Variability of Hepatic 18F-FDG Uptake at Interim PET in Patients With Hodgkin Lymphoma

Rubello, Domenico; Gordien, Pierre; Morlière, Camille; Guyot, M.; Bordenave, Laurence; Colletti, Patrick M.; Hindié, Elif

doi:10.1097/rlu.0000000000000828

Cited by 19 publications

(8 citation statements)

References 26 publications

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“…The study showing a positive relationship between steatosis and SUV max did not actually take into account patients BMI, and; therefore, these results were certainly biased [ 15 ]. In our study, BMI and BGL appeared to be statistically different between steatotic and non-steatotic groups of patients whereas other parameters described as potentially affecting hepatic uptake {age, sex, treatment, time course of treatment [ 14 , 19 – 21 ]} were not. Concerning BGL, a proportional relationship with 18 F–FDG liver uptake has been shown, even for blood glucose in line with EANM recommendations [ 22 ].…”

Section: Discussioncontrasting

confidence: 64%

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

Salomon

Nganoa

Gac

et al. 2017

Eur J Nucl Med Mol Imaging

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AimOur aim was (1) to evaluate the prevalence of steatosis in lymphoma patients and its evolution during treatment; (2) to evaluate the impact of hepatic steatosis on 18F–FDG liver uptake; and (3) to study how hepatic steatosis affects the Deauville score (DS) for discriminating between responders and non-responders.MethodsOver a 1-year period, 358 PET scans from 227 patients [122 diffuse large B cell lymphoma (DLBCL), 57 Hodgkin lymphoma (HL) and 48 Follicular lymphoma (FL)] referred for baseline (n = 143), interim (n = 79) and end-of-treatment (EoT, n = 136) PET scans were reviewed. Steatosis was diagnosed on the unenhanced CT part of PET/CT examinations using a cut-off value of 42 Hounsfield units (HU). EARL-compliant SULmax were recorded on the liver and the tumour target lesion. DS were then computed.ResultsPrevalence of steatosis at baseline, interim and EoT PET was 15/143 (10.5%), 6/79 (7.6%) and 16/136 (11.8%), respectively (p = 0.62).Ten out of 27 steatotic patients (37.0%) displayed a steatotic liver on all examinations. Six patients (22.2%) had a disappearance of hepatic steatosis during their time-course of treatment. Only one patient developed steatosis during his course of treatment. Liver SULmax values were significantly lower in the steatosis versus non-steatotic groups of patients for interim (1.66 ± 0.36 versus 2.15 ± 0.27) and EoT (1.67 ± 0.29 versus 2.17 ± 0.30) PET. CT density was found to be an independent factor that correlated with liver SULmax, while BMI, blood glucose level and the type of chemotherapy regimen were not. Using a method based on this correlation to correct liver SULmax, all DS4 steatotic patients on interim (n = 1) and EoT (n = 2) PET moved to DS3.ConclusionsSteatosis is actually a theoretical but not practical issue in most patients but should be recognised and corrected in appropriate cases, namely, for those patients scored DS4 with a percentage difference between the target lesion and the liver background lower than 30%.Electronic supplementary materialThe online version of this article (10.1007/s00259-017-3914-y) contains supplementary material, which is available to authorized users.

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Section: Discussioncontrasting

confidence: 64%

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

Salomon

Nganoa

Gac

et al. 2017

Eur J Nucl Med Mol Imaging

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“…It has been noticed that the comparability of quantitative values, calculated under different reconstruction methods, may be limited [13,14]. It should also be taken into account that the liver SUV depends on gender and body mass index, but not the liver standardized uptake value corrected for lean body mass (SUL) [15]. One proposal for tackling the problem Table 2 Maximal standard uptake values corrected for body weight (SUVmax) and for lean body mass (SULmax) as well as the peak SUV and SUL (SUVpeak, SULpeak) were measured in the single hottest lesion in the lung after OSEM reconstruction and UHD reconstruction for each patient.…”

Section: Introductionmentioning

confidence: 99%

Impact of PET/CT image reconstruction methods and liver uptake normalization strategies on quantitative image analysis

Kuhnert

Boellaard

Sterzer

et al. 2015

Eur J Nucl Med Mol Imaging

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“…Each facility has its own policy regarding the need for glucose level testing prior to PET CT examination, and some facilities do not routinely perform glucose level testing prior to PET CT scans, unless the patients have diabetes or feel unwell. This practice is based on several published reports that have demonstrated that the impact of glucose levels on SUVs in most organs is negligible, and delaying the scan might harm the patient [20][21][22][23]. Nonetheless, among the patients for whom glucose data were available, there was no difference in the mean glucose levels between the steroid-treated and steroidnaïve groups.…”

Section: Discussionmentioning

confidence: 99%

Effect of steroid treatment on the diagnostic yield of baseline 18f-fluorodeoxyglucose positron emission tomography in aggressive B cell lymphoma

et al. 2022

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Aggressive B cell lymphoma often requires prompt steroid treatment, even before baseline 18f-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) and definitive treatment, to alleviate symptoms or prevent organ damage. Since lymphoma is a steroid-sensitive malignancy, there are concerns that steroids might affect the results of FDG PET/CT and decrease its diagnostic yield. The aim of the current study was to evaluate the effect of steroids administered before baseline PET/CT on the maximum standardized uptake value (SUVmax) and additional PET/CT parameters. Retrospective review of the database in a tertiary medical center yielded 178 patients newly diagnosed with aggressive B cell lymphoma between January 2017 and May 2020 who had an available baseline FDG PET/CT scan. The cohort was divided into patients who received steroids before PET/CT (n = 47) and those who did not (n = 131), and the groups were compared for SUVmax and additional PET/CT parameters. The steroid-treated group had a higher disease stage and lactate dehydrogenase level compared to the steroid-naïve group, with a trend toward a higher international prognostic index. There was no significant between-group difference in SUVmax (P = 0.61). This finding remained consistent across steroid treatment durations and dosage regimens. Further evaluation revealed a significantly larger mean tumor volume and a trend toward a higher tumor metabolic burden in the steroid-treated group, yet no between-group difference in SUV mean or other PET/CT parameters. In this retrospective analysis of patients with aggressive B cell lymphoma, steroid prophase prior to baseline PET/CT did not decrease the diagnostic yield of the scan. However, further studies are required to fully appreciate the impact of steroids on PET CT parameters.

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Variability of Hepatic 18F-FDG Uptake at Interim PET in Patients With Hodgkin Lymphoma

Cited by 19 publications

References 26 publications

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

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

Impact of PET/CT image reconstruction methods and liver uptake normalization strategies on quantitative image analysis

Effect of steroid treatment on the diagnostic yield of baseline 18f-fluorodeoxyglucose positron emission tomography in aggressive B cell lymphoma

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