Conventional imaging and 2-deoxy-2-[18]fluoro-D-glucose positron emission tomography for predicting the clinical outcome of previously treated Non-Hodgkin's Lymphoma patients

Jean Emmanuel Filmont, Duska Vranjesevic, Andrew Quon, Daniel J.A. Margolis, Fred Ko, Arash Safaei, Christos Emmanouilides, Daniel H.S. Silverman, Jyotsna Rao, Peter E. Valk, Michael E. Phelps, Johannes Czernin

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12 Scopus citations

Abstract

Purpose: The aim of this study was to determine the impact of positron emission tomography (PET) with 2-deoxy-2-[18F]fluoro-D-glucose (FDG) and combined conventional imaging on clinical stage and their ability to predict the clinical outcome of previously treated lymphoma patients. Procedures: Seventy-eight patients with Non-Hodgkin's Lymphoma (NHL) were studied with PET within a median interval of 5.3 months after treatment. Conventional imaging performed after treatment and within three months before PET included 3.3±1.3 imaging tests/patient. To determine the independent ability of PET for predicting clinical outcome, PET images were re-read in a blinded fashion. Study endpoints were disease-free survival, or clinical evidence of disease or death. Results: PET downstaged 18 patients, upstaged nine and revealed the same stage as conventional imaging in 51 patients. Using the clinical outcome as gold standard, the positive and negative predictive values of PET were 95% and 83% versus 72% and 67% for conventional imaging (P<0.05). The prognostic accuracy of PET was superior to that of conventional imaging (90 vs. 71%; P<0.05). Kaplan-Meier analysis for disease-free survival showed a significant difference between PET negative and PET positive results (P<0.0001). Conclusion: Whole-body FDG-PET imaging modified the clinical stage in 35% of lymphoma patients who were reevaluated after treatment. Moreover, FDG-PET predicted patient outcome with a higher predictive accuracy than conventional imaging. This superior prognostic accuracy was achieved with a single FDG-PET study versus multiple conventional imaging procedures/patient.

Original languageEnglish
Pages (from-to)232-239
Number of pages8
JournalMolecular Imaging and Biology
Volume5
Issue number4
DOIs
StatePublished - Jul 2003
Externally publishedYes

Keywords

  • Metabolic imaging
  • Non-Hodgkin's Lymphoma
  • Positron emission tomography
  • Prognostic value

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