Uptake of [18F]fluorodeoxyglucose in initial positron-emission tomography predicts survival in MALT lymphoma.

The role of [18F]fluorodeoxyglucose (FDG) positron-emission tomography (PET) in mucosa-associated lymphoid tissue (MALT) of marginal zone lymphoma remains poorly defined. We correlated initial PET with pathology, clinical factors, and outcome. From January 2001 to July 2012, 173 MALT lymphoma patients with a biopsied lesion identified on PET within 90 days of tissue biopsy were analyzed. PET positivity and intensity of FDG uptake were correlated with clinical factors and patient outcome. Among 173 accrued cases, biopsied site was PET avid in 123 patients (71%); median standardized uptake value (SUV) was 6.0 (range: 0.7-28.0), and SUV >10.0 in 20 patients (16%). PET avidity varied by organ sites. PET positivity correlated with higher International Prognostic Index, but not with 5-year overall survival (OS; 96% vs 88%, PET negative vs positive, P = .229) or 5-year progression-free survival (67% vs 56%, P = .493). SUV was an independent prognostic factor of OS, and an increased SUV was associated with a decreasing 5-year OS. Patients who presented with SUV ≥10 had a higher rate of subsequent large cell transformation (20% vs 5%, P = .035) and inferior OS (78% vs 92%, P = .008). The exact role of FDG PET in the management of MALT lymphoma, beyond initial staging, remains to be defined.

Clinical perspectives regarding patients with internal auditory canal or cerebellopontine angle lesions: surgical and radiation oncology perspectives.

The management of patients with cerebellopontine angle (CPA) or internal auditory canal (IAC) lesions is presented from the surgical and radiation oncology perspective. A full appreciation of the treatment options these patients experience is important so that their pre- and post-operative imaging exams may be understood and interpreted correctly. This article discusses in detail the clinical management of these patients.