18F-FDG positron emission tomography in the diagnosis and staging of marginal zone non-Hodgkin lymphomas

Objective: to investigate the diagnostic value of 18F-FDG positron  emission tomography (PET) in the diagnosis and staging of marginal zone non-Hodgkin lymphomas (NHLs).

Objective: to investigate the diagnostic value of 18F-FDG positron  emission tomography (PET) in the diagnosis and staging of marginal zone non-Hodgkin lymphomas (NHLs).

Material and methods. Twenty-four patients with new-onset NHLs were examined. Extranodal MALT lymphoma, splenic marginal zone  lymphoma (MZL), and nodal MZL lymphoma were diagnosed in 18, 3, and 3 patients, respectively. 18F-FDG PЕT was carried out by the standard protocol via whole-body examination, by estimating the  standardized tracer uptake value (SUVmax) in the abnormal foci.

Results. Most (83.3%) of the examinees were found to have abnormal tracer hyperfixation foci. The mean SUVmax was 5.05±0.9. There was no correlation between SUVmax in the tumor foci and their metabolic sizes (r = 0.1; p = 0.7). No significant differences between the mean SUVmax were found in patients with different histological types of MZL (p > 0.05). Disease staging by PET and other diagnostic methods yielded  contradictory results in three patients. The final analysis suggested that the stage had been correctly determined in all the 3 patients from PET findings.

Conclusion. The results of 18F-FDG PET suggest that it is of high diagnostic value in imaging marginal zone NHLs. The major advantage of PET is that it can accurately stage the disease, which can provide a rationale for optimal treatment policy.

1. Ferreri A.J., Zucca E. Marginal-zone lymphoma. Crit. Rev. Oncol. Hematol.2007; 63 (3): 245–56.

2. Bertoni F., Zucca E. State-of-the-art therapeutics: marginal-zone lymphoma. J. Clin. Oncol. 2005; 23 (26): 6415–20.

3. Copie-Bergman C., Wotherspoon A. MALT lymphoma pathology, initial diagnosis, and posttreatmentev aluation. In: Cavalli F., Stein H., Zucca E. (eds). Extranodal lymphomas pathology and management. London: Informa Health Care; 2008: 114–23.

4. Ferrucci P.F., Zucca E. Primary gastric lymphoma pathogenesis and treatment: what has changed over the past 10 years? Br. J. Haematol. 2007; 136 (4): 521–38.

5. Raderer M., Vorbeck F., Formanek M., Osterreicher C., Valencak J., Penz M. et al. Importance of extensive staging in patients with mucosaassociated lymphoid tissue (MALT)- type lymphoma. Br. J. Cancer. 2000; 83 (4): 454–7.

6. O’Doherty M.J., Hoskin P.J. Positron emission tomography in the management of lymphomas: a summary. Eur. J. Nucl. Med. Mol. Imag. 2003; 30 (1, Suppl): 128–30.

7. Hoskin P.J. PET in lymphoma: what are the oncologist’s need. Eur. J. Nucl. Med. Mol. Imag. 2003; 30 (1, Suppl): 37–41.

8. Wohrer S., Jaeger U., Kletter K., Becherer A., Hauswirth A., Turetschek K. et al. 18F-fluoro-deoxy-glucose positron emission tomography (18F-FDG-PET) visualizes follicular lymphoma irrespective of grading. Ann. Oncol. 2006; 17 (5): 780–4.

9. Gill S., Wolf M., Prince H.M., Januszewicz H., Ritchie D., Hicks R.J. et al. [18F] Fluorodeoxyglucose positron emission tomography scanning for staging, response assessment, and disease surveillance in patients with mantle cell lymphoma. Clini. Lymph. Myel. 2008; 8 (3): 159–65.

10. Michallet A.S., Trotman J., TychyjPinel C. Role of early PET in the management of diffuse large B-cell lymphoma. Curr. Opin. Oncol. 2010; 22 (5): 414–8.

11. Hoffmann M., Kletter K., Diemling M., Becherer A., Pfeffel F., Petkov V. et al. Positron emission tomography with fluorine-18-2-fluoro-2-deoxy-D-glucose (F18-FDG) does not visualize extranodal B-cell lymphoma of the mucosa-associated lymphoid tissue (MALT)-type. Ann. Oncol. 1999; 10 (10): 1185–9.

12. Hoffmann M., Kletter K., Becherer A., Jдger U., Chott A., Raderer M. et al. 18F-fluorodeoxyglucose positron emission tomography (18F-FDGPET) for staging and follow-up of marginal zone B-cell lymphoma. Oncology. 2003; 64 (4): 336–40.

13. Schoder H., Noy A., Gonen M., Weng L., Green D., Erdi Yu.E. et al. Intensity of 18fluorodeoxyglucose uptake in positron emission tomography distinguishes between indolent and aggressive non-Hodgkin’s lymphoma. J. Clin. Oncol. 2005; 23 (21): 4643–51.

14. Khodzhibekova M.M. Role of positron emission tomography with 18F-FDG in predicting malignancy grade of non-Hodgkin’s Lymphoma. Radiologiya-praktika. 2014; 1: 31–7 (in Russian).

15. Beal K.P., Yeung H.W., Yahalom J. FDG-PET scanning for detection and staging of extranodal marginal zone lymphomas of the MALT type: a report of 42 cases. Ann. Oncol. 2005; 16 (3): 473–80.

16. Elstrom R., Guan L., Baker G., Nakhoda Kh., Vergilio J.A., Zhuang H. et al. Utility of FDG-PET scanning in lymphoma by WHO classification. Blood. 2003; 101 (10): 3875–6.