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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
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 grade,
(that occurs in up to 10 -20% of low-grade lymphomas).
This is important to consider because not in all lymphoma cases would be indicated to make a 18F-FDG-PET,
because low-grade NHL can not accumulate enough 18F-FDG like to view them,
it can lead to false negative,
therefore are not evaluated reliably using 18F-FDG-PET. These cases must be studied by other imaging techniques (CT,
MRI,
ultrasound).
Furthermore,
the presence of residual disease after treatment in NHL can not be clinically relevant,
as these types of lymphomas usually have no cure,
but its course is indolent and with a survivance of 10-12 years.
However,
in some cases of low-grade NHL,
as in the cases of follicular lymphoma,
FDG-PET has proved to be useful despite being a type of lymphoma that has low affinity for 18F-FDG,
so there are cases of low-grade NHL in which could also be useful to perform a 18F-FDG-PET.
In summary,
the 18F-FDG-PET has proven to be useful in:
- Hodgkin's disease and high and intermediate non-Hodgkin lymphomas.
- In low grade non-Hodgking lymphomas that becomes high grade (10-20%).
- And has a limited role in the management of low-grade lymphomas,
excluding some subtypes such as follicular lymphoma.