Founded in 1993
  Year: 2012 | Volume: 20 | Issue: 3-4 | Pages: 94-96
  Special Article
Stanley J. Goldsmith
  DOI: 10.2298/AOO1204094G
  18F-FDG PET/CT has become essential in the management of patients with Hodgkin’s and non-Hodgkin’s lymphoma. The utility of 18F-FDG PET/CT imaging is based upon increased anaerobic metabolism of neoplastic tissue. The degree of hypermetabolism is somewhat proportional to lymphoma grade. Based on the ability of 18F-FDG PET/CT to identify hypermetabolic tissue, it has greater sensitivity and specificity for the detection of tumors in general and lymphoma in particular compared to CT or MRI. 18FFDG PET/CT has made a significant impact in lymphoma management in the following instances: 1. Extent of disease in patients already diagnosed with lymphoma; 2. Identification of hypermetabolic disease in lymphadenopathy identified by other means; 3. Evaluation of response to therapy – with greater specificity than CT alone; 4. Early detection of recurrent disease; 5. Identification of transformation from low grade to high-grade lymphoma; 6. Prediction of response to therapy and prognosis. In many clinical trials, 18F-FDG PET/CT has replaced CT as the standard for assessment of residual disease. It has become a standard procedure at the time of initial diagnosis and following completion of therapy as well at 6-24 month intervals during the follow-up or upon the recurrence of symptoms suggestive of relapse. On an investigational basis, we have demonstrated that resolution of lymph node hypermetabolism, as early as following a single cycle of chemotherapy, is predictive of a prolonged disease-free interval whereas failure to respond after a single cycle indicates that even if there is resolution of disease after completion of a full course of treatment, relapse occurs earlier. If confirmed by additional studies, early 18F-FDG PET/CT evaluation of response may provide a basis to select patients for a change to more aggressive or alternate therapy. In fact, it may also identify a sub-population of patients who do not require an extended course of chemotherapy.
  Key words: Positron-Emission Tomography and Computed Tomography; Lymphoma; Fluorodeoxyglucose F18; Hodgkin Disease; Lymphoma, Non-Hodgkin
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Founder, owner and publisher: Oncology Institute of Vojvodina, Serbia
Online since 1997 (Abstracts only); 2000 (Abstracts and Full text)
ISSN: 0354-7310 eISSN: 1450-9520