Skip to main content
SpringerLink
Log in

Use of FDG-PET to monitor response to chemotherapy and radiotherapy in patients with lymphomas

  • Published:
European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Lymphoma is a heterogeneous group of diseases with many curable subtypes. Primary treatment cures a significant proportion of, but not all, patients. Patients not achieving a complete remission with primary treatment, or those who relapse later, have a second chance of cure with high-dose chemotherapy and haematopoietic stem cell transplantation. Response assessment is therefore crucial in the management of lymphomas. FDG-PET has an emerging role in assessing response, both at the end of and during treatment. This article will review the current published evidence and offer some suggestions on future directions from a clinician’s viewpoint.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Cheson BD, Horning SJ, Coiffier B, Shipp MA, Fisher RI, Connors JM, et al. Report of an international workshop to standardize response criteria for non-Hodgkin’s lymphomas. J Clin Oncol 1999;17:1244–1253

    PubMed  CAS  Google Scholar 

  2. Lewis E, Bernardino ME, Salvador PG, Cabanillas FF, Barnes PA, Thomas JL. Post-therapy CT-detected masses in lymphoma patients: is it viable tissue? J Comput Tomogr 1982;6:972–975

    Google Scholar 

  3. Surbone A, Longo DL, DeVita VT Jr, Ihde DC, Duffey PL, Jaffe ES, et al. Residual abdominal masses in aggressive non-Hodgkin’s lymphoma after combination chemotherapy: significance and management. J Clin Oncol 1988;6:1832–1837

    PubMed  CAS  Google Scholar 

  4. De Wit M, Bumann D, Beyer W, Herbst K, Clausen M, Hossfeld DK. Whole-body positron emission tomography (PET) for diagnosis of residual mass in patients with lymphoma. Ann Oncol 1997;8(Suppl 1):S57–S60

    Article  Google Scholar 

  5. Cremerius U, Fabry U, Neuerberg J, Zinmy M, Osieka R, Buell U. Positron emission tomography with 18F-FDG to detect residual disease after therapy for malignant lymphoma. Nucl Med Commun 1998;19:1055–1063

    Article  PubMed  CAS  Google Scholar 

  6. Bangerter M, Kotzerke J, Greisshammer M, Elsner K, Reske SN, Bergmann L. Positron emission tomography with 18-fluorodeoxyglucose in the staging and follow-up of lymphoma in the chest. Acta Oncol 1999;38:799–804

    Article  PubMed  CAS  Google Scholar 

  7. Bangerter M, Moog F, Greisshammer M, et al. Role of whole-body FDG-PET imaging in predicting relapse of malignant lymphoma in patients with residual masses after treatment. Radiography 1999;5:155–163

    Article  Google Scholar 

  8. Jerusalem G, Beguin Y, Fassotte MF, Najjar F, Paulus P, Rigo P, et al. Whole-body positron emission tomography using 18F-fluorodeoxyglucose for post-treatment evaluation in Hodgkin’s disease and non-Hodgkin’s lymphoma has higher diagnostic and prognostic value than classical computed tomography scan imaging. Blood 1999;94:429–433

    PubMed  CAS  Google Scholar 

  9. Mikhaeel NG, Timothy AR, Hain SF, O’Doherty MJ. 18-FDG-PET for the assessment of residual masses on CT following treatment of lymphomas. Ann Oncol 2000;11(Suppl 1):S147–S150

    Article  Google Scholar 

  10. Mikhaeel NG, Timothy AR, O’Doherty MJ, Hain S, Maisey MN. 18-FDG-PET as a prognostic indicator in the treatment of aggressive non-Hodgkin’s lymphoma, comparison with CT. Leuk Lymphoma 2000;39:543–553

    PubMed  CAS  Google Scholar 

  11. Maisey NR, Hill ME, Webb A, Cunningham D, Flux GD, Padhani A, et al. Are 18fluorodeoxyglucose positron emission tomography and magnetic resonance imaging useful in the prediction of relapse in lymphoma residual masses? Eur J Cancer 2000;36:200–206

    Article  PubMed  CAS  Google Scholar 

  12. Spaepen K, Stroobants S, Dupont P, Van Steenweghen SV, Thomas J, Vandenberghe P, et al. Prognostic value of positron emission tomography with fluorine-18 fluorodeoxyglucose ([18F]FDG) after first-line chemotherapy in non-Hodgkin’s lymphoma: is [18F]FDG-PET a valid alternative to conventional diagnostic methods? J Clin Oncol 2001;19:414–419

    PubMed  CAS  Google Scholar 

  13. Van den Bossche B, Lambert B, De Winter F, Kolindou A, Dierckx RA, Noens L, et al. 18-FDG PET vs high-dose 67Ga scintigraphy for restaging and treatment follow-up of lymphoma patients. Nucl Med Commun 2002;23(11):1079–1083

    Article  Google Scholar 

  14. Filmont J-E, Vranjesevic D, Quon A, Margolis DJA, Ko F, Safaei A, et al. Conventional imaging and 2-deoxy-2-[18F]fluoro-D-glucose positron emission tomography for predicting the clinical outcome of previously treated non-Hodgkin’s lymphoma patients. Mol Imaging Biol 2003;5(4):232–239

    Article  PubMed  Google Scholar 

  15. Lavely WC, Delbeke D, Greer JP, Morgan DS, Byrne DW, Price RR, et al. FDG-PET in the follow-up management of patients with newly diagnosed Hodgkin and non-Hodgkin lymphoma after first-line chemotherapy. Int J Radiat Oncol Biol Phys 2003;57(2):307–315

    Article  PubMed  Google Scholar 

  16. Kumar R, Xiu Y, Potenta S, Mavi A, Zhuang H, Yu JQ, et al. 18F-FDG PET for evaluation of the treatment response in patients with gastrointestinal tract lymphomas. J Nucl Med 2004;45:1796–1803

    PubMed  Google Scholar 

  17. Zinzani PL, Fanti S, Battista G, Tani M, Castellucci P, Stefoni V, et al. Predicitve role of positron emission tomography (PET) in the outcome of lymphoma patients. Br J Cancer 2004;91:850–854

    PubMed  CAS  Google Scholar 

  18. Reinhardt MJ, Herkel C, Altehoefer C, Finke J, Moser E. Computed tomography and 18F-FDG positron emission tomography for therapy control of Hodgkin’s and non-Hodgkin’s lymphoma patients: when do we really need FDG-PET? Ann Oncol 2005;16:1524–1529

    Article  PubMed  CAS  Google Scholar 

  19. Juweid ME, Wiseman GA, Vose JM, Ritchie JM, Menda Y, Wooldridge JE, et al. Response assessment of aggressive non-Hodgkin’s lymphoma by integrated International Workshop Criteria and fluorine-18-fluorodeoxyglucose positron emission tomography. J Clin Oncol 2005;23:4652–4661

    Article  PubMed  Google Scholar 

  20. Spaepen K, Stroobants S, Dupont P, Thomas J, Vandenberghe P, Balzarini J, et al. Can positron emission tomography with (18F)-fluorodeoxyglucose after first-line treatment distinguish Hodgkin’s disease patients who need additional therapy from others in whom additional therapy would mean avoidable toxicity? Br J Haematol 2001;15:272–278

    Article  Google Scholar 

  21. Hueltenschmidt B, Sautter-Bihl ML, Lang O, Bihl H. Whole body positron emission tomography in the treatment of Hodgkin disease. Cancer 2001;91:302–310

    Article  PubMed  CAS  Google Scholar 

  22. Naumann R, Vaic A, Beuthien-Baumann B, Bredow J, Kropp J, Kittner T, et al. Prognostic value of positron emission tomography in the evaluation of post-treatment residual mass in patients with Hodgkin’s disease and non-Hodgkin’s lymphoma. Br J Haematol 2001;115:793–800

    Article  PubMed  CAS  Google Scholar 

  23. Weihrauch MR, Re D, Scheidhauer K, Ansen S, Dietlein M, Bischoff S, et al. Thoracic positron emission tomography using 18F-fluorodeoxyglucose for the evaluation of residual mediastinal Hodgkin disease. Blood 2001;98:2930–2934

    Article  PubMed  CAS  Google Scholar 

  24. De Wit M, Bohuslavizki KH, Buchert R, Bumann D, Clausen M, Hossfeld DK. 18FDG-PET following treatment as valid predictor for disease-free survival in Hodgkin’s lymphoma. Ann Oncol 2001;12:29–37

    Article  PubMed  Google Scholar 

  25. Dittman H, Sokler M, Kollmansberger C, Dohmen BM, Baumann C, Kopp A, et al. Comparison of 18FDG-PET with CT scans in the evaluation of patients with residual and recurrent Hodgkin’s lymphoma. Oncol Rep 2001;8:1393–1399

    Google Scholar 

  26. Jerusalem G, Beguin Y, Fassotte MF, Belhocine T, Hustinx R, Rigo P, et al. Early detection of relapse by whole-body positron emission tomography in the follow-up of patients with Hodgkin’s disease. Ann Oncol 2003;14:123–130

    Article  PubMed  CAS  Google Scholar 

  27. Guay C, Lepine M, Verreault J, Benard F. Prognostic value of PET using 18F-FDG in Hodgkin’s disease for posttreatment evaluation. J Nucl Med 2003;44:1225–1231

    PubMed  Google Scholar 

  28. Panizo C, Perez-Salazar M, Bendandi M, Rodriguez-Calvillo M, Boan JF, Garcia-Celloso MJ, et al. Positron emission tomography using 18F-fluorodeoxyglucose for the evaluation of residual Hodgkin’s disease mediastinal masses. Leuk Lymph 2004;45(9):1829–1833

    Article  Google Scholar 

  29. Filmont J-E, Yap CS, Ko F, Vranjesevic D, Quon A, Margolis DJA, et al. Conventional imaging and 2-deoxy-2-[18F]fluoro-D-glucose positron emission tomography for predicting the clinical outcome of patients with previously treated Hodgkin’s disease. Mol Imaging Biol 2004;6(1):47–54

    Article  PubMed  Google Scholar 

  30. Zinzani PL, Chierichetti F, Zompatori M, Tani M, Stefoni V, Garraffa G, et al. Advantages of positron emission tomography (PET) with respect to computed tomography in the follow-up of lymphoma patients with abdominal presentation. Leuk Lymphoma 2002;43(6):1239–1243

    PubMed  CAS  Google Scholar 

  31. Jerusalem G, Hustinx R, Beguin Y, Fillet G. Evaluation of therapy for lymphoma. Semin Nucl Med 2005;35:186–196

    Article  PubMed  Google Scholar 

  32. Coiffier B, Lepage E, Briere J, Herbrecht R, Tilly H, Boubdallah R, et al. CHOP chemotherapy plus rituximab compared with CHOP alone in elderly patients with diffuse large-B-cell lymphoma. N Engl J Med 2002;346:235–242

    Article  PubMed  CAS  Google Scholar 

  33. Jerusalem G, Beguin Y, Fassotte M-F, Najjar F, Paulus P, Rigo P, et al. Persistent tumour 18F-FDG uptake after a few cycles of polychemotherapy is predictive of treatment failure in non-Hodgkin’s lymphoma. Haematologica 2000;85:613–618

    PubMed  CAS  Google Scholar 

  34. Spaepen K, Stroobants S, Dupont P, Vandenberghe P, Thomas J, de Groot T, et al. Early re-staging positron emission tomography with 18F-fluorodeoxyglucose predicts outcome in patients with aggressive non-Hodgkin’s lymphoma. Ann Oncol 2002;13:1356–1363

    Article  PubMed  CAS  Google Scholar 

  35. Ziljstra JM, Hoekstra OS, Raijhmakers PGHM, Comans EFI, van der Hoeven JJM, Teule GJJ, et al. 18FDG positron emission tomography versus 67Ga scintigraphy as prognostic test during chemotherapy for non-Hodgkin’s lymphoma. Br J Haematol 2003;123:454–462

    Article  Google Scholar 

  36. Friedberg JW, Fischman A, Neuberg D, Kim H, Takvorian T, Ng AK, et al. FDG-PET is superior to gallium scintigraphy in staging and more sensitive in the follow-up of patients with de novo Hodgkin lymphoma. Leuk Lymphoma 2004;45:85–92

    Article  PubMed  Google Scholar 

  37. Torizuka T, Nakamura F, Kanno T, Futatsubashi M, Yoshikawa E, Okada H, et al. Early therapy monitoring with FDG-PET in aggressive non-Hodgkin’s lymphoma and Hodgkin’s lymphoma.Eur J Nucl Med Mol Imaging 2004;31:22–28

    Article  PubMed  Google Scholar 

  38. Haioun C, Itti E, Rahmouni A, Brice P, Rain J-D, Belhadj K, et al. [18F]fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) in aggressive lymphoma: an early prognostic tool for predicting patient outcome. Blood 2005;106:1376–1381

    Article  PubMed  CAS  Google Scholar 

  39. Mikhaeel NG, Hutchings M, Fields P, O’Doherty MJO, Timothy AR. FDG-PET after two to three cycles of chemotherapy predicts progression-free and overall survival in high-grade non-Hodgkin lymphoma. Ann Oncol 2005;16:1514–1523

    Article  PubMed  CAS  Google Scholar 

  40. Hutchings M, Mikhaeel NG, Fields PA, Nunan T, Timothy AR. Prognostic value of interim FDG-PET after two or three cycles of chemotherapy in Hodgkin lymphoma. Ann Oncol 2005;16:1160–1168

    Article  PubMed  CAS  Google Scholar 

  41. Hutchings M, Loft A, Hansen M, Pederson LM, Buhl T, Jurlander J, et al. FDG-PET after two cycles of chemotherapy predicts treatment failure and progression-free survival in Hodgkin lymphoma. Blood 2006;107:52–59

    Article  PubMed  CAS  Google Scholar 

  42. http://www.ncrn.org.uk/portfolio/dbase.asp?GroupID=9

  43. Romer W, Hanauske A, Ziegler S, Thodtmann R, Weber W, Fuchs C, et al. Positron emission tomography in non-Hodgkin’s lymphoma: assessment of chemotherapy with fluorodeoxyglucose. Blood 1998;91:4464–4471

    PubMed  CAS  Google Scholar 

  44. Kostakoglu L, Coleman M, Leonard J, Kuji I, Zoe H. PET predicts prognosis after 1 cycle of chemotherapy in aggressive lymphoma and Hodgkin’s disease. J Nucl Med 2002;43:1018–1027

    PubMed  Google Scholar 

  45. Spaepen K, Stroobants S, Dupont P, Vandenberghe P, Maertens J, Bormans G, et al. Prognostic value of pretransplantation positron emission tomography using fluorine 18-fluorodeoxyglucose in patients with aggressive lymphoma treated with high-dose chemotherapy and stem cell transplantation. Blood 2003;102:53–59

    Article  PubMed  CAS  Google Scholar 

  46. Cremerius U, Fabry U, Wildberger JE, Zimny M, Reinartz P, Nowak B, et al. Pre-transplant positron emission tomography (PET) using fluorine-18-fluoro-deoxyglucose (FDG) predicts outcome in patients treated with high-dose chemotherapy and autologous stem cell transplantation for non-Hodgkin’s lymphoma. Bone Marrow Transplant 2002;30:103–111

    Article  PubMed  CAS  Google Scholar 

  47. Becherer A, Mitterbauer M, Jaeger U, Kalhs P, Greinix HT, Karanikas G, et al. Positron emission tomography with(18F)2-fluorodeoxyglucose (FDG-PET) predicts relapse of malignant lymphoma after high-dose therapy with stem cell transplantation. Leukaemia 2002;16:260–267

    Article  CAS  Google Scholar 

  48. Hart DP, Avivi I, Thomson KJ, Peggs KS, Morris EC, Goldstone AH, et al. Use of 18F-FDG positron emission tomography following allogeneic transplantation to guide adoptive immunotherapy with donor lymphocyte infusions. Br J Haematol 2005;128:824–829

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Clinical Oncology, Guy’s and St. Thomas’ Hospital, London, SE1 7EH, UK

    N. George Mikhaeel

Authors
  1. N. George Mikhaeel
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to N. George Mikhaeel.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Mikhaeel, N.G. Use of FDG-PET to monitor response to chemotherapy and radiotherapy in patients with lymphomas. Eur J Nucl Med Mol Imaging 33 (Suppl 1), 22–26 (2006). https://doi.org/10.1007/s00259-006-0132-4

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00259-006-0132-4

Keywords

Search

Navigation