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European Journal of Nuclear Medicine and Molecular Imaging
Published in: European Journal of Nuclear Medicine and Molecular Imaging 12/2017

01-11-2017 | Original Article

Poor predictive value of positive interim FDG-PET/CT in primary mediastinal large B-cell lymphoma

Authors: Julien Lazarovici, Marie Terroir, Julia Arfi-Rouche, Jean-Marie Michot, Sacha Mussot, Valentina Florea, Maria-Rosa Ghigna, Peggy Dartigues, Cynthia Petrovanu, Alina Danu, Christophe Fermé, Vincent Ribrag, David Ghez

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 12/2017

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Abstract

Purpose

Though commonly used to assess response to therapy, the prognostic value of interim FDG-PET/CT in Primary Mediastinal Large B-cell Lymphoma (PMBCL) is unclear.

Methods

We conducted a retrospective study on 36 consecutive patients treated at our institution for a PMBCL between 2006 and 2014. All patients with a positive interim FDG-PET/CT had undergone histological restaging consisting either in a surgical debulking of the residual lesion (15 patients) or a CT-guided core needle biopsy (two patients). All FDG-PET/CT were secondarily reviewed according to the more recent Deauville criteria.

Results

Interim FDG-PET/CT was considered positive in 17/36 patients using visual evaluation. Among these patients, 14 had a Deauville score of 4. Histological restaging was negative in all but one case, showing inflammation and/or fibrosis. After a median follow-up of 48.5 months, a total of five patients have relapsed, two patients in the positive FDG-PET/CT group, and three patients in the negative FDG-PET/CT group, respectively.

Conclusions

These data indicate that a positive interim FDG-PET/CT does not reflect persistence of active disease in the vast majority of PMBCL cases. The relapse rate appears similar regardless of interim FDG-PET/CT results and interpretation criteria. This suggests that interim FDG-PET/CT has a poor positive predictive value, thus kt should be used with caution in PMBCL.
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Metadata
Title
Poor predictive value of positive interim FDG-PET/CT in primary mediastinal large B-cell lymphoma
Authors
Julien Lazarovici
Marie Terroir
Julia Arfi-Rouche
Jean-Marie Michot
Sacha Mussot
Valentina Florea
Maria-Rosa Ghigna
Peggy Dartigues
Cynthia Petrovanu
Alina Danu
Christophe Fermé
Vincent Ribrag
David Ghez
Publication date
01-11-2017
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Nuclear Medicine and Molecular Imaging / Issue 12/2017
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-017-3758-5

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