Does Delayed-Time-Point Imaging Improve 18F-FDG-PET in Patients with MALT Lymphoma? Observations in a Series of 13 Patients

Marius E. Mayerhoefer, Chiara Giraudo, Daniela Senn, Markus Hartenbach, Michael Weber, Ivo Rausch, Barbara Kiesewetter, Christian J. Herold, Marcus Hacker, Matthias Pones, Ingrid Simonitsch-Klupp, Leonhard Müllauer, Werner Dolak, Julius Lukas, Markus Raderer

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose To determine whether in patients with extranodal marginal zone B-cell lymphoma of the mucosa-associated lymphoid tissue lymphoma (MALT), delayed-time-point 2-18F-fluoro-2-deoxy-d-glucose-positron emission tomography (18F-FDG-PET) performs better than standard-time-point 18F-FDG-PET. Materials and Methods Patients with untreated histologically verified MALT lymphoma, who were undergoing pretherapeutic 18F-FDG-PET/computed tomography (CT) and consecutive 18F-FDG-PET/magnetic resonance imaging (MRI), using a single 18F-FDG injection, in the course of a larger-scale prospective trial, were included. Region-based sensitivity and specificity, and patient-based sensitivity of the respective 18F-FDG-PET scans at time points 1 (45-60 minutes after tracer injection, TP1) and 2 (100-150 minutes after tracer injection, TP2), relative to the reference standard, were calculated. Lesion-to-liver and lesion-to-blood SUVmax (maximum standardized uptake values) ratios were also assessed. Results 18F-FDG-PET at TP1 was true positive in 15 o f 23 involved regions, and 18F-FDG-PET at TP2 was true-positive in 20 of 23 involved regions; no false-positive regions were noted. Accordingly, region-based sensitivities and specificities were 65.2% (confidence interval [CI], 45.73%-84.67%) and 100% (CI, 100%-100%) for 18F-FDG-PET at TP1; and 87.0% (CI, 73.26%-100%) and 100% (CI, 100%-100%) for 18F-FDG-PET at TP2, respectively. FDG-PET at TP1 detected lymphoma in at least one nodal or extranodal region in 7 of 13 patients, and 18F-FDG-PET at TP2 in 10 of 13 patients; accordingly, patient-based sensitivity was 53.8% (CI, 26.7%-80.9%) for 18F-FDG-PET at TP1, and 76.9% (CI, 54.0%-99.8%) for 18F-FDG-PET at TP2. Lesion-to-liver and lesion-to-blood maximum standardized uptake value ratios were significantly lower at TP1 (ratios, 1.05 ± 0.40 and 1.52 ± 0.62) than at TP2 (ratios, 1.67 ± 0.74 and 2.56 ± 1.10; P = 0.003 and P = 0.001). Conclusions Delayed-time-point imaging may improve 18F-FDG-PET in MALT lymphoma.

Original languageEnglish (US)
Pages (from-to)101-105
Number of pages5
JournalClinical nuclear medicine
Volume41
Issue number2
DOIs
StatePublished - Feb 1 2016

Keywords

  • 2-F-fluoro-2-deoxy-d-glucose
  • Computed tomography
  • Lymphoma
  • Magnetic resonance imaging
  • Positron emission tomography

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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