evaluation of Lung Cancer Response: Current Practice and Advances Jeremy J. Erasmus I have no financial relationships, arrangements or affiliations and this presentation will not include discussion of

More information

objectives Pitfalls and Pearls in PET/CT imaging Kevin Robinson, DO Assistant Professor Department of Radiology Michigan State University

objectives Pitfalls and Pearls in PET/CT imaging Kevin Robinson, DO Assistant Professor Department of Radiology Michigan State University objectives Pitfalls and Pearls in PET/CT imaging Kevin Robinson, DO Assistant Professor Department of Radiology Michigan State University To determine the regions of physiologic activity To understand

More information

The Comparative analysis of PET/CT and Contrast CT in the Evaluation of Patients with Lymphoma

The Comparative analysis of PET/CT and Contrast CT in the Evaluation of Patients with Lymphoma ONCOLOGY, ORIGINAL ARTICLE Egyptian J. Nucl. Med., Vol. 2, No. 1, Dec. 2010 8 The Comparative analysis of PET/CT and Contrast CT in the Evaluation of Patients with Lymphoma Khalifa, N. * and Fawzy, A.

More information

Diagnostic value of MR-DWI technique in the diagnosis and staging of Hodgkin and non-hodgkin lymphoma: comparison with PET-CT methods

Diagnostic value of MR-DWI technique in the diagnosis and staging of Hodgkin and non-hodgkin lymphoma: comparison with PET-CT methods Diagnostic value of MR-DWI technique in the diagnosis and staging of Hodgkin and non-hodgkin lymphoma: comparison with PET-CT methods Poster No.: C-2106 Congress: ECR 2015 Type: Scientific Exhibit Authors:

More information

PET CT for Staging Lung Cancer

PET CT for Staging Lung Cancer PET CT for Staging Lung Cancer Rohit Kochhar Consultant Radiologist Disclosures Neither I nor my immediate family members have financial relationships with commercial organizations that may have a direct

More information

Positron emission tomography (PET) in residual post-treatment Hodgkin s disease masses

Positron emission tomography (PET) in residual post-treatment Hodgkin s disease masses J. Appl. Biomed. 3: 147 153, 2005 ISSN 1214-0287 BRIEF COMMUNICATION Positron emission tomography (PET) in residual post-treatment Hodgkin s disease masses Gustavo H. Marin, Jorge Dellagiovanna, Pablo

More information

Ryan Niederkohr, M.D. Slides are not to be reproduced without permission of author

Ryan Niederkohr, M.D. Slides are not to be reproduced without permission of author Ryan Niederkohr, M.D. CMS: PET/CT CPT CODES 78814 Limited Area (e.g., head/neck only; chest only) 78815 78816 Regional (skull base to mid-thighs) True Whole Body (skull vertex to feet) SELECTING FIELD

More information

Society of Nuclear Medicine Procedure Guideline for Tumor Imaging Using F-18 FDG

Society of Nuclear Medicine Procedure Guideline for Tumor Imaging Using F-18 FDG Society of Nuclear Medicine Procedure Guideline for Tumor Imaging Using F-18 FDG version 2.0, approved February 7, 1999 Authors: Heinrich R. Schelbert, MD, PhD (UCLA School of Medicine, Los Angeles, CA);

More information

PET/CT Frequently Asked Questions

PET/CT Frequently Asked Questions PET/CT Frequently Asked Questions General Q: Is FDG PET specific for cancer? A: No, it is a marker of metabolism. In general, any disease that causes increased metabolism can result in increased FDG uptake

More information

NON HODGKINS LYMPHOMA: INDOLENT Updated June 2015 by Dr. Manna (PGY-5 Medical Oncology Resident, University of Calgary)

NON HODGKINS LYMPHOMA: INDOLENT Updated June 2015 by Dr. Manna (PGY-5 Medical Oncology Resident, University of Calgary) NON HODGKINS LYMPHOMA: INDOLENT Updated June 2015 by Dr. Manna (PGY-5 Medical Oncology Resident, University of Calgary) Reviewed by Dr. Michelle Geddes (Staff Hematologist, University of Calgary) and Dr.

More information

PET with the glucose analog, 18 F-FDG PET, is increasingly

PET with the glucose analog, 18 F-FDG PET, is increasingly 18 F-FDG PET/CT in Evaluating Non-CNS Pediatric Malignancies Mitsuaki Tatsumi 1, John H. Miller 2, and Richard L. Wahl 1 1 Division of Nuclear Medicine, Department of Radiology, The Johns Hopkins Medical

More information

During past decades, because of the lack of knowledge

During past decades, because of the lack of knowledge Staging and Classification of Lymphoma Ping Lu, MD In 2004, new cases of non-hodgkin s in the United States were estimated at 54,370, representing 4% of all cancers and resulting 4% of all cancer deaths,

More information

Th. Bury*, P. Paulus**, A. Dowlati*, J.L. Corhay*, T. Weber*, B. Ghaye +, J. Schoffers +#, R. Limet ++, A. Albert, P. Rigo**, M.

Th. Bury*, P. Paulus**, A. Dowlati*, J.L. Corhay*, T. Weber*, B. Ghaye +, J. Schoffers +#, R. Limet ++, A. Albert, P. Rigo**, M. Eur Respir J, 1996, 9, 2560 2564 DOI: 10.1183/09031936.96.09122560 Printed in UK - all rights reserved Copyright ERS Journals Ltd 1996 European Respiratory Journal ISSN 0903-1936 Staging of the mediastinum:

More information

PET/CT F-18 FDG. Objectives. Basics of PET/CT Imaging. Objectives. Basic PET imaging

PET/CT F-18 FDG. Objectives. Basics of PET/CT Imaging. Objectives. Basic PET imaging Basics of PET/CT Imaging Kevin Robinson, DO Department of Radiology Michigan State University Objectives Basic PET imaging Evaluating the therapeutic response Evaluating the big 5 Lymphoma Breast Lung

More information

Lung hilar Ga-67 uptake in patients with lymphoma following chemotherapy

Lung hilar Ga-67 uptake in patients with lymphoma following chemotherapy ORIGINAL ARTICLE Annals of Nuclear Medicine Vol. 18, No. 5, 391 397, 2004 Lung hilar Ga-67 uptake in patients with lymphoma following chemotherapy Emel Ceylan GUNAY,* Bilge Volkan SALANCI,* Ibrahim BARISTA**

More information

The Use of PET Scanning in Urologic Oncology

The Use of PET Scanning in Urologic Oncology The Use of PET Scanning in Urologic Oncology Dr Nicholas C. Buchan Uro-oncology Fellow 1 2 Aims To understand the basic concepts underlying PET scanning. Understand the emerging role of PET Scanning for

More information

Yiyan Liu. 1. Introduction

Yiyan Liu. 1. Introduction AIDS Research and Treatment Volume 2012, Article ID 764291, 6 pages doi:10.1155/2012/764291 Clinical Study Concurrent FDG Avid Nasopharyngeal Lesion and Generalized Lymphadenopathy on PET-CT Imaging Is

More information

Prof. Dr. NAGUI M. ABDELWAHAB,M.D.; MARYSE Y. AWADALLAH, M.D. AYA M. BASSAM, Ms.C.

Prof. Dr. NAGUI M. ABDELWAHAB,M.D.; MARYSE Y. AWADALLAH, M.D. AYA M. BASSAM, Ms.C. Role of Whole-body Diffusion MR in Detection of Metastatic lesions Prof. Dr. NAGUI M. ABDELWAHAB,M.D.; MARYSE Y. AWADALLAH, M.D. AYA M. BASSAM, Ms.C. Cancer is a potentially life-threatening disease,

More information

New Visions in PET: Surgical Decision Making and PET/CT

New Visions in PET: Surgical Decision Making and PET/CT New Visions in PET: Surgical Decision Making and PET/CT Stanley J. Goldsmith, MD Director, Nuclear Medicine Professor, Radiology & Medicine New York Presbyterian Hospital- Weill Cornell Medical Center

More information

Clinical summary. Male 30 year-old with past history of non-seminomous germ cell tumour. Presents with retroperitoneal lymphadenopathy on CT.

Clinical summary. Male 30 year-old with past history of non-seminomous germ cell tumour. Presents with retroperitoneal lymphadenopathy on CT. Clinical summary Male 30 year-old with past history of non-seminomous germ cell tumour. Presents with retroperitoneal lymphadenopathy on CT. For restaging PET/CT. PET/CT findings No significant FDG uptake

More information

PET imaging of cancer metabolism is commonly performed with F18

PET imaging of cancer metabolism is commonly performed with F18 PCRI Insights, August 2012, Vol. 15: No. 3 Carbon-11-Acetate PET/CT Imaging in Prostate Cancer Fabio Almeida, M.D. Medical Director, Arizona Molecular Imaging Center - Phoenix PET imaging of cancer metabolism

More information

Contribution of PET imaging to the initial staging and prognosis of patients with Hodgkin s disease

Contribution of PET imaging to the initial staging and prognosis of patients with Hodgkin s disease Original article Annals of Oncology 15: 1699 1704, 2004 doi:10.1093/annonc/mdh426 Contribution of PET imaging to the initial staging and prognosis of patients with Hodgkin s disease R. Munker 1 *, J. Glass

More information

Understanding the Diagnostic and Prognostic Role of Imaging in the Evaluation of an Anterior Mediastinal Mass

Understanding the Diagnostic and Prognostic Role of Imaging in the Evaluation of an Anterior Mediastinal Mass Understanding the Diagnostic and Prognostic Role of Imaging in the Evaluation of an Anterior Mediastinal Mass Daniel W. Kim, Harvard Medical School Year III Agenda Mediastinum Menu of tests Anatomy Normal

More information

Imaging Features of Sarcoidosis on MDCT, FDG PET, and PET/CT

Imaging Features of Sarcoidosis on MDCT, FDG PET, and PET/CT AJR Integrative Imaging LIFELONG LEARNING FOR RADIOLOGY Imaging Features of Sarcoidosis on MDCT, FDG PET, and PET/CT Hima B. Prabhakar 1, Chad B. Rabinowitz 1, Fiona K. Gibbons 2, Walter J. O Donnell 2,

More information

Molecular Imaging and Cancer

Molecular Imaging and Cancer Molecular Imaging and Cancer Cancer causes one in every four deaths in the United States, second only to heart disease. According to the U.S. Department of Health and Human Services, more than 512,000

More information

Principles of nuclear metabolic imaging. Prof. Dr. Alex Maes AZ Groeninge Kortrijk and KULeuven Belgium

Principles of nuclear metabolic imaging. Prof. Dr. Alex Maes AZ Groeninge Kortrijk and KULeuven Belgium Principles of nuclear metabolic imaging Prof. Dr. Alex Maes AZ Groeninge Kortrijk and KULeuven Belgium I. Molecular imaging probes A. Introduction - Chemical disturbances will precede anatomical abnormalities

More information

Staging: Recommendations for bone marrow investigations

Staging: Recommendations for bone marrow investigations International Workshop for PET in Lymphoma Staging and Restaging Thursday October 4th, Menton. Staging: Recommendations for bone marrow investigations Martin Hutchings Department of Haematology Rigshospitalet,

More information

Staging recurrent ovarian cancer with 18 FDG PET/CT

Staging recurrent ovarian cancer with 18 FDG PET/CT ONCOLOGY LETTERS 5: 593-597, 2013 Staging recurrent ovarian cancer with FDG PET/CT SANJA DRAGOSAVAC 1, SOPHIE DERCHAIN 2, NELSON M.G. CASERTA 3 and GUSTAVO DE SOUZA 2 1 DIMEN Medicina Nuclear and PET/CT

More information

Lancashire and South Cumbria Haematology NSSG Guidelines for Follicular Lymphoma:

Lancashire and South Cumbria Haematology NSSG Guidelines for Follicular Lymphoma: 1 Lancashire and South Cumbria Haematology NSSG Guidelines for Follicular Lymphoma: 2018-19 1.1 Pretreatment evaluation The following tests should be performed: FBC, U&Es, creat, LFTs, calcium, LDH, Igs/serum

More information

Sally Barrington Martin Hutchings

Sally Barrington Martin Hutchings Sally Barrington Martin Hutchings Therapeutic implications of BMI Bone marrow involvement means extranodal disease and by definition stage IV BMI detected by BMB is a poor prognostic feature in most lymphomas

More information

Diagnostic Value of EBUS-TBNA in Various Lung Diseases (Lymphoma, Tuberculosis, Sarcoidosis)

Diagnostic Value of EBUS-TBNA in Various Lung Diseases (Lymphoma, Tuberculosis, Sarcoidosis) Diagnostic Value of EBUS-TBNA in Various Lung Diseases (Lymphoma, Tuberculosis, Sarcoidosis) Sevda Sener Cömert, MD, FCCP. SBU, Kartal Dr.Lütfi Kırdar Training and Research Hospital Department of Pulmonary

More information

Radiation and Hodgkin s Disease: A Changing Field. Sravana Chennupati Radiation Oncology PGY-2

Radiation and Hodgkin s Disease: A Changing Field. Sravana Chennupati Radiation Oncology PGY-2 Radiation and Hodgkin s Disease: A Changing Field Sravana Chennupati Radiation Oncology PGY-2 History of Present Illness 19 yo previously healthy male college student began having pain in his R shoulder

More information

VIII. 9. FDG-PET for Diagnosis of an Advanced Jejunal Adenocarcinoma with Distant Metastases, Compared with Gallium Scintigraphy

VIII. 9. FDG-PET for Diagnosis of an Advanced Jejunal Adenocarcinoma with Distant Metastases, Compared with Gallium Scintigraphy CYRIC Annual Report 2003 VIII. 9. FDG-PET for Diagnosis of an Advanced Jejunal Adenocarcinoma with Distant Metastases, Compared with Gallium Scintigraphy Yamaura G., Yoshioka T., Yamaguchi K. *, Fukuda

More information

Imaging of Pulmonary Tuberculosis with 18 F-Fluoro-Deoxy-Glucose and

Imaging of Pulmonary Tuberculosis with 18 F-Fluoro-Deoxy-Glucose and Send Orders for Reprints to reprints@benthamscience.net The Open Nuclear Medicine Journal, 2014, 6, 17-21 17 Open Access Imaging of Pulmonary Tuberculosis with 18 F-Fluoro-Deoxy-Glucose and 18 F-Ethylcholine

More information

Utility of ADC Measurements in the Discrimination between Benign and Lymphomatous Abdomino-Pelvic Lymph Nodes

Utility of ADC Measurements in the Discrimination between Benign and Lymphomatous Abdomino-Pelvic Lymph Nodes Med. J. Cairo Univ., Vol. 84, No. 2, September: 1-7, 2016 www.medicaljournalofcairouniversity.net Utility of ADC Measurements in the Discrimination between Benign and Lymphomatous Abdomino-Pelvic Lymph

More information

Lymphoma. Hodgkin s Disease. Christopher J. Palestro, Josephine N. Rini, and Maria B. Tomas

Lymphoma. Hodgkin s Disease. Christopher J. Palestro, Josephine N. Rini, and Maria B. Tomas 12 Lymphoma Christopher J. Palestro, Josephine N. Rini, and Maria B. Tomas In patients with lymphoma, prognosis and treatment are related to the stage of disease at diagnosis, and accurate staging, therefore,

More information

Lymphoma/CLL 101: Know your Subtype. Dr. David Macdonald Hematologist, The Ottawa Hospital

Lymphoma/CLL 101: Know your Subtype. Dr. David Macdonald Hematologist, The Ottawa Hospital Lymphoma/CLL 101: Know your Subtype Dr. David Macdonald Hematologist, The Ottawa Hospital Function of the Lymph System Lymph Node Lymphocytes B-cells develop in the bone marrow and influence the immune

More information

PET/CT for Therapy Assessment in Oncology

PET/CT for Therapy Assessment in Oncology PET/CT for Therapy Assessment in Oncology Rodolfo Núñez Miller, M.D. Nuclear Medicine Section Division of Human Health International Atomic Energy Agency Vienna, Austria Clinical Applications of PET/CT

More information

PET in Rectal Carcinoma

PET in Rectal Carcinoma Case Report PET in Rectal Carcinoma Josefina Jofré M 1, Paulina Sierralta C 1, José Canessa G 1,2, Pamela Humeres A 3, Gabriel Castro M 4, Teresa Massardo V 1,4 1 Centro PET de Imágenes Moleculares, Hospital

More information

Overview of Cutaneous Lymphomas: Diagnosis and Staging. Lauren C. Pinter-Brown MD, FACP Health Sciences Professor of Medicine and Dermatology

Overview of Cutaneous Lymphomas: Diagnosis and Staging. Lauren C. Pinter-Brown MD, FACP Health Sciences Professor of Medicine and Dermatology Overview of Cutaneous Lymphomas: Diagnosis and Staging Lauren C. Pinter-Brown MD, FACP Health Sciences Professor of Medicine and Dermatology Definition of Lymphoma A cancer or malignancy that comes from

More information

1 Introduction. 2 Materials and methods. LI Na 1 LI Yaming 1,* YANG Chunming 2 LI Xuena 1 YIN Yafu 1 ZHOU Jiumao 1

1 Introduction. 2 Materials and methods. LI Na 1 LI Yaming 1,* YANG Chunming 2 LI Xuena 1 YIN Yafu 1 ZHOU Jiumao 1 Nuclear Science and Techniques 20 (2009) 354 358 18 F-FDG PET/CT in diagnosis of skeletal metastases LI Na 1 LI Yaming 1,* YANG Chunming 2 LI Xuena 1 YIN Yafu 1 ZHOU Jiumao 1 1 Department of Nuclear Medicine,

More information

Positron emission tomography using F-18 fluorodeoxyglucose pre- and post-autologous stem cell transplant in non-hodgkin s lymphoma

Positron emission tomography using F-18 fluorodeoxyglucose pre- and post-autologous stem cell transplant in non-hodgkin s lymphoma (2008) 41, 919 925 & 2008 Nature Publishing Group All rights reserved 0268-3369/08 $30.00 www.nature.com/bmt REVIEW Positron emission tomography using F-18 fluorodeoxyglucose pre- and post-autologous stem

More information

The Diagnostic Value of PET/CT in Breast Cancer Recurrence and Metastases

The Diagnostic Value of PET/CT in Breast Cancer Recurrence and Metastases Original Paper, Oncology. The Diagnostic Value of PET/CT in Breast Cancer Recurrence and Metastases Taalab, Kh. 1 ; Abutaleb, AS 1 ; Moftah, SG 2 ; Abdel-Mutaleb, MG 2 and Abdl-Mawla, YA 2. 1 Military

More information

Short summary of published results of PET with fluoromethylcholine (18F) in prostate cancer

Short summary of published results of PET with fluoromethylcholine (18F) in prostate cancer Short summary of published results of PET with fluoromethylcholine (18F) in prostate cancer JN TALBOT and all the team of Service de Médecine Nucléaire Hôpital Tenon et Université Pierre et Marie Curie,

More information

FDG-PET/CT in Gynaecologic Cancers

FDG-PET/CT in Gynaecologic Cancers Friday, August 31, 2012 Session 6, 9:00-9:30 FDG-PET/CT in Gynaecologic Cancers (Uterine) cervical cancer Endometrial cancer & Uterine sarcomas Ovarian cancer Little mermaid (Edvard Eriksen 1913) honoring

More information

MRI in lymphoma: where are we in 2016

MRI in lymphoma: where are we in 2016 MRI in lymphoma: where are we in 2016 Alain Rahmouni Henri Mondor Academic Hospital Paris Est Créteil University, France Plan Requirements DWI signal in lymphoma ADC measurement SNR: Surface coils 1.5

More information

The role of positron emission tomography in T-cell lymphoma and T-cell specific response criteria

The role of positron emission tomography in T-cell lymphoma and T-cell specific response criteria Hematology Meeting Reports 2009;3(1):20 27 SESSION I B.D. Cheson Head of Hematology, Georgetown University, Hospital Lombardi, Comprehensive Cancer Center, Washington D.C., USA The role of positron emission

More information

Tumor Board Discussions: Case 1

Tumor Board Discussions: Case 1 Tumor Board Discussions: Case 1 David S. Ettinger, MD The Alex Grass Professor of Oncology Johns Hopkins University School of Medicine Baltimore, Maryland Case #1 50-year-old Asian female, never smoker

More information

FDG-PET value in deep endometriosis

FDG-PET value in deep endometriosis Gynecol Surg (2011) 8:305 309 DOI 10.1007/s10397-010-0652-6 ORIGINAL ARTICLE FDG-PET value in deep endometriosis A. Setubal & S. Maia & C. Lowenthal & Z. Sidiropoulou Received: 3 December 2010 / Accepted:

More information

Involvement of Abdominal and Pelvic Lymph Nodes in Non--Hodgkin Lymphoma: the Nodal Distribution in Chinese Patients

Involvement of Abdominal and Pelvic Lymph Nodes in Non--Hodgkin Lymphoma: the Nodal Distribution in Chinese Patients 2?8 Involvement of Abdominal and Pelvic Lymph Nodes in Non--Hodgkin Lymphoma: the Nodal Distribution in Chinese Patients Ning Wu Ying Uu Dongmei Un Yu Chen Mulan Shi Department of Diagnostic Radiology,

More information

POSITRON EMISSION TOMOGRAPHY (PET)

POSITRON EMISSION TOMOGRAPHY (PET) Status Active Medical and Behavioral Health Policy Section: Radiology Policy Number: V-27 Effective Date: 08/27/2014 Blue Cross and Blue Shield of Minnesota medical policies do not imply that members should

More information

FDG-PET/CT in the management of lymphomas

FDG-PET/CT in the management of lymphomas FDG-PET/CT in the management of lymphomas Olivier Gheysens, MD, PhD Dept. of Nuclear Medicine, UZ Leuven BHS, Feb 4th 2017 Brussels Dept. of Nuclear Overview Introduction on FDG-PET/CT Staging Response

More information

Recommendations for cross-sectional imaging in cancer management, Second edition

Recommendations for cross-sectional imaging in cancer management, Second edition www.rcr.ac.uk Recommendations for cross-sectional imaging in cancer management, Second edition Carcinoma of unknown primary origin (CUP) Faculty of Clinical Radiology www.rcr.ac.uk Contents Carcinoma of

More information

Martin Charron, MD, FRCP(C) Toronto, Canada

Martin Charron, MD, FRCP(C) Toronto, Canada Preface Positron emission tomography (PET), a powerful research tool 20 years ago, has recently gained widespread application in oncology and is now a procedure clinically available on each continent.

More information

High incidence of false-positive PET scans in patients with aggressive non-hodgkin s lymphoma treated with rituximab-containing regimens

High incidence of false-positive PET scans in patients with aggressive non-hodgkin s lymphoma treated with rituximab-containing regimens original article 20: 309 318, 2009 doi:10.1093/annonc/mdn629 Published online 7 October 2008 High incidence of false-positive PET scans in patients with aggressive non-hodgkin s lymphoma treated with rituximab-containing

More information

Reproducibility of Uptake Estimates in FDG PET: a Monte Carlo study

Reproducibility of Uptake Estimates in FDG PET: a Monte Carlo study Reproducibility of Uptake Estimates in FDG PET: a Monte Carlo study Juliette Feuardent, Marine Soret, Irène Buvat 1 Abstract Tumor glucose metabolism measurements from Fluoro-deoxyglucose (FDG) Positron

More information

PET/CT in Gynaecological Cancers. Stroobants Sigrid, MD, PhD Departement of Nuclear Medicine University Hospital,Antwerp

PET/CT in Gynaecological Cancers. Stroobants Sigrid, MD, PhD Departement of Nuclear Medicine University Hospital,Antwerp PET/CT in Gynaecological Cancers Stroobants Sigrid, MD, PhD Departement of Nuclear Medicine University Hospital,Antwerp Cervix cancer Outline of this talk Initial staging Treatment monitoring/guidance

More information

FDG PET/CT STAGING OF LUNG CANCER. Dr Shakher Ramdave

FDG PET/CT STAGING OF LUNG CANCER. Dr Shakher Ramdave FDG PET/CT STAGING OF LUNG CANCER Dr Shakher Ramdave FDG PET/CT STAGING OF LUNG CANCER FDG PET/CT is used in all patients with lung cancer who are considered for curative treatment to exclude occult disease.

More information

MINI SYMPOSIUM: PET THE PRESENT. Tuesday 17 October 2006, 09:00 12:00. PET in lymphoma. Conor D Collins

MINI SYMPOSIUM: PET THE PRESENT. Tuesday 17 October 2006, 09:00 12:00. PET in lymphoma. Conor D Collins Cancer Imaging (2006) 6, S63 S70 DOI: 10.1102/1470-7330.2006.9013 CI MINI SYMPOSIUM: PET THE PRESENT Tuesday 17 October 2006, 09:00 12:00 PET in lymphoma Conor D Collins St Vincent s University Hospital,

More information

Executive Summary. Positron emission tomography (PET and PET/CT) in malignant lymphoma 1. IQWiG Reports Commission No. D06-01A

Executive Summary. Positron emission tomography (PET and PET/CT) in malignant lymphoma 1. IQWiG Reports Commission No. D06-01A IQWiG Reports Commission No. D06-01A Positron emission tomography (PET and PET/CT) in malignant lymphoma 1 Executive Summary 1 Translation of the executive summary of the final report Positronenemissionstomographie

More information

Positron Emission Tomography in Lung Cancer

Positron Emission Tomography in Lung Cancer May 19, 2003 Positron Emission Tomography in Lung Cancer Andrew Wang, HMS III Patient DD 53 y/o gentleman presented with worsening dyspnea on exertion for the past two months 30 pack-year smoking Hx and

More information

Index. Surg Oncol Clin N Am 16 (2007) Note: Page numbers of article titles are in boldface type.

Index. Surg Oncol Clin N Am 16 (2007) Note: Page numbers of article titles are in boldface type. Surg Oncol Clin N Am 16 (2007) 465 469 Index Note: Page numbers of article titles are in boldface type. A Adjuvant therapy, preoperative for gastric cancer, staging and, 339 B Breast cancer, metabolic

More information

Assessment of renal cell carcinoma by two PET tracer : dual-time-point C-11 methionine and F-18 fluorodeoxyglucose

Assessment of renal cell carcinoma by two PET tracer : dual-time-point C-11 methionine and F-18 fluorodeoxyglucose Assessment of renal cell carcinoma by two PET tracer : dual-time-point C-11 methionine and F-18 fluorodeoxyglucose Poster No.: C-0805 Congress: ECR 2015 Type: Scientific Exhibit Authors: S. Ito, K. Kato,

More information

Using PET/CT in Prostate Cancer

Using PET/CT in Prostate Cancer Using PET/CT in Prostate Cancer Legal Disclaimer These materials were prepared in good faith by MITA as a service to the profession and are believed to be reliable based on current scientific literature.

More information

Diagnostic value of fluorine-18 fluorodeoxyglucose positron emission tomography / computed tomography in fever of unknown origin

Diagnostic value of fluorine-18 fluorodeoxyglucose positron emission tomography / computed tomography in fever of unknown origin 175 18 F-FDG PET /CT 1* 2* 1 1 1 1 1 1 1. 100034 2. 100850 18 F-FDG PET /CT fever of unknown origin FUO 2010 8 2013 4 51 FUO FDG PET /CT 3 FDG PET /CT t 51 FUO 32 9 7 3 FDG PET FUO 27 52. 9% 14 27. 5%

More information

Bone and CT Scans Are Complementary for Diagnoses of Bone Metastases in Breast Cancer When PET Scans Findings Are Equivocal: A Case Report

Bone and CT Scans Are Complementary for Diagnoses of Bone Metastases in Breast Cancer When PET Scans Findings Are Equivocal: A Case Report Bone and CT Scans Are Complementary for Diagnoses of Bone Metastases in Breast Cancer When Scans Findings Are Equivocal: A Case Report Yuk-Wah Tsang 1, Jyh-Gang Leu 2, Yen-Kung Chen 3, Kwan-Hwa Chi 1,4

More information

An Introduction to PET Imaging in Oncology

An Introduction to PET Imaging in Oncology January 2002 An Introduction to PET Imaging in Oncology Janet McLaren, Harvard Medical School Year III Basics of PET Principle of Physiologic Imaging: Allows in vivo visualization of structures by their

More information

Imaging for Oncologic Response Assessment in Lymphoma

Imaging for Oncologic Response Assessment in Lymphoma Special Articles Review Kulkarni et al. Use of CT and PET for Response Assessment in Lymphoid Malignancies Special Articles Review Naveen M. Kulkarni 1 Daniella F. Pinho 2 Srikala Narayanan 3 Avinash R.

More information

Hodgkin s disease (HD) and non-hodgkin s lymphoma

Hodgkin s disease (HD) and non-hodgkin s lymphoma PET/CT in Lymphoma: Prospective Study of Enhanced Full-Dose PET/CT Versus Unenhanced Low-Dose PET/CT Beatriz Rodríguez-Vigil 1, Nieves Gómez-León 1, Inmaculada Pinilla 1, Dolores Hernández-Maraver 2, Juan

More information

Low-grade non-hodgkin s lymphomas (NHLs) often

Low-grade non-hodgkin s lymphomas (NHLs) often Somatostatin Receptor Scintigraphy in the Initial Staging of Low-Grade Non-Hodgkin s Lymphomas Pieternella J. Lugtenburg, Bob Löwenberg, Roelf Valkema, Hong-Yoe Oei, Steven W. Lamberts, Marinus J. Eijkemans,

More information

PET IMAGING (POSITRON EMISSION TOMOGRAPY) FACT SHEET

PET IMAGING (POSITRON EMISSION TOMOGRAPY) FACT SHEET Positron Emission Tomography (PET) When calling Anthem (1-800-533-1120) or using the Point of Care authorization system for a Health Service Review, the following clinical information may be needed to

More information

The Proper Use of PET/CT in Tumoring Imaging

The Proper Use of PET/CT in Tumoring Imaging The Proper Use of PET/CT in Tumoring Imaging Mijin Yun, M.D. Jong Doo Lee, M.D. Department of Radiology / Division of Nuclear Medicine Yonsei University College of Medicine, Severance Hospital E mail :

More information

Optimized PET/CT protocols: how much CT is needed? Increasing use of PET-CT. Imaging in Lymphoma

Optimized PET/CT protocols: how much CT is needed? Increasing use of PET-CT. Imaging in Lymphoma BVS/ABR Workshop 2011 on dose related to multimodality imaging Optimized PET/CT protocols: how much CT is needed? 2008 Mean medical radiation exposure/head Belgium= 2.42 msv The Netherlands= 0.8 msv Belgium

More information

Page: 1 of 29. For this policy, PET scanning is discussed for the following 4 applications in oncology:

Page: 1 of 29. For this policy, PET scanning is discussed for the following 4 applications in oncology: Emission Tomography Scanning Page: 1 of 29 Last Review Status/Date: June 2015 Description Positron emission tomography (PET) scans are based on the use of positron-emitting radionuclide tracers coupled

More information

PET/CT in breast cancer staging

PET/CT in breast cancer staging PET/CT in breast cancer staging Anni Morsing Consultant, PhD, DMSc Rigshospitalet 1 18F- FDG PET/CT for breastcancer staging Where is the clinical impact? To which women should 18F- FDG PET/CT be offered?

More information

Digital Washington University School of Medicine. Russell Schilder Fox Chase Comprehensive Cancer Center. Arturo Molina Biogen Idec

Digital Washington University School of Medicine. Russell Schilder Fox Chase Comprehensive Cancer Center. Arturo Molina Biogen Idec Washington University School of Medicine Digital Commons@Becker Open Access Publications 2004 Follow-up results of a phase II study of ibritumomab tiuetan radioimmunotherapy in patients with relapsed or

More information

The Importance of PET/CT in Human Health. Homer A. Macapinlac, M.D.

The Importance of PET/CT in Human Health. Homer A. Macapinlac, M.D. The Importance of PET/CT in Human Health Homer A. Macapinlac, M.D. Learning objectives Provide an overview of the impact of PET/CT imaging on the management of patients and its impact on health care expenditures.

More information