2021 ASM / R-0283
The role of SUV measured on 18F-FDG PET/CT in follicular lymphoma versus diffuse large B-cell lymphoma: a retrospective review
Keywords:
Nuclear medicine, PET-CT, Molecular imaging, Lymphoma
Authors:
T. Skalina, J. Blazak; Sunshine Coast, QLD/AU
DOI:
10.26044/ranzcr2021/R-0283
Conclusion
- 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 excluded indolent NHL with 81% sensitivity and found no patient with indolent NHL had a SUVmax of >13.5
- A 2018 study assessed the SUVmax of patients with various NHL subtypes measured on non-TOF PET/CT versus TOF PET/CT and found that the SUVmax measured on TOF scanners was significantly higher than on non-TOF scanners suggesting technical aspects and not just the histological subtype of NHL influences the SUVmax.1
- In a subpopulation prospective cohort study of 549 patients from the GALLIUM trial researchers aimed to assess the rate of histological transformation (HT) in patients with FL. The baseline SUVmax was > 10 in 360 (65.5%) patients with only 3.3% of those undergoing HT while 74 (13%) of these patients with FL had an SUVmax > 20 with only 1 patient undergoing HT.6
- Our findings may negate the need for further biopsy and treatment delay in patients with histologically indolent NHL (FL) and an SUVmax in the 10-15 range.