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J Nucl Med. 2008; 49 (Supplement 1):135P
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General Clinical Specialties: General Practice-Oncology

Lymphoma

Quantitative assessment of tumor response in patients with lymphoma and bone marrow involvement by PET/CT

Behnaz Goudarzi1, Heather Jacene1 and Richard Wahl1

1 Johns Hopkins University, Baltimore, Maryland

536

Objectives: To assess response of lymphoma in bone marrow (BM) using FDG PET and compare these results to the PET and anatomic response seen in "measurable" lymph node (LN) tumors to determine if BM disease is assessable for response by PET/CT criteria.

Methods: Twenty-seven patients with histologically proven aggressive lymphoma and FDG-avid lesions in BM and at least one involved LN on the baseline scan were retrospectively identified (mean age 45 ± 21 y; 20 male; 18 NHL and 9 HL). The levels of FDG uptake in 6 target LN and 6 FDG-avid BM foci were determined pre and post therapy using the maximum standardized uptake value (SUVmax). LN size (mm) was also determined in the 6 target lesions pre and post therapy and is reported as the sum of the products of the longest and perpendicular dimensions (SPD). The correlation between percent decrease in LN size and percent decrease in SUV post therapy was determined for LN and BM foci using the Pearson correlation coefficient.

Results: Mean SUVmax of LN and LN size was significantly less post vs. pre- therapy (1.02 ± 1.00 vs. 6.71 ± 4.91 and 322 ± 317 vs. 2,360 ± 1,786, p<0.0001, respectively). SUVmax of BM foci also decreased significantly after therapy (6.81 ± 4.58 to 1.84 ± 1.58, p<0.0001). Strong correlations were observed between the percentage declines of LN size and LN SUVmax (r=0.85, p<0.0001) and BM SUVmax and LN SUVmax (r=0.73, p<0.0001). A positive correlation between percentage decrease in LN size and BM SUVmax was also seen (r=0.56, p = 0.002).

Conclusions: Using a semi-quantitative analysis of FDG uptake, foci of lymphoma in BM behave similarly to disease in LN in response to therapy. In response assessment of lymphoma, FDG PET/CT is a useful technique for monitoring lesions, such as BM, which were previously considered to be "unmeasureable" by imaging.





This Article
Services
Right arrow Email this article to a friend
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Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Google Scholar
Right arrow Articles by Goudarzi, B.
Right arrow Articles by Wahl, R.
PubMed
Right arrow Articles by Goudarzi, B.
Right arrow Articles by Wahl, R.