Uptake of [18F]fluorodeoxyglucose in initial positron-emission tomography predicts survival in MALT lymphoma

Abstract

The role of [F]fluorodeoxyglucose (FDG) positron-emission tomography (PET) in mucosa-associated lymphoid tissue (MALT) of marginal zone lymphoma remains poorly defined. We correlated initial PET with pathology, clinical factors, and outcome. From January 2001 to July 2012, 173 MALT lymphoma patients with a biopsied lesion identified on PET within 90 days of tissue biopsy were analyzed. PET positivity and intensity of FDG uptake were correlated with clinical factors and patient outcome. Among 173 accrued cases, biopsied site was PET avid in 123 patients (71%); median standardized uptake value (SUV) was 6.0 (range: 0.7-28.0), and SUV >10.0 in 20 patients (16%). PET avidity varied by organ sites. PET positivity correlated with higher International Prognostic Index, but not with 5-year overall survival (OS; 96% vs 88%, PET negative vs positive, = .229) or 5-year progression-free survival (67% vs 56%, = .493). SUV was an independent prognostic factor of OS, and an increased SUV was associated with a decreasing 5-year OS. Patients who presented with SUV ≥10 had a higher rate of subsequent large cell transformation (20% vs 5%, = .035) and inferior OS (78% vs 92%, = .008). The exact role of FDG PET in the management of MALT lymphoma, beyond initial staging, remains to be defined.

A case of Barrett’s esophageal cancer with gastric mucosa-associated lymphoma

“…Although FDG uptake during PET-CT is frequently observed in many MALT lymphomas with high-grade malignant potential [7], this case did not show abnormal FDG uptake in the mesenteric lymph nodes or in other lesions. We removed the enlarged lymph nodes during the surgery for esophageal cancer and submitted the specimens for pathological examination.…”

Pre-Therapeutic Total Lesion Glycolysis on [18F]FDG-PET Enables Prognostication of 2-Year Progression-Free Survival in MALT Lymphoma Patients Treated with CD20-Antibody-Based Immunotherapy

“…For extranodal marginal zone B cell lymphoma of the mucosa-associated lymphoid tissue (MALT lymphoma), only three studies have, so far, evaluated quantitative pretherapeutic [ 18 F]FDG/PET-derived parameters for outcome prognostication [6][7][8], probably because of the variable FDG avidity of this lymphoma subtype, due to which [ 18 F]FDG/ PET is not recommended for imaging of MALT lymphomas by the International Conference on Malignant Lymphoma (ICML) [9]. Notably, none of the these studies-including the single, very recently published study that included an evaluation of TMTV and TLG, and was unable to establish either parameter as a prognostic factor for overall survival (OS) or progression-free survival (PFS) [6]-focused on a specific treatment group, contrary to studies in other lymphoma subtypes.…”

18F-FDG PET/CT for staging and response assessment of primary parotid MALT lymphoma with multiple sites involvement

“…In addition, some literatures indicated that few MALT lymphoma transformed into diffuse large B-cell Lymphoma (DLBCL). [27,28] Qi et al [29] reported the MALT lymphoma patients with an SUV≥10 had a higher incident rate of large cell transformation and inferior overall survival (OS). The patient in this report was diagnosed as MALT lymphoma in her parotid gland, but the PET/CT findings presented as extreme invasiveness.…”