Patients with histologically indolent lymphoma that display discordant characteristics of aggressive disease as evidenced by high SUVmax on PET/CT are often subject to treatment delay for the purpose of attaining further confirmatory histological samples. The purpose of this study was to investigate whether the SUVmax of patients with diffuse large B-cell lymphoma (DLBCL) or follicular lymphoma (FL) measured on time of flight (TOF) 18F-FDG PET/CT at the site of biopsy could help differentiate between aggressive (DLBCL) and indolent (FL) non-Hodgkin lymphoma (NHL).

Patient population A retrospective review of 97 patients with a histological diagnosis of lymphoma that underwent TOF 18F-FDG PET/CT examinations between January 2018 and December 2019 was undertaken. A total of 56 patients (58 lymphomas) satisfied inclusion and exclusion criteria. PET/CT imaging and SUV measurement All patients fasted for 6 hours prior to TOF 18F-FDG PET/CT examinations. Blood glucose levels were confirmed to be less than 11.0mmol/L. Images were acquired on an integrated PET/CT scanner (Biograph mCT Flow Edge; Siemens Medical Solutions, USA) 60 minutes...

A total of 56 patients were included (58 lymphomas). The median age was 67.5 years (62.8–75 years); 51.79% were female; 31 (53.45%) of the NHLs were DLBCL and 27 (46.55%) were FL. The median SUVmax for DLBCL was 18.37 (IQR:11.80, 28.42) and for FL was 10.98 (IQR: 6.96, 13.65) (Figure 1 and 3a). There was a statistically significant difference (p=0.005) in the SUVmax between NHL subtypes where the majority of patients with an SUVmax <10 and 10-15 were FL patients (63.16% and 69.23% respectively) and...

We found that DLBCL patients tended to have higher SUVmax levels than FL patients in keeping with previously published literature.1-4 This study demonstrates that an SUVmax of 14 and above could differentiate between DLBCL and FL with 75% accuracy (≥14 classified as DLBCL; <14 was FL) for our data set. Previously explored SUVmax cut-offs of 10 and 15 were investigated and we found a significant proportion of patients with FL had an SUVmax in the 10-15 category (69.23%). Older research suggests that an SUVmax >10...

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