Assessment of alteration in liver 18F–FDG uptake due to steatosis in lymphoma patients and its impact on the Deauville score

Salomon, Thibault; Nganoa, Catherine; Gac, Anne-Claire; Fruchart, Christophe; Damaj, Gandhi; Aide, Nicolas; Lasnon, Charline

doi:10.1007/s00259-017-3914-y

Cited by 16 publications

(8 citation statements)

References 25 publications

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“…Lower 18 F-FDG hepatic uptake in lymphoma patients due to a tumour sink effect has already been suspected by Wu et al [14]. Another confounding factor potentially decreasing liver metabolism is liver steatosis [12]. However, in the present series, steatotic liver was only observed in 14 patients (18.9%) and liver densities were not different between baseline and interim PET/CT examinations, meaning that %Variation_ LIVER is certainly not biased by steatosis.…”

Section: Discussionsupporting

confidence: 55%

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Comprehensive analysis of the influence of G-CSF on the biodistribution of 18F-FDG in lymphoma patients: insights for PET/CT scheduling

et al. 2019

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Aims (1) To perform a comprehensive analysis of the time elapsed between the last G-CSF injection and the PET/CT examination on the biodistribution of 18 F-FDG, with emphasis on liver, spleen, and bone marrow uptake, and (2) to investigate whether an inversion of the liver to spleen ratio affects the Deauville scoring. Materials and methods Retrospectively included were 74 consecutive diffuse large B cell lymphoma (DLBCL) patients referred for baseline and interim examinations and receiving immunochemotherapy with various G-CSF regimens. A comprehensive evaluation considering baseline metabolic active tumour volume (MATV), factors affecting liver uptake, the type of G-CSF, and the time elapsed between chemotherapy/G-CSF and interim PET/CTs was performed. Results Mean (± SD) percentage variations between baseline and interim PET/CTs (i-PET/CT) for bone marrow (%Variation_ BONE ), liver (%Variation_ LIVER ) and spleen (%Variation_ SPLEEN ) were equal to 32.0 ± 46.9%, 16.1 ± 42.8%, and 10.6 ± 51.1 %, respectively. %Variation_ LIVER and %Variation_ SPLEEN were higher in patients using lenograstim, but this was linked to lower uptakes at baseline and was therefore likely not due to G-CSF itself. The mean delay between G-CSF injection and i-PET/CT acquisition was not an independent explanatory variable for %Variation_ BONE , %Variation_ LIVER , and %Variation_ SPLEEN . On the contrary, %Variation_ BONE and %Variation_ SPLEEN were negatively correlated to the time-lapse between the end of chemotherapy and i-PET/CT: ρ = − 0.342 ( p = 0.010) and ρ = − 0.529 ( p < 0.0001), respectively. Patients with a time-lapse since the last injection of chemotherapy < 17 days displayed higher bone and spleen SUVmax EARL . %Variation_ LIVER was positively correlated to baseline MATV: ρ = 0.243 ( p = 0.039). Patients displaying a high baseline MATV ≥ 177 cc had significantly lower liver SUVmax EARL at baseline. This difference was no longer observed at i-PET/CT, after tumours had shrunk. Conclusions Neither the type of G-CSF used nor the time elapsed between its last injection and i-PET/CT examination independently influences bone, hepatic, or splenic uptakes at i-PET/CT. The major determinant for the occurrence of a bone or spleen hypermetabolism on i-PET/CT is the time elapsed between the chemotherapy and the examination, which should be maintained above 15 days. Inversion of the liver to spleen ratio a...

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Section: Discussionsupporting

confidence: 55%

“…Liver mean Hounsfield units (HU) were measured to seek hepatic steatosis [12]. Baseline metabolic active tumour volume (MATV) was measured for each patient using a 41% isocontour method as per the EANM guidelines.…”

Section: Methodsmentioning

confidence: 99%

Comprehensive analysis of the influence of G-CSF on the biodistribution of 18F-FDG in lymphoma patients: insights for PET/CT scheduling

et al. 2019

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“…HS patients with liver impairment may impact the use of liver as one of our reference organs, but the data on this matter are rather limited. [ 12 ] Any discordance between SUVmax value and visual scoring can be easily detected and in actual clinical practice. Therefore, the nuclear medicine physician needs to be mindful to correlate visual interpretation using liver as a reference organ and objective interpretation (SUVmax).…”

Section: Discussionmentioning

confidence: 99%

The findings of 18F-fluorodeoxyglucose positron emission tomography–computed tomography scan in patients with hidradenitis suppurativa in Malaysia: A multicenter study

et al. 2021

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Hidradenitis suppurativa (HS) is known to have association with systemic diseases with chronic inflammation such as psoriasis. We aim to describe the concomitant systemic inflammation in patients with HS using 18F-fluorodeoxyglucose positron emission tomography–computed tomography ( 18 F-FDG PET/CT) scan. This was a case–control study conducted in three tertiary hospitals in Northern Malaysia from January to December 2017, involving HS patients aged 18 years and above. Thirty-two HS patients with age- and sex-matched controls were recruited with a mean age of 31.4 years (range: 18–56). Numerous cutaneous inflammatory foci were detected on FDG-PET/CT scan in clinically unapparent sites (27/32, 84.4%). Approximately 90.6%, 93.8%, and 50.0% of the patients had significantly higher cutaneous uptake over nasal, mandibular, and scalp regions, respectively ( P < 0.0001). PET/CT scan did not detect any systemic inflammation unlike those found in psoriasis. Three (9.4%) patients had thyroid nodules with high uptake (maximum standard uptake values ranging from 2.9 to 11.3). Two of them were confirmed to have papillary thyroid carcinoma, while the third patient has inconclusive finding. 18 F-FDG PET/CT scan may be useful to map disease burden of HS. Nonlesional inflammatory foci on the skin of the nose, mandibular, and scalp are probably significant. The association of thyroid carcinoma in HS warrants further evaluation.

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“…For example, in the random dataset of 100 patients attributed to the second observer, the liver uptake ranged from 1.89 to 4.38 with a median value equal to 2.95. Indeed, it is wellknown that liver uptake can be influenced by various factors as BMI [18] steatosis [19], as well as the blood glucose level [20] and time interval between 18 F-FDG injection [21] and PET acquisition [22]. Therefore, there is a significant risk to overestimate the event in patients with low liver uptake and underestimate the event in those with high liver uptake, whatever the underlying cause.…”

Section: Discussionmentioning

confidence: 99%

HYPHYCA: a prospective study in 613 patients conducting a comprehensive analysis for predictive factors of physiological 18F-FDG anal uptake

et al. 2020

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Background: Anal cancer is a relatively rare tumor of which incidence increases in developed countries. 18 F-FDG PET has been increasingly used for its post radio-chemotherapy evaluation. However, several authors have reported the risk of local false-positive findings leading to low specificity and positive predictive values. These false-positive results could be due to post-radiotherapy inflammation or infection but certainly also to physiological anal canal uptake that is observed on a regular basis in clinical practice. The purpose of this prospective study (NCT03506529; HYPHYCA) was therefore to seek predictive factors of physiological anal canal hypermetabolism. Materials and methods: Over a 2-month period, patients aged 18 years old and more, referred for 18 F-FDG PET-CT at two EARL-accredited PET centers were included, after obtaining their informed and written consent. They were asked to fill in a questionnaire including seven closed questions about usual intestinal transit, ongoing medications relative to intestinal transit, history of digestive, and anal and/or pelvic diseases. Age, gender, and body mass index (BMI) were recorded. A single nuclear medicine physician visually and quantitatively analyzed anal canal uptake (SUV max_EARL) and assessed visual rectal content (air, feces, or both) and the largest rectal diameter (mm). Results: Six hundred and thirteen patients were included (sex ratio F/M = 0.99) and 545 (89%) questionnaires were entirely completed. Significantly more males presented anal canal hypermetabolism (sex ratio (M/F) = 1.18 versus 0.85, p = 0.048). Moreover, patients with anal canal hypermetabolism had higher BMI (27.6 (5.7) kg/m 2 versus 23.9 (4.5) kg/m 2 , p < 0.0001), higher rate of hemorrhoid history (43% versus 27%, p = 0.016), and higher rate of rectum filled with only feces (21% versus 12%, p = 0.019) as compared to patients with no anal canal uptake. On logistic regression, all these variables were found to be independent predictors of the occurrence of an anal canal hypermetabolism. Odds ratio were 1.16 (1.12-1.20) per unit of BMI (kg/m 2) (p < 0.0001), 1.48 (1.04-2.11) for males (p = 0.030), 1.64 (1.10-2.45) for hemorrhoids history (p = 0.016), and 1.94 (1.147-3.22) for the rectum filled with only feces (p = 0.010).

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Assessment of alteration in liver 18F–FDG uptake due to steatosis in lymphoma patients and its impact on the Deauville score

Cited by 16 publications

References 25 publications

Comprehensive analysis of the influence of G-CSF on the biodistribution of 18F-FDG in lymphoma patients: insights for PET/CT scheduling

Comprehensive analysis of the influence of G-CSF on the biodistribution of 18F-FDG in lymphoma patients: insights for PET/CT scheduling

The findings of 18F-fluorodeoxyglucose positron emission tomography–computed tomography scan in patients with hidradenitis suppurativa in Malaysia: A multicenter study

HYPHYCA: a prospective study in 613 patients conducting a comprehensive analysis for predictive factors of physiological 18F-FDG anal uptake

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