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Keywords:
Oncology, Haematologic, Nuclear medicine, PET, PET-CT, CT, Chemotherapy, Staging, Computer Applications-Detection, diagnosis, Lymphoma, Cancer, Haematologic diseases
Authors:
M. Khodjibekova1, L. A. Tyutin2, N. A. Kostenikov2, N. Il`in1, A. A. Stanzhevskiy2, M. Tlostanova1; 1Saint-Petersburg/RU, 2St. Petersburg/RU
DOI:
10.1594/ecr2014/C-1606
Aims and objectives
Non-Hodgkin`s lymphoma (NHL) consists of heterogeneous groups of neoplasm with different histopathological structure,
response to therapy and prognosis.
The main method of treatment used for almost all histological types of NHL with different stages and localization of disease is chemotherapy (CHT).
Achievement of complete remission (CR) after 1st line CHT associated with prolonged disease-free survival and good prognosis.
Partial remission (PR) is a sign of poor prognosis and requires correction of treatment strategies and regular monitoring of the patient [1,
2].
The duration of CR basically affected by the sensitivity of the tumor to the CHT. The differentiation between viable tumor and fibrosis or tumor necrosis is an actual problem because in many cases it is complicated task.
Until now morphological imaging modalities,
using sequential determination of tumor size are performed to assess tumor response to induced CHT.
However changes in anatomical structures can be slow and tumor may remain enlarged due to the development of fibrosis or necrosis (fig.
1) [3-5].The first method of metabolic imaging for the assessment of resiual tumor tissue was Gallium (67Ga) scintigraphy.
However the main limitations of 67Ga scintigraphy are the low resolution,
low sensitivity and specificity,
difficulties in visualizing tumors below the diaphragm due to physiological uptake of radiopharmaceutical in the liver,
spleen and intestine [6].
Fluorine-18 fluorodeoxyglucose positron emission tomography (18F-FDG PET),
using increased glycolysis to differentiate between fibrosis and active tumor has inherent superior resolution and sensitivity,
and also better interpretation of the abdomen [7-10].
Utilization of 18F-FDG PET after 1st line CHT is very useful in assessing tumor response to treatment [11].
In our study we performed 18F-FDG PET scan after 2-3 cycles of CHT in order to predict clinical outcome in patients with NHL.
The aim of the study was the investigation of prognostic value of interim 18F-FDG PET in patients with NHL.