Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
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ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
Periodicity – monthly

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Advances in Clinical and Experimental Medicine

2015, vol. 24, nr 2, March-April, p. 325–330

doi: 10.17219/acem/31804

Publication type: original article

Language: English

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PET/CT Assessment of Follicular Lymphoma and High Grade B Cell Lymphoma – Good Correlation with Clinical and Histological Features at Diagnosis

Silvana Novelli1,A,B,C,D,E,F, Javier Briones1,A,E,F, Albert Flotats2,A,E,F, Jorge Sierra1,E,F

1 Department of Hematology, Hospital of the Holy Cross and Saint Paul, Barcelona, Spain

2 Nuclear Medicine, Hospital of the Holy Cross and Saint Paul, Barcelona, Spain

Abstract

Background. Follicular lymphoma is a common type of non-Hodgkin’s lymphoma observed in Western countries. The diagnosis of this disease is based primarily on morphological and immunohistochemical assessment. The proliferative index Ki67 correlates with histological grading and clinical aggressiveness. Currently, positron emission tomography/computed tomography scanning are not applied for standard staging at diagnosis of follicular lymphoma and its use is limited to those patients for whom the identification of residual disease is crucial for therapeutic decisions and only when transformation to a high-grade lymphoma is suspected.
Objectives. Our aim was to assess whether a correlation exists between the maximal standardized uptake value (SUVmax) at the biopsy site as detected via positron emission tomography/computed tomography and pathological (Ki67 and FL histological grade) and clinico-biological features (e.g. LDH, beta-2-microglobulin, Ann Arbor stage and FL International Prognostic Index – FLIPI) at diagnosis.
Material and Methods. We retrospectively identified 16 patients during the previous 3.5 years in whom node biopsies were guided, taking into account the SUVmax as detected upon PET/CT scan at diagnosis. The results of these biopsies were diagnostic of follicular lymphoma. We also included 6 patients with high grade B cell lymphoma: 5 diffuse large B cell lymphoma (DLBCL) and 1 FL 3b histological grade. A 2-tailed non-parametric Spearman’s correlation analysis of the SUVmax with Ki67, histological grade, LDH and b-2-microglobuline was performed.
Results. The Ki67 (r = 0.73) and follicular lymphoma histological grade (r = 0.75) at the biopsy displayed a significant correlation with the SUVmax at diagnosis (p < 0.01).
Conclusion. Our results suggest that SUV detected by positron emission tomography/computed tomography correlates with histological grade in follicular lymphoma/high grade B cell lymphoma, Ki67 and LDH. Positron emission tomography/computed tomography should be considered for guiding lymph node biopsy when transformation to a high-grade B cell lymphoma is suspected.

Key words

PET, follicular lymphoma, Ki67, high grade B cell lymphoma

References (16)

  1. Novelli S, Briones J, Sierra J: Epidemiology of lymphoid malignancies: last decade update. Springerplus 2013, 2, 70.
  2. Jaffe ES, Harris NL, Stein H, Campo E, Pileri SA, Swerdlow SH: Introduction and Overview of the Classification of the Lymphoid Neoplasms. WHO classification of tumours of haematopoietic and lymphoid tissues. Lyon: IARC 2008, 4th ed., 8, 220–226.
  3. Klapper W: Pathobiology and diagnosis of follicular lymphoma. Semin Diagn Pathol 2011, 28, 146–160.
  4. Miller TP, Grogan TM, Dahlberg S, Spier CM, Braziel RM, Banks PM, Foucar K, Kjeldsberg CR, Levy N, Nathwani BN: Prognostic significance of the Ki-67-associated proliferative antigen in aggressive non-Hodgkin’s lymphomas: a prospective Southwest Oncology Group trial. Blood 1994, 83, 1460–1466.
  5. Solal-Céligny P, Roy P, Colombat P, White J, Armitage JO, Arranz-Saez R, Au WY, Bellei M, Brice P, Caballero D, Coiffier B, Conde-Garcia E, Doyen C, Federico M, Fisher RI, Garcia-Conde JF, Guglielmi C, Hagenbeek A, Haïoun C, LeBlanc M, Lister AT, Lopez-Guillermo A, McLaughlin P, Milpied N, Morel P, Mounier N, Proctor SJ, Rohatiner A, Smith P, Soubeyran P, Tilly H, Vitolo U, Zinzani PL, Zucca E, Montserrat E: Follicular lymphoma international prognostic index. Blood 2004, 104, 1258–1265.
  6. Wohrer S, Jaeger U, Kletter K, Becherer A, Hauswirth A, Turetschek K, Raderer M, Hoffmann M: 18F-fluorodeoxyglucose positron emission tomography (18F-FDG-PET/CT) visualizes follicular lymphoma irrespective of grading. Ann Oncol 2006, 17, 780–784.
  7. Jerusalem G, Beguin Y, Najjar F, Fillet G, Rigo P: Positron emission tomography (PET/CT) with 18F-fluorodeoxyglucose (18F-FDG) for the staging of low-grade non-Hodgkin’s lymphoma (NHL). Ann Oncol 2001, 12, 825–830
  8. Cheson BD, Pfistner B, Juweid ME, Gascoyne RD, Specht L, Horning SJ, Coiffier B, Fisher RI, Hagenbeek A, Zucca E, Rosen ST, Stroobants S, Lister TA, Hoppe RT, Dreyling M, Tobinai K, Vose JM, Connors JM, Federico M, Diehl V: International Harmonization Project on Lymphoma. Revised response criteria for malignant lymphoma. J Clin Oncol 2007, 25, 579–586.
  9. Ngeow JY, Quek RH, Ng DC, Hee SW, Tao M, Lim LC, Tan YH, Lim ST: High SUV uptake on FDG-PET/CT predicts for an aggressive B-cell lymphoma in a prospective study of primary FDG-PET/CT staging in lymphoma. Ann Oncol 2009, 20, 1543–1547.
  10. Noy A, Schöder H, Gönen M, Weissler M, Ertelt K, Cohler C, Portlock C, Hamlin P, Yeung HW: The majority of transformed lymphomas have high standardized uptake values (SUVs) on positron emission tomography (PET) scanning similar to diffuse large B-cell lymphoma (DLBCL). Ann Oncol 2009, 20, 508-512.
  11. Lapela M, Leskinen S, Minn HR, Lindholm P, Klemi PJ, Söderström KO, Bergman J, Haaparanta M, Ruotsalainen U, Solin O, Joensuu H: Increased glucose metabolism in untreated non-Hodgkin’s lymphoma: a study with positron emission tomography and fluorodeoxyglucose. Blood 1995, 86, 3522–3527.
  12. Elstrom R, Guan L, Baker G, Nakhoda K, Vergilio J, Zhuang H, Pitsilos S, Bagg A, Downs L, Mehrotra A, Kim S, Alavi A, Schuster SJ: Utility of FDG-PET/CT scanning in lymphoma by WHO classification. Blood 2003, 101, 3875–3876.
  13. Luminari S, Biasoli I, Arcaini L, Versari A, Rusconi C, Merli F, Spina M, Ferreri AJ, Zinzani PL, Gallamini A, Mastronardi S, Boccomini C, Gaidano G, D’Arco AM, Di Raimondo F, Carella AM, Santoro A, Musto P, Federico M: The use of FDG-PET/CT in the initial staging of 142 patients with follicular lymphoma: a retrospective study from the FOLL05 randomized trial of the Fondazione Italiana Linfomi. Ann Oncol 2013, 24, 2108–2112.
  14. Trotman J, Fournier M, Lamy T, Seymour JF, Sonet A, Janikova A, Shpilberg O, Gyan E, Tilly H, Estell J, Forsyth C, Decaudin D, Fabiani B, Gabarre J, Salles B, Van Den Neste E, Canioni D, Garin E, Fulham M, Vander Borght T, Salles G: Positron emission tomography-computed tomography (PET-CT) after induction therapy is highly predictive of patient outcome in follicular lymphoma: analysis of PET-CT in a subset of PRIMA trial participants. J Clin Oncol 2011, 29, 3194–3200.
  15. Salaverria I, Siebert R: 2011. Follicular lymphoma grade 3B. Best Pract Res Clin Haematol 2009, 24, 111–119.
  16. Adam P, Schoof J, Hartmann M, Schwarz S, Puppe B, Ott M, Rosenwald A, Ott G, Muller-Hermelink HK: Cell migration patterns and ongoing somatic mutations in the progression of follicular lymphoma. Cytogenet Genome Res 2007, 118, 328–336.
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