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Decreased ¹⁸F-FDG Uptake 1 Day After Initiation of Chemotherapy for Malignant Lymphomas

¹ Department of Radiology, Daiyukai General Hospital, Ichinomiya, Japan
² Department of Hematology, Daiyukai General Hospital, Ichinomiya, Japan

View larger version (66K): [in a new window]   FIGURE 1. Results for patient 2, a 52-y-old woman with a B-cell diffuse large lymphoma. (A) A baseline 18F-FDG PET image revealed increased activity in left subclavicular and paraaortic abdominal nodes. (B) At day 1, almost all abnormal uptake was sharply reduced. (C) At day 20, although bowel uptake was seen, abnormal uptake in lymph nodes was negligible. (D) At the end of chemotherapy, abnormal uptake to lymph nodes was not apparent.

View larger version (53K): [in a new window]   FIGURE 2. Results for patient 5, a 32-y-old man with a B-cell diffuse large lymphoma. (A) A baseline 18F-FDG PET image revealed increased activity throughout the right nasal cavity and mediastinal nodes. (B) At day 1, abnormal uptake in the nasal cavity was visually identical to that at baseline, but uptake in the mediastinum was decreased. (C) At day 20, the 18F-FDG image was basically normal, with slightly abnormal uptake in the nasal cavity or mediastinal nodes. (D) At the end of chemotherapy, uptake in the mediastinal nodes reappeared, but uptake in the nasal cavity remained normal.

View larger version (55K): [in a new window]   FIGURE 3. Results for patient 12, a 76-y-old man with a B-cell diffuse mixed lymphoma. (A) A baseline 18F-FDG PET image revealed multiple foci of increased activity in mesenteric lymph nodes. (B) At day 1, uptake in mesenteric lymph nodes was visually identical to that at baseline. (C) At day 20, abnormal uptake disappeared. Renal uptake was unclear because of the presence of multiple renal cysts. (D) At the end of chemotherapy, the 18F-FDG image showed no abnormal uptake.

View larger version (17K): [in a new window]   FIGURE 4. Changes in the representative index for the ROI with the highest SUVcor at baseline 18F-FDG PET for all 12 patients at baseline, day 1, day 20, and the end of chemotherapy. Compared with that at baseline, the SUV at day 1 was significantly decreased (P = 0.0002, paired t test). The SUV at day 20 was further significantly decreased compared with that at day 1 (P = 0.01), but no significant difference was observed between day 20 and the end of chemotherapy (P = 0.37). N/S = nonsignificant.