SUVmax in FDG-PET at the biopsy site correlates with the proliferation potential of tumor cells in non-Hodgkin lymphoma

Watanabe, Reina; Tomita, Naoto; Takeuchi, Kengo; Sakata, Seiji; Tateishi, Ukihide; Tanaka, Masatsugu; Fujita, Hiroyuki; Inayama, Yoshiaki; Ishigatsubo, Yoshiaki

doi:10.3109/10428190903440953

Cited by 59 publications

(39 citation statements)

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“…Previous studies suggested the association between SUV max and tumor aggressiveness [21][22][23]. And recently, the fact that proliferation potential of tumor cells measured by Ki-67 stain positively correlated with SUV max has been reported [24][25][26][27][28]. However, the measurement of SUV max has confined to the detection of the most obvious metabolic activity of the tumor at single site, but not the overall tumor activity.…”

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confidence: 99%

The impact of baseline and interim PET/CT parameters on clinical outcome in patients with diffuse large B cell lymphoma

et al. 2012

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mg administered during two or three annual cycles (12 mg or 24 mg, 3 times a week). The shorter time to ITP development observed in our study may be related to the different cumulative dose and to the different schedule of drug administration.It has been previously suggested that ITP secondary to lymphoproliferative disorders could be ascribed to autoreactive non-malignant B-cell clones, favored by the loss of immune tolerance due to T-cell dysfunction and/or inappropriate pathological (auto)antigen presentation by CLL cells [16,17]. During alemtuzumab treatment, immune-dysregulation of T lymphocytes may further favor autoimmunity.In conclusion, while reporting for the first time the association between lowdose alemtuzumab treatment and ITP in a cohort of CLL patients, we would also suggest to maintain a high level of vigilance and to strongly consider routine monitoring for ITP in patients treated with this agent for any pathologic condition. MethodsWe retrospectively analyzed a cohort of 64 patients affected by CLL, diagnosed according to NCIWG-CLL criteria and referred to the Hematology-BMT Unit of the Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan between 2003 and. Median age of patients was 68 years (range: 40-83 years).Patients had been treated with low-dose Alemtuzumab, defined as a total weekly dose lower than 45 mg and a cumulative dose inferior to 600 mg, administered for up to 18 weeks [18,19,20].The diagnosis of ITP was based on (1) an otherwise unexplained, rapid (<2 weeks) and severe fall (at least half of the initial level and below 100 3 10 9 /L) of the platelet counts; (2) a normal or augmented number of megakaryocytes in the bone marrow; (3) no or limited (not palpable) splenomegaly, and (4) no cytotoxic treatment in the last month except for alemtuzumab. We also evaluated assays for antibodies to specific platelet glycoproteins, even if they are not routinely recommended, as platelet-associated IgG is elevated in both immune and non-immune thrombocytopenia [21]. Conflict of interest: Nothing to report. A.C., G.R., C.V., and F.R. designed the research study; F.M., G.G., G.R., A.G., F.B., and F.G. performed the research; F.M., G.G., A.G., and A.P. analyzed the data; A.C., G.R., F.M., G.G., C.V. wrote the paper. The impact of baseline and interim PET/CT parameters on clinical outcome in patients with diffuse large B cell lymphoma F-FDG PET/CT as a tool for guidance in risk stratification in patients with aggressive non-Hodgkin's lymphoma (NHL). Here, we analyzed the predictive value of various PET/CT parameters in patients with DLBCL. Particularly, we were interested in patients with an IPI score of 1, 2, or 3, whose prognosis are confusing. Between Jul 2008 and Feb 2010, a total of 100 patients (including 57 patients with an IPI score of 1-3) who were treated with R-CHOP for DLBCL, and had assessable PET/CT parameters were analyzed in this study. Absolute value of SUV max , SUV sum (sum of SUV max ) and TLG sum (SUV mean x Volume meta ) from baseline and interim PET/CT, and DS...

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confidence: 99%

The impact of baseline and interim PET/CT parameters on clinical outcome in patients with diffuse large B cell lymphoma

et al. 2012

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“…This is of interest, because only the image pattern, but not the underlying information (i.e., tumor property) assessed is similar between the two techniques: DWI visualizes intercellular space narrowing, and thus, cell density (35); whereas 18F-FDG-PET visualizes glucose metabolism, which in turn has been shown to correlate with cell proliferation (36,37). We hypothesize that the reason for our findings is that, at least in the FDG-avid lymphomas included in the present study, there is more glucose consumption in areas of higher cell density, such a correlation between cell density and glucose metabolism has already been reported for malignant lung nodules and pancreatic adenocarcinoma (38,39).…”

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confidence: 99%

Evaluation of Diffusion-Weighted Magnetic Resonance Imaging for Follow-up and Treatment Response Assessment of Lymphoma: Results of an 18F-FDG-PET/CT–Controlled Prospective Study in 64 Patients

Mayerhoefer

Karanikas

Kletter

et al. 2015

Clinical Cancer Research

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Purpose: To determine the value of diffusion-weighted MRI (DWI-MRI) for treatment response assessment in 2-[18F]fluoro-2-deoxy-D-glucose (FDG)-avid lymphoma.Experimental Design: Patients with FDG-avid Hodgkin (HL) or non-Hodgkin lymphoma (NHL) at pretherapeutic 18F-FDG-PET/CT, who had also undergone pretherapeutic whole-body DWI-MRI, were included in this prospective study. Depending on the histologic lymphoma subtype, patients received different systemic treatment regimens, and follow-up DWI-MRI and 18F-FDG-PET/CT were performed at one or more time points, depending on the clinical course. For each follow-up DWI-MRI, regionbased rates of agreement, and rates of agreement in terms of treatment response (complete remission, partial remission, stable disease, or progressive disease), relative to the corresponding 18F-FDG-PET/CT, were calculated.Results: Sixty-four patients were included: 10 with HL, 22 with aggressive NHL, and 32 with indolent NHL. The overall region-based agreement of DWI-MRI with 18F-FDG-PET/CT was 99.4%. For the 51 interim examinations (performed after 1-3 therapy cycles), region-based agreement of DWI-MRI with 18F-FDG-PET/CT was 99.2%, and for the 48 end-oftreatment examinations, agreement was 99.8%. No significant differences, in terms of region-based agreement between DWI-MRI and 18F-FDG-PET/CT, were observed between the three lymphoma groups (HL, aggressive NHL, indolent NHL; P ¼ 0.25), or between interim and end-of-treatment examinations (P ¼ 0.21). With regard to treatment response assessment, DWI-MRI agreed with 18F-FDG-PET/CT in 99 of 102 follow-up examinations (97.1%), with a k value of 0.94 (P < 0.0001).Conclusions: In patients with FDG-avid lymphoma, DWI-MRI may be a feasible alternative to 18F-FDG-PET/CT for follow-up and treatment response assessment. Clin Cancer Res; 21(11); 2506-13.Ó2015 AACR.

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“…Regarding systemic NHL, Watanabe et al recently reported a strong correlation between the Ki-67 proliferating index and the SUV max of the biopsy site and proposed SUV max as a useful predictor for the proliferation potential of NHL (37). Transferring these findings to primary CNS lymphoma would be difficult since these cells usually have an extremely high proliferation rate (35).…”

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confidence: 99%

¹⁸F-FDG PET Is an Independent Outcome Predictor in Primary Central Nervous System Lymphoma

et al. 2012

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Primary central nervous system (CNS) lymphoma is an aggressive non-Hodgkin lymphoma with poor prognosis. We evaluated pretreatment 18 F-FDG PET as a prognostic marker in primary CNS lymphoma. Methods: Forty-two immunocompetent patients with newly diagnosed primary CNS lymphoma who underwent pretreatment 18 F-FDG PET were retrospectively analyzed. Baseline status and response to treatment were evaluated by MR imaging. Tumor maximum standardized uptake values were assessed by volume-of-interest analyses using an automatic isocontour definition. A 10-step semiquantitative visual rating system (metabolic imaging lymphoma aggressiveness scale, or MILAS) was used to assess primary CNS lymphoma metabolism as a marker of clinical aggressiveness. Logistic regression, log-rank testing, and multivariable Cox regression were used to investigate the association between 18 F-FDG uptake and tumor response and survival. Results: Mean maximum standardized uptake value correlated linearly with MILAS. The distribution of patients according to MILAS (0-9) was 0%, 28.6%, 23.8%, 21.4%, 11.9%, 4.8%, 7.1%, 0%, 0%, and 2.4%. There was no correlation between MILAS and response to treatment. Respective 2-and 5-y survival rates were 52% and 32% for progression-free survival (PFS) and 64% and 50% for overall survival (OS). A cutoff at MILAS 3 was a good separator for PFS (median: 54.7 mo [#3], 3.8 mo [.3], P 5 0.0272) and OS (median: not reached [#3], 13.8 mo [.3], P 5 0.131). In multivariable analyses, increasing MILAS was significantly associated with shorter PFS (hazard ratio, 1.49, P 5 0.006) and OS (hazard ratio, 1.43, P 5 0.018). Conclusion: Increased pretreatment 18 F-FDG uptake may offer new opportunities for baseline risk evaluation in untreated primary CNS lymphoma.

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SUVmax in FDG-PET at the biopsy site correlates with the proliferation potential of tumor cells in non-Hodgkin lymphoma

Cited by 59 publications

References 11 publications

The impact of baseline and interim PET/CT parameters on clinical outcome in patients with diffuse large B cell lymphoma

The impact of baseline and interim PET/CT parameters on clinical outcome in patients with diffuse large B cell lymphoma

Evaluation of Diffusion-Weighted Magnetic Resonance Imaging for Follow-up and Treatment Response Assessment of Lymphoma: Results of an 18F-FDG-PET/CT–Controlled Prospective Study in 64 Patients

¹⁸F-FDG PET Is an Independent Outcome Predictor in Primary Central Nervous System Lymphoma

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SUVmax in FDG-PET at the biopsy site correlates with the proliferation potential of tumor cells in non-Hodgkin lymphoma

Cited by 59 publications

References 11 publications

The impact of baseline and interim PET/CT parameters on clinical outcome in patients with diffuse large B cell lymphoma

The impact of baseline and interim PET/CT parameters on clinical outcome in patients with diffuse large B cell lymphoma

Evaluation of Diffusion-Weighted Magnetic Resonance Imaging for Follow-up and Treatment Response Assessment of Lymphoma: Results of an 18F-FDG-PET/CT–Controlled Prospective Study in 64 Patients

18F-FDG PET Is an Independent Outcome Predictor in Primary Central Nervous System Lymphoma

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¹⁸F-FDG PET Is an Independent Outcome Predictor in Primary Central Nervous System Lymphoma