Grading, staging and prognosis of follicular lymphoma: the value of 18F-FDG PET/CT / 中华核医学与分子影像杂志

ABSTRACT

Objective To evaluate the value of 18F-FDG PET/CT in histological grading and staging of follicular lymphoma (FL) and prediction of prognosis after first-line treatment.Methods From May 2007 to April 2013,24 patients (11 males,13 females; median age 55 years) with histopathological proof of FL were retrospectively studied.All patients were evaluated by 18F-FDG PET/CT before the first-line treatment and were divided into indolent FL and aggressive FL according to their histological grades and clinical stages.The sensitivity,specificity and SUVmax were calculated.Analysis of variance of factorial design was used to analyze the data.Within the same study period,18F-FDG PET/CT was also performed in 16 FL patients (9 males,7 females; median age 50.5 years) after first-line treatment (7/16 patients belonged to the aforementioned group with pretreatment PET/CT performed) ; and they were then divided into PET/CTpositive and PET/CT-negative groups.All 16 patients were followed for 6-49 months to evaluate the prognosis.The rates of overall survival (OS) and progression-free survival (PFS) were calculated.Results (1)The sensitivities of PET/CT in indolent and aggressive FL were 92.3％ (12/13) and 100％ (11/11),respectively.The SUVmax was 5.26± 1.70 vs 9.54±5.09 (F=5.196,P＜0.05).(2) According to PET/CT,3patients(12.5％,3/24) were upstaged from Ⅰ-Ⅱ to Ⅲ-Ⅳ,and 2 patients(8.3％,2/24) were downstaged from Ⅲ-Ⅳ to Ⅰ-Ⅱ.The SUVmax of stage Ⅰ-Ⅱ and Ⅲ-Ⅳ FL was 5.22±2.92 and 8.04±4.46(F=2.904,P＞0.05).(3)For the 16 FL patients with PET/CT after first-line treatment,the negative and positive groups had different OS and PFS.The 6-month OS,1-year OS and 3-year OS were 100％(13/13),9/9,4/5,respectively for the negative group,and 2/3,2/3,1/2,respectively for the positive group; while the corresponding 6-month PFS,1-year PFS and 3-year PFS were 92.3 ％ (12/13),8/9,3/5 and 2/3,0/3,0/2,respectively.Conclusions 18F-FDG PET/CT is valuable in the evaluation of histological grading and clinical staging of FL patients and in the prediction of prognosis after fist-line treatment.