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KMID : 0338420210360000245
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The Korean Journal of Internal Medicine
2021 Volume.36 No. 0 p.245 ~ p.252
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Different roles of surveillance positron emission tomography according to the histologic subtype of non-Hodgkin’s lymphoma
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Kim Yu-Ri
Kim Soo-Jeong
Cheong June-Won
Kim Yun-Deok
Jang Ji-Eun
Cho Hyun-Soo
Chung Hae-Rim
Min Yoo-Hong
Yang Woo-Ick
Cho Arthur
Kim Jin-Seok
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Abstract
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Background/Aims: Although the use of surveillance 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) is discouraged in patients with diffuse large B-cell lymphoma, its usefulness in different subtypes has not been thoroughly investigated.
Methods: We retrospectively evaluated 157 patients who showed positive results on surveillance FDG-PET/CT every 6 months following complete response for up to 5 years. All of the patients also underwent biopsies.
Results: Seventy-eight (49.6%) of 157 patients had true positive results; the remaining 79 (50.3%), including eight (5.1%) with secondary malignancies, were confirmed to yield false positive results. Among the 78 patients with true positive results, the disease in seven (8.9%) had transformed to a different subtype. The positive predictive value (PPV) of FDG-PET/CT for aggressive B-cell non-Hodgkin’s lymphoma (NHL) was lower than that for indolent B-cell or aggressive T-cell NHL (p = 0.003 and p = 0.018, respectively), especially in patients with a low/low-intermediate international prognostic index (IPI) upon a positive PET/CT finding. On the other hand, indolent B-cell and aggressive T-cell NHL patients showed PPVs of > 60%, including those with low/low-intermediate secondary IPIs.
Conclusions: The role of FDG-PET/CT surveillance is limited, and differs according to the lymphoma subtype. FDG-PET/CT may be useful in detecting early relapse in patients with aggressive T-cell NHL, including those with low/low-intermediate risk secondary IPI; as already known, FDG-PET/CT has no role in aggressive B-cell NHL. Repeat biopsy should be performed to discriminate relapse or transformation from false positive findings in patients with positive surveillance FDG-PET/CT results.
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KEYWORD
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Positron emission tomography computed tomography, Sensitivity and specificity
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