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First published online December 15, 2009, 10.2967/jnumed.109.067892
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Journal of Nuclear Medicine Vol. 51 No. 1 25-30
© 2010 by Society of Nuclear Medicine
doi: 10.2967/jnumed.109.067892

Clinical Investigation

18F-FDG Avidity in Lymphoma Readdressed: A Study of 766 Patients

Michal Weiler-Sagie1, Olga Bushelev2, Ron Epelbaum2,3, Eldad J. Dann2,4,5, Nissim Haim2,3, Irit Avivi2,5, Ayelet Ben-Barak6, Yehudit Ben-Arie2,7, Rachel Bar-Shalom1,2 and Ora Israel1,2

1 Department of Nuclear Medicine, Rambam Health Care Campus, Haifa, Israel; 2 Ruth and Bruce Rappaport Faculty of Medicine, Technion–Israel Institute of Technology, Haifa, Israel; 3 Department of Oncology, Rambam Health Care Campus, Haifa, Israel; 4 Blood Bank and Apheresis Unit, Rambam Health Care Campus, Haifa, Israel; 5 Department of Hematology and Bone Marrow Transplantation, Rambam Health Care Campus, Haifa, Israel; 6 Department of Pediatric Hematology-Oncology, Meyer Children's Hospital, Rambam Health Care Campus, Haifa, Israel; and 7 Department of Pathology, Rambam Health Care Campus, Haifa, Israel

Correspondence: For correspondence or reprints contact: Michal Weiler-Sagie, Nuclear Medicine Department, Rambam Health Care Campus, P.O. Box 9602, Haifa, Israel, 31096. E-mail: m_weiler{at}rambam.health.gov.il

PET/CT with 18F-FDG is an important noninvasive diagnostic tool for management of patients with lymphoma, and its use may surpass current guideline recommendations. The aim of the present study is to enlarge the growing body of evidence concerning 18F-FDG avidity of lymphoma to provide a basis for future guidelines. Methods: The reports from 18F-FDG PET/CT studies performed in a single center for staging of 1,093 patients with newly diagnosed Hodgkin disease and non-Hodgkin lymphoma between 2001 and 2008 were reviewed for the presence of 18F-FDG avidity. Of these patients, 766 patients with a histopathologic diagnosis verified according to the World Health Organization classification were included in the final analysis. 18F-FDG avidity was defined as the presence of at least 1 focus of 18F-FDG uptake reported as a disease site. Nonavidity was defined as disease proven by clinical examination, conventional imaging modalities, and histopathology with no 18F-FDG uptake in any of the involved sites. Results: At least one 18F-FDG–avid lymphoma site was reported for 718 patient studies (94%). Forty-eight patients (6%) had lymphoma not avid for 18F-FDG. 18F-FDG avidity was found in all patients (100%) with Hodgkin disease (n = 233), Burkitt lymphoma (n = 18), mantle cell lymphoma (n = 14), nodal marginal zone lymphoma (n = 8), and lymphoblastic lymphoma (n = 6). An 18F-FDG avidity of 97% was found in patients with diffuse large B-cell lymphoma (216/222), 95% for follicular lymphoma (133/140), 85% for T-cell lymphoma (34/40), 83% for small lymphocytic lymphoma (24/29), and 55% for extranodal marginal zone lymphoma (29/53). Conclusion: The present study indicated that with the exception of extranodal marginal zone lymphoma and small lymphocytic lymphoma, most lymphoma subtypes have high 18F-FDG avidity. The cumulating evidence consistently showing high 18F-FDG avidity in the potentially curable Burkitt, natural killer/T-cell, and anaplastic large T-cell lymphoma subtypes justifies further investigations of the utility of 18F-FDG PET in these diseases at presentation.

Key Words: lymphoma • 18F-FDG • PET/CT • avidity • WHO

COPYRIGHT © 2010 by the Society of Nuclear Medicine, Inc.


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