Hossein Jadvar MD, PhD, Presenter: Nothing to Disclose

Alan Xu BS, Abstract Co-Author: Nothing to Disclose

Paul Tumeh BS, Abstract Co-Author: Nothing to Disclose

Juliet Pollock BS, Abstract Co-Author: Nothing to Disclose

Mohammad Nezami MD, Abstract Co-Author: Nothing to Disclose

Peter Stephen Conti MD, PhD, Abstract Co-Author: Nothing to Disclose

To assess the diagnostic utility of serial FDG PET-CT in the management and surveillance of patients with non-Hodgkin's lymphoma.

Forty-five patients (20 men, 25 women, age range 19-82 years) underwent serial FDG PET-CT (Siemens Biograph, Knoxville, TN) scans (range 2 to 5 scans on average every 6 months) before and either during, after, or both during and after treatments with chemotherapy, radiation therapy, or combined chemoradiation therapy. The imaging studies were retrospectively reviewed and interval changes were correlated with the clinical and radiological follow-up information. The concordance of CT and PET findings were tabulated and correlated to the clinical outcome.

In 30 patients with abnormal pre-treatment PET-CT scans, the post-treatment PET-CT studies were true negative in as early as 2 weeks after the end of chemotherapy cycles and 2 months after the end of radiation therapy. In 5 patients with serial surveillance PET-CT scans over a period of 1-2 years, recurrence was demonstrated before the clinical manifestation of disease leading to early additional treatment with chemotherapy and subsequent PET-CT documentation of favorable response. In another 2 patients, PET-CT demonstrated larger and more hypermetabolically active nodal disease after the initial therapy that prompted a change in the chemotherapeutic regimen with subsequent PET-CT and clinical documentation of response. In 3 patients, PET-CT showed partial response to therapy based on partial decline in the metabolic activity of nodal disease without significant change in the nodal sizes. Overall, PET-CT affected the clinical management of 10 patients (22% of total) by either allowing early therapeutic intervention or a change in treatment regimen.

Serial FDG PET-CT is useful in the early detection of recurrence before clinical manifestation of disease and has a significant impact on the clinical management of up to a quarter of patients with non-Hodgkin s lymphoma. FDG PET-CT may be performed to evaluate for treatment response in as early as 2 weeks after the end of chemotherapy and 2 months after the end of radiation therapy.

Jadvar, H, Xu, A, Tumeh, P, Pollock, J, Nezami, M, Conti, P, Surveillance and Management of Lymphoma with Serial FDG PET-CT.  Radiological Society of North America 2005 Scientific Assembly and Annual Meeting, November 27 - December 2, 2005 ,Chicago IL. http://archive.rsna.org/2005/4407297.html