Utility of 18F-FDG-PET-CT in the diagnosis of different types of lymphomas.

This poster is published under an open license. Please read the disclaimer for further details.

Congress:

ECR 2015

Poster Number:

C-0154

Type:

Educational Exhibit

Keywords:

Diagnostic procedure, Nuclear medicine conventional, PET-CT, PET, Lymph nodes, Neoplasia

Authors:

I. López-Vidaur¹, A. Santiago Chinchilla², N. Testar Dardel³, F. Cordido³, L. I. Armendariz Blanco³, I. Rozas Gómez³, T. M. Garcia³, E. agrela³; ¹Madrid/ES, ²Granada/ES, ³Alcorcón/ES

DOI:

10.1594/ecr2015/C-0154

DOI-Link:

https://dx.doi.org/10.1594/ecr2015/C-0154

Fig. 1: Low-grade follicular lymphoma with affinity for 18F-FDG. Staging: IIIE

Fig. 2: Nodular Sclerosis Hodgkin lymphoma. Initial staging: IIA

Fig. 3: Lymphoblastic non-Hodgkin lymphoma of high grade. Initial staging: IIIA + S

Fig. 4: B lymphoma of intermediate-high grade. Staging: IIIE

Learning objectives

To know the utility of 18F-FDG-PET and 18F-FDG-PET-CT in the different types of lymphomas, in order to perform this test in those histological types of lymphoma in which the test has higher performance.

Background

18F-FDG-PET is approved by MEDICARE since July 2001 for the diagnosis, staging and restaging of lymphoma, and now these same applications are approved for hybrid PET-CT equipments. We know there is a direct correlation between the degree of 18F-FDG and the histological grade of lymphomas. This is because when the histological grade of tumor is higher, this will behave more aggressively and will extend faster, needing a major energy substrate, which would explain the high affinity of these tumors by the 18F -FDG.

Findings and procedure details

The non-Hodgkin lymphomas (NHL) are divided into 3 groups according to the histological grade of malignancy: LOW GRADE (40-45%): small cell follicular lymphoma, lymphoplasmacytic lymphoma, MALT lymphoma, lymphocytic small cells lymphoma. INTERMEDIATE LEVEL (40-45%) follicular large cell lymphoma, diffuse lymphoma. HIGH GRADE (5-10%): immunoblastic lymphoma, lymphoblastic lymphoma, Burkitt's lymphoma. Hodgkin's disease is considered a high histological grade lymphoma. Thus, the 18F-FDG-PET has demonstrated a high sensitivity in Hodgkin lymphomas, non-Hodgkin lymphoma, in high grade non-Hodgkin lymphomas and in those which are low-grade that becomes high...

Conclusion

It is important to know the histological type of lymphoma before indicating the realization of a 18F-FDG-PET and 18F-FDG-PET-CT, because there are types of lymphoma that would not benefit from this technique beeing more useful following them through conventional imaging techniques (ultrasound, CT, MRI).

Personal information

References

- Fletcher, James W., et al. "Recommendations on the use of 18F-FDG PET in oncology."Journal of Nuclear Medicine49.3 (2008): 480-508. -Moulin-Romsee, Gerard, et al. "18F-FDG PET/CT bone/bone marrow findings in Hodgkin’s lymphoma may circumvent the use of bone marrow trephine biopsy at diagnosis staging."European journal of nuclear medicine and molecular imaging37.6 (2010): 1095-1105. -Antoch, Gerald, et al. "To enhance or not to enhance? 18F-FDG and CT contrast agents in dual-modality 18F-FDG PET/CT."Journal of Nuclear Medicine45.1 suppl (2004): 56S-65S. -Delbeke, Dominique, et al. "Procedure guideline for...