Utility of 18F-FDG PET/CT for staging NK/T-cell lymphomas

Wu, Hubing; Wang, Quanshi; Wang, Mingfang; Li, Hongsheng; Zhou, Wenlan; Ye, Xianghua; Wang, Qiaoyu

doi:10.1097/mnm.0b013e32833310fa

Cited by 40 publications

(56 citation statements)

References 16 publications

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“…Because of the rarity of the disease, published experience and recommendations on the role of 18 F-FDG PET in ENKTL are limited. The few reports in the literature have found ENKTL to be consistently 18 F-FDG-avid, with PET superior to conventional cross-sectional imaging and therefore useful in disease staging (3)(4)(5)(6). The mean 18 F-FDG uptake measured by maximum standardized uptake value (SUV max ) was found to be significantly higher in the more common B-cell lymphomas than in indolent B-cell lymphomas and significantly lower than in aggressive B-cell lymphomas (7).…”

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confidence: 99%

Midtreatment ¹⁸F-FDG PET/CT Scan for Early Response Assessment of SMILE Therapy in Natural Killer/T-Cell Lymphoma: A Prospective Study from a Single Center

et al. 2014

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In a prospective study of newly diagnosed or relapsed histologically proven extranodal natural killer/T-cell lymphoma (ENKTL) patients, we aimed to determine the accuracy of midtreatment 18 F-FDG PET for response assessment using both visual and quantitative analyses. Methods: Twenty-four patients (12 men, 12 women; median age, 50 y; age range, 16-83 y) were referred for pre-, mid-(after 2-3 cycles of SMILE [prednisolone, methotrexate, ifosfamide, L-asparaginase, etoposide] chemotherapy), and end-treatment PET/CT scans (n 5 24, 24, and 17, respectively) using a standardized protocol. Sixty-five PET/CT scans were analyzed visually using the Deauville 5-point score (DS), and the lesion with the highest maximum standardized uptake value (SUV max ) was recorded. Survival curves were obtained using Kaplan-Meier analysis and compared using the log rank test, followed by multivariate analysis using the Cox proportional hazards model to assess the independent effects of International Prognostic Index (IPI) score (0-1 vs. 2-5), stage (stage I/II vs. stage III/IV), sex, DS (1-3 vs. 4-5), SUV max , and change in SUV max on overall survival (OS) and progression-free survival (PFS). The mean (±SD) follow-up period was 32 mo (±21 mo). Results: For 2-y OS, the following parameters were predictive: IPI score (P 5 0.047), DS at mid-and end-treatment (P , 0.001), and SUV max at mid-and end-treatment (P , 0.001 and 0.045, respectively). For 2-y PFS, the following parameters were predictive: sex (P 5 0.006), stage (P 5 0.034), IPI score (P 5 0.038), DS at mid-and end-treatment (P , 0.001 and 0.001, respectively), and SUV max at midtreatment (P 5 0.001). Multivariate analysis showed DS on mid-and end-treatment scans to be the only significant independent predictor of both OS (P 5 0.004 and 0.018, respectively) and PFS (P 5 0.004 and 0.014, respectively). The 2-y estimate for OS and PFS was 81% and 62%, respectively, in patients with a DS of 1-3, compared with 17% in patients with a DS of 4-5 (P , 0.001 and 0.001, respectively). The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the midtreatment DS for prediction of OS and PFS were 63%, 94%, 83%, 83%, and 83%, respectively. Conclusion: Midtreatment PET/CT is a valuable tool for early treatment response assessment in extranodal natural killer/T-cell lymphoma patients.

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confidence: 99%

Midtreatment ¹⁸F-FDG PET/CT Scan for Early Response Assessment of SMILE Therapy in Natural Killer/T-Cell Lymphoma: A Prospective Study from a Single Center

et al. 2014

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“…Radiation therapy with or without chemotherapy is now considered the optimal treatment for stage I or II nasal-type NK/T-cell lymphoma; thus, knowing the exact stage of this cancer is critical in determining the appropriate treatment (9)(10)(11). 18 F-FDG PET/CT is part of clinical practice for evaluating aggressive B-cell and Hodgkin lymphomas (12)(13)(14)(15). Research indicates that 18 F-FDG PET/CT scans are useful for staging, evaluating treatment response, predicting prognosis, and looking for recurrence during follow-up in patients with various lymphomas.…”

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confidence: 99%

“…18 F-FDG PET/CT is part of clinical practice for evaluating aggressive B-cell and Hodgkin lymphomas (12)(13)(14)(15). Research indicates that 18 F-FDG PET/CT scans are useful for staging, evaluating treatment response, predicting prognosis, and looking for recurrence during follow-up in patients with various lymphomas. However, using 18 F-FDG PET/CT scans for staging patients with nasal-type NK/Tcell lymphoma is not well established.…”

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confidence: 99%

“…Research indicates that 18 F-FDG PET/CT scans are useful for staging, evaluating treatment response, predicting prognosis, and looking for recurrence during follow-up in patients with various lymphomas. However, using 18 F-FDG PET/CT scans for staging patients with nasal-type NK/Tcell lymphoma is not well established. Until now, conventional staging methods (CSMs), including physical examination, CT with intravenous contrast, biopsies from primary sites, and bone marrow examinations, have been used to stage the disease as a standard method (6).…”

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confidence: 99%

“…Until now, conventional staging methods (CSMs), including physical examination, CT with intravenous contrast, biopsies from primary sites, and bone marrow examinations, have been used to stage the disease as a standard method (6). There are few studies that have investigated the utility of 18 F-FDG PET/CT scans for staging purposes in this disease, and those that have been conducted were limited by their sample size (16)(17)(18)(19). Therefore, the purpose of this study was to investigate the effectiveness of 18 F-FDG PET/CT scans, as compared with CSMs, for staging patients with nasal-type NK/T-cell lymphoma.…”

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The Role of¹⁸F-FDG PET/CT for Initial Staging of Nasal Type Natural Killer/T-Cell Lymphoma: A Comparison with Conventional Staging Methods

et al. 2013

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The utility of 18 F-FDG PET/CT in patients with nasal-type natural killer (NK)/T-cell lymphoma has not been established. Therefore, we evaluated the role of 18 F-FDG PET/CT for determining cancer staging by comparing its results to those of conventional staging methods (CSMs) (physical examination, CT with intravenous contrast, biopsies from primary sites, and bone marrow examinations) in patients with nasal-type NK/T-cell lymphoma. Methods: In this study, 52 consecutive patients (34 men, 18 women; mean age, 49.4 y) with newly diagnosed nasal-type NK/T-cell lymphoma were studied. Anatomic regions (n 5 1,300; 16 nodal and 9 extranodal regions per patient) were assessed with an 18 F-FDG PET/CT scan and with CSMs, and each anatomic region was classified as positive or negative for malignancy. Biopsy and clinical follow-up, including additional imaging studies, were used as the gold standard for diagnosis. Results: Of the 59 nodal and 71 extranodal anatomic regions that were truly positive for malignancy, 18 F-FDG PET/CT detected 58 nodal and 69 extranodal. CSMs, however, detected only 44 of the nodal and 61 of the extranodal anatomic regions that were positive for malignancy (nodal comparison of PET/CT vs. CSMs, P , 0.001; extranodal comparison of PET/CT vs. CSMs, P 5 0.008). PET/CT scans exhibited a significantly better sensitivity (97.7% vs. 80.7%, P , 0.001) than CSMs for the detection of malignant lesions. PET/CT findings altered the original staging category for 12 patients (21.2%) and affected treatment planning in 23 cases (44.2%). Conclusion: Our study demonstrated that 18 F-FDG PET/CT scanning is a valuable modality for staging and treatment planning in patients with nasal-type NK/T-cell lymphoma.

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Weakly supervised deep learning for determining the prognostic value of 18F-FDG PET/CT in extranodal natural killer/T cell lymphoma, nasal type

Guo

Song

et al. 2021

Eur J Nucl Med Mol Imaging

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Purpose To develop a weakly supervised deep learning (WSDL) method that could utilize incomplete/missing survival data to predict the prognosis of extranodal natural killer/T cell lymphoma, nasal type (ENKTL) based on pretreatment 18F-FDG PET/CT results. Methods One hundred and sixty-seven patients with ENKTL who underwent pretreatment 18F-FDG PET/CT were retrospectively collected. Eighty-four patients were followed up for at least 2 years (training set = 64, test set = 20). A WSDL method was developed to enable the integration of the remaining 83 patients with incomplete/missing follow-up information in the training set. To test generalization, these data were derived from three types of scanners. Prediction similarity index (PSI) was derived from deep learning features of images. Its discriminative ability was calculated and compared with that of a conventional deep learning (CDL) method. Univariate and multivariate analyses helped explore the significance of PSI and clinical features. Results PSI achieved area under the curve scores of 0.9858 and 0.9946 (training set) and 0.8750 and 0.7344 (test set) in the prediction of progression-free survival (PFS) with the WSDL and CDL methods, respectively. PSI threshold of 1.0 could significantly differentiate the prognosis. In the test set, WSDL and CDL achieved prediction sensitivity, specificity, and accuracy of 87.50% and 62.50%, 83.33% and 83.33%, and 85.00% and 75.00%, respectively. Multivariate analysis confirmed PSI to be an independent significant predictor of PFS in both the methods. Conclusion The WSDL-based framework was more effective for extracting 18F-FDG PET/CT features and predicting the prognosis of ENKTL than the CDL method.

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Utility of 18F-FDG PET/CT for staging NK/T-cell lymphomas

Abstract: The lesions of the NK/T-cell lymphoma are F-FDG avid and PET/CT seems to be useful in the staging of this disease.

Cited by 40 publications

References 16 publications

Midtreatment ¹⁸F-FDG PET/CT Scan for Early Response Assessment of SMILE Therapy in Natural Killer/T-Cell Lymphoma: A Prospective Study from a Single Center

Midtreatment ¹⁸F-FDG PET/CT Scan for Early Response Assessment of SMILE Therapy in Natural Killer/T-Cell Lymphoma: A Prospective Study from a Single Center

The Role of¹⁸F-FDG PET/CT for Initial Staging of Nasal Type Natural Killer/T-Cell Lymphoma: A Comparison with Conventional Staging Methods

Weakly supervised deep learning for determining the prognostic value of 18F-FDG PET/CT in extranodal natural killer/T cell lymphoma, nasal type

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Utility of 18F-FDG PET/CT for staging NK/T-cell lymphomas

Abstract: The lesions of the NK/T-cell lymphoma are F-FDG avid and PET/CT seems to be useful in the staging of this disease.

Cited by 40 publications

References 16 publications

Midtreatment 18F-FDG PET/CT Scan for Early Response Assessment of SMILE Therapy in Natural Killer/T-Cell Lymphoma: A Prospective Study from a Single Center

Midtreatment 18F-FDG PET/CT Scan for Early Response Assessment of SMILE Therapy in Natural Killer/T-Cell Lymphoma: A Prospective Study from a Single Center

The Role of18F-FDG PET/CT for Initial Staging of Nasal Type Natural Killer/T-Cell Lymphoma: A Comparison with Conventional Staging Methods

Weakly supervised deep learning for determining the prognostic value of 18F-FDG PET/CT in extranodal natural killer/T cell lymphoma, nasal type

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Midtreatment ¹⁸F-FDG PET/CT Scan for Early Response Assessment of SMILE Therapy in Natural Killer/T-Cell Lymphoma: A Prospective Study from a Single Center

Midtreatment ¹⁸F-FDG PET/CT Scan for Early Response Assessment of SMILE Therapy in Natural Killer/T-Cell Lymphoma: A Prospective Study from a Single Center

The Role of¹⁸F-FDG PET/CT for Initial Staging of Nasal Type Natural Killer/T-Cell Lymphoma: A Comparison with Conventional Staging Methods