Abstract
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Objectives The purpose of this study was to assess the potential role of FDG-PET in chronic lymphocytic leukaemia (CLL) stages A and B.
Methods Thirty five patients (61±9 years; 11 women, 24 men; 8B and 27A) have benefited of a FDG-PETscan at baseline, i.e. before an eventual treatment. FDG-PETscans were analyzed visually and the SUVsmax (maximum values of the Standardised Uptake Value) were measured in the main lymph nodes areas. The ability of FDG-PET to differentiate stages A and B patients was evaluated by Student’s tests and ROC analysis.
Results All patients with a normal FDG-PET (n=18) were stages A. The remaining 17 patients (9A and 8B) showed hypermetabolisms in nodal areas above diaphragm (n=17) and below (n=9), and no visceral involvement. The lymph nodes hypermetabolisms were always bilateral, and of low intensity (≤mediastinum; 9A), or of higher intensity (≥ liver, 8B). The SUVmax of stage B (n=8) were significantly higher than those of the 27 stages A, in all lymph nodes areas except in mediastinum. The highest intensity of FDG uptake was observed in axillary area in stages B patients (SUVmax=2.74 ± 1.03). An axillary SUVmax of 1.33 is the more suitable value for the discrimination between stages A and B patients (ROC; AUC = 0968; sensitivity 1.00; specificity 0.91).
Conclusions Lymph nodes hypermetabolisms are constant in the B stage, and more intense than in stage A. These anomalies are always bilateral, unlike what is observed in Richter’s transformation. The intensity of axillary lymph nodes FDG uptake can distinguish CLL stages A and B.
- © 2009 by Society of Nuclear Medicine