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

Lymphoma

Evaluation of the impact of FDG PET and Gallium on the clinical management of patients with low grade non-Hodgkin's lymphoma: A prospective, multi-centre study as part of the Australian PET Data Collection Project

Andrew Scott1, Dish Gunawardana1, Joseph Wong2, Rodney Hicks3, Ian Kirkwood4, Ivan Ho Shon5, Jayne Ramshaw6 and Peter Robbins7

1 Austin Hospital, Melbourne, Victoria, Australia; 2 Wesley Hospital, Brisbane, Queensland, Australia; 3 Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; 4 Royal Adelaide Hospital, Adelaide, South Australia, Australia; 5 Liverpool Hospital, Sydney, New South Wales, Australia; 6 ANZAPNM, Melbourne, Victoria, Australia; 7 Sir Charles Gardiner Hospital, Perth, Western Australia, Australia

539

Objectives: The aims of this study were to assess the impact of 18F-fluorodeoxyglucose (FDG) PET on disease staging, and management, of patients (pts) with previously untreated clinically localised low grade non-Hodgkin's lymphoma (LGNHL), and to compare the relative impact of FDG PET and Gallium on staging and management in these pts.

Methods: Pts with biopsy proven LGNHL (Stage I-III) underwent FDG PET scans. All pts underwent comprehensive staging investigations including including contrast CT scans and bone marrow aspirate. Pre-PET management plans were documented blinded to PET results and management plan changes due to PET scan findings, and clinical follow-up to 12 months, were recorded.

Results: There were 74 pts (37M:37F, median age 58 yrs). PET detected an additional 105 sites of disease (87 lymph node, 18 extra-nodal) in 37 (50%) pts. PET resulted in management change in 25 (33.8%) pts (95% CI 23.0% - 44.6%). A high and medium management impact was seen in 20 (27.0%) and 5 (6.8%) pts respectively. Compared to PET, gallium scans (n=16) detected fewer additional lesions, and had less impact on management plans. Pts with additional lesions detected by PET compared to standard imaging had a significantly inferior disease free survival (p<0.001), and a lower complete response rate (47.2% vs 62.2%).

Conclusions: This study clearly demonstrates that PET changes management plans and provides important prognostic information in pts with untreated LGNHL.





This Article
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Right arrow Articles by Robbins, P.
PubMed
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Right arrow Articles by Robbins, P.