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Annals of Oncology Advance Access published online on June 9, 2005

Annals of Oncology, doi:10.1093/annonc/mdi271
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© 2005 European Society for Medical Oncology
Received January 28, 2005
Revised April 4, 2005
Accepted April 13, 2005

Original article

Computed tomography and 18F-FDG positron emission tomography for therapy control of Hodgkin's and non-Hodgkin's lymphoma patients: when do we really need FDG-PET?

M. J. Reinhardt 1*, C. Herkel 2, C. Altehoefer 3, J. Finke 4, and E. Moser 2

1 Department of Nuclear Medicine, University Hospital Bonn, Bonn, Germany Department of Nuclear Medicine, University Hospital Freiburg, Freiburg, Germany
2 Department of Nuclear Medicine, University Hospital Freiburg, Freiburg, Germany
3 Department of Diagnostic Radiology, University Hospital Freiburg, Freiburg, Germany
4 Department of Hematology & Oncology, University Hospital Freiburg, Freiburg, Germany

* To whom correspondence should be addressed.
M. J. Reinhardt, E-mail: michael.reinhardt{at}ukb.uni-bonn.de


   Abstract

Background: The aim of this study was to evaluate the accuracy of computed tomography (CT) and [18F]fluoro-deoxy-d-glucose positron emission tomography (FDG-PET) for prediction of progression-free survival of Hodgkin's disease (HD) and non-Hodgkin's lymphoma (NHL) patients after completion of therapy.

Patients and methods: CT and FDG-PET were performed in 40 HD, 17 indolent NHL and 44 aggressive NHL patients (29 women, 72 men; aged 41±14 years) in a median of 2 months after therapy. Progression-free survival was evaluated using the Kaplan-Meier method. Independent prognostic factors were identified by means of Cox proportional hazards model.

Results: CT imaging results were progressive disease (PD) in five, stable disease (SD) in 57, and partial response (PR) or complete remission (CR) in 39 patients. FDG-PET suggested residual lymphoma in 24 patients. Three-year progression-free survival rates after exclusion of five PD patients were: 100% (PET negative; CT: PR or CR), 81% (PET negative; CT: SD), 21% (PET positive; CT: SD) and 0% (PET positive; CT: PR). FDG-PET (P<0.0001) and bulky disease (P <0.05) were identified as independent prognostic variables.

Conclusions: Among lymphoma patients with PR and SD on CT, FDG-PET discriminated those destined to progress into a low risk of ≤20% and a high risk for recurrence of ≥80%.

Keywords: computed tomography; fluorodeoxyglucose; Hodgkin's disease; non-Hodgkin's lymphoma; positron emission tomography.
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