Early Restaging Positron Emmision Tomography (PET) with 18F-Fluorodeoxyglucose (18FDG)Predicts Outcome in Patients with Aggressive Non-Hodgkin's Lymphoma (NHL)

Reviewer: William Levin, MD
The University of Pennsylvania
Last Modified: December 10, 2001

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Presenter: Karoline Spaepen
Affiliation: Leuven, Belgium

Positron Emission Tomography (PET) with FDG (a radiolabeled sugar molecule) is a nuclear medicine study that is able to detect areas of active cancer by showing areas of increased sugar metabolism.

Materials and Methods
NHL, treated on a doxorubicin chemotherapy regimen underwent PET scan at midtreatment.

  • All patients had an abnormal PET scan prior to treatment.
  • Each scan was reviewed by a group of nuclear medicine physicians.
  • Scans were graded as showing evidence of abnormal uptake or absence of abnormal FDG uptake.


  • After 3-4 cycles of chemotherapy, 33 patients showed persistent abnormal uptake of FDG on PET, whereas 37 pts had a negative scan.
  • 31 of the 37 pts with negative midtreatment scans remained in CR, with a median follow-up of 1107 days.
  • When pts with negative midtreatment PETs were compared to those who had abnormal scans, those who achieved a midtreatment CR had a significantly better progression free survival and overall survival (p<0.00001)
  • PET was also better at predicting survival (OS, PFS) than the International Prognostic Index.

Author's Conclusions
Early PET-FDG restaging at midtreatment may allow for the tailoring of chemotherapy in patients with aggressive NHL.

Clinical/Scientific Implications

  • PET appears to be useful in the evaluation of cancer patients. But one must remeber that the accuracy of these studies is highly dependent on the person interpreting them.
  • Because PET is neither 100% sensitive or specific, results must be used in conjunction with other clinical information.

PET More Sensitive Than CT for Merkel Cell Carcinoma

May 16, 2012 - Fluorine-18-fluorodeoxyglucose positron emission tomography is significantly more sensitive and equally specific compared with traditional computed tomography imaging for evaluation of the regional lymph node basin in patients with Merkel cell carcinoma, according to research published online May 2 in the Journal of the American Academy of Dermatology.

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