Annals of Oncology Advance Access originally published online on September 15, 2006
Annals of Oncology 2006 17(12):1761-1765; doi:10.1093/annonc/mdl295
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© 2006 European Society for Medical Oncology
hematologic malignancies |
18F-Fluoro-deoxy-glucose positron emission tomography in lymphoma of mucosa-associated lymphoid tissue: histology makes the difference
1 Department of Nuclear Medicine, Medical University Vienna, Vienna, Austria
2 Department of Pathology, Medical University Vienna, Vienna, Austria
3 Department of Internal Medicine I, Medical University Vienna, Vienna, Austria
* Correspondence to: Dr M. Hoffmann, Department of Nuclear Medicine, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria. Tel: +43 (0)1 40400 5274; Fax: +43 (0)1 40400 5552; E-mail: martha.hoffmann{at}meduniwien.ac.at
Background: The usefulness of 2-[fluorine-18]fluoro-2-deoxy-D-glucose Positron emission tomography (18F-FDG–PET) in lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) is still a matter of debate, and conflicting results have been reported. We have evaluated whether the histological feature of plasmacytic differentiation (PD) might explain the heterogeneous behavior of MALT lymphoma regarding 18F-FDG uptake.
Patients and methods: A total of 35 patients with a diagnosis of MALT lymphoma referred to our PET unit were studied. Whole-body 18F-FDG–PET scans were carried out on a General Electrics advanced PET scanner 40 min after i.v. injection of 300–380 MBq 18F-FDG. Images were reconstructed iteratively. In areas with focally elevated FDG uptake, standard uptake values (SUVs) were calculated.
Results: A total of 19 patients had MALT lymphoma with plasmacytic differentiation (pMALT), while MALT lymphoma without plasmacytic features was diagnosed in 16 patients. Sixteen of 19 patients with PD showed significant 18F-FDG uptake in involved sites (SUV: 3.5–11.7). By contrast, 13 of 16 patients with normal MALT lymphoma showed a false-negative 18F-FDG–PET result. Two of these patients disclosed no tracer uptake in the majority of involved sites apart from one single lesions, while three had a true-positive 18F-FDG–PET scan (SUV: 3.4–6.0).
Conclusions: 18F-FDG–PET visualizes pMALT in a high proportion of patients, whereas FDG–PET results are significantly less reliable in typical MALT (P = 0.001). This finding may partly account for the heterogeneous results of 18F-FDG–PET-studies in MALT lymphoma.
Key words: 18F-FDG–PET, imaging, MALT lymphoma, plasmacytic differentiation
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