Complete metabolic response (CMR) in positron emission tomography–computed tomography (PET-CT) scans may have prognostic significance in patients with marginal zone lymphomas (MZL)
Ji Hyun Park
Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Search for more papers by this authorShin Kim
Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Search for more papers by this authorJin Sook Ryu
Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Search for more papers by this authorSang-wook Lee
Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Search for more papers by this authorChan-sik Park
Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Search for more papers by this authorJooryung Huh
Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Search for more papers by this authorCorresponding Author
Cheolwon Suh
Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Correspondence
Cheolwon Suh, Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 138-736, Korea.
Email: [email protected]
Search for more papers by this authorJi Hyun Park
Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Search for more papers by this authorShin Kim
Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Search for more papers by this authorJin Sook Ryu
Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Search for more papers by this authorSang-wook Lee
Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Search for more papers by this authorChan-sik Park
Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Search for more papers by this authorJooryung Huh
Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Search for more papers by this authorCorresponding Author
Cheolwon Suh
Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Correspondence
Cheolwon Suh, Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 138-736, Korea.
Email: [email protected]
Search for more papers by this authorAbstract
Although clinical use of positron emission tomography–computed tomography (PET-CT) scans is well established in aggressive lymphomas, its prognostic value in marginal zone lymphoma (MZL) remains yet unclear. Hence, we investigated potential role of PET-CT in predicting MZL patients' outcomes following systemic chemotherapy. A total of 32 patients with MZL who received first-line chemotherapy were included in the analysis. They all underwent pretreatment, interim, and posttreatment PET-CT scans. The primary objective was to evaluate the role of complete metabolic response (CMR) in posttreatment PET-CT scans in predicting progression-free survival (PFS). Compared with non-CMR group, 5-year PFS rate was significantly higher in patients who achieved CMR in posttreatment PET-CT (54.2% vs 0.0%, P = .003) and also in patients gaining CMR in interim PET-CT scans (62.5% vs 15.6%, P = .026). Interestingly, early CMR group, who achieved and maintained CMR in both interim and posttreatment PET-CT scans, showed significantly higher 5-year PFS than those with delayed or never CMR group (62.5% vs 37.5% vs 0%, P = .008). Therefore, interim and/or posttreatment CMR can be prognostic at least in these subsets of patients with MZL treated with chemotherapy.
Supporting Information
Filename | Description |
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HON_2414-Supp-0001-Supplement_170118.docxWord 2007 document , 213.3 KB |
Supplement 1. Patients characteristics by histological subtypes Supplement 2. Comparison of progression-free survival and overall survival between patients with both CMR and CR vs. others in (A, B) interim and (C, D) post-treatment response assessmentss Supplement 3. Progression-free survival and overall survival according to (A, B) achievement of conventional CR in patients with CMR, and (C, D) achievement of CMR in patients with no CR in post-treatment assessment |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
REFERENCES
- 1Seam P, Juweid ME, Cheson BD. The role of FDG-PET scans in patients with lymphoma. Blood. 2007; 110(10): 3507-3516.
- 2Ansell SM, Armitage JO. Positron emission tomographic scans in lymphoma: convention and controversy. Mayo Clin Proc. 2012; 87(6): 571-580.
- 3Kwee TC, Kwee RM, Nievelstein RA. Imaging in staging of malignant lymphoma: a systematic review. Blood. 2008; 111(2): 504-516.
- 4Cheson BD, Pfistner B, Juweid ME, et al. Revised response criteria for malignant lymphoma. J Clin Oncol. 2007; 25(5): 579-586.
- 5Juweid ME, Stroobants S, Hoekstra OS, et al. Use of positron emission tomography for response assessment of lymphoma: aonsensus of the Imaging Subcommittee of International Harmonization Project in Lymphoma. J Clin Oncol. 2007; 25(5): 571-578.
- 6Shankar LK, Hoffman JM, Bacharach S, et al. Consensus recommendations for the use of 18F-FDG PET as an indicator of therapeutic response in patients in National Cancer Institute trials. J Nucl Med. 2006; 47(6): 1059-1066.
- 7Trotman J, Fournier M, Lamy T, et al. Positron emission tomography-computed tomography (PET-CT) after induction therapy is highly predictive of patient outcome in follicular lymphoma: analysis of PET-CT in a subset of PRIMA trial participants. J Clin Oncol. 2011; 29(23): 3194-3200.
- 8Lopci E, Zanoni L, Chiti A, et al. FDG PET/CT predictive role in follicular lymphoma. Eur J Nucl Med Mol Imaging. 2012;
- 9Karam M, Novak L, Cyriac J, Ali A, Nazeer T. Nugent F. Role of fluorine-18 fluoro-deoxyglucose positron emission tomography scan in the evaluation and follow-up of patients with low-grade lymphomas. Cancer. 2006; 175-183.
- 10Jerusalem G, Beguin Y, Najjar F, et al. Positron emission tomography (PET) with 18F-fluorodeoxyglucose (18F-FDG) for the staging of low-grade non-Hodgkin's lymphoma (NHL). Ann Oncol. 2001; 12(6): 825-830.
- 11Park HJ, Park EH, Jung KW, et al. Statistics of hematologic malignancies in Korea: incidence, prevalence and survival rates from 1999 to 2008. Korean J Hematol. 2012; 47(1): 28-38.
- 12Yoon SO, Suh C, Lee DH, et al. Distribution of lymphoid neoplasms in the Republic of Korea: analysis of 5318 cases according to the World Health Organization classification. Am J Hematol. 2010; 85(10): 760-764.
- 13Thieblemont C. Clinical presentation and management of marginal zone lymphomas. Hematology Am Soc Hematol Educ Program. 2005; 307-313.
- 14Weiler-Sagie M, Bushelev O, Epelbaum R, et al. (18)F-FDG avidity in lymphoma readdressed: a study of 766 patients. J Nucl Med. 2010; 51(1): 25-30.
- 15Campo E, Swerdlow SH, Harris NL, Pileri S, Stein H, Jaffe ES. The 2008 WHO classification of lymphoid neoplasms and beyond: evolving concepts and practical applications. Blood. 2011; 117(19): 5019-5032.
- 16Rappaport H, Berard CW, Butler JJ, Dorfman RF, Lukes RJ, Thomas LB. Report of the Committee on Histopathological criteria contributing to staging of Hodgkin's disease. Cancer Res. 1971; 31(11): 1864-1865.
- 17Meignan M, Gallamini A, Haioun C. Report on the first International Workshop on interim-PET-scan in lymphoma. Leuk Lymphoma. 2009; 50(8): 1257-1260.
- 18Wahl RL, Jacene H, Kasamon Y, Lodge MA. From RECIST to PERCIST: evolving considerations for PET response criteria in solid tumors. J Nucl Med. 2009; 50(Suppl 1): 122S-150S.
- 19Cheson BD, Fisher RI, Barrington SF, et al. Recommendations for initial evaluation, staging, and response assessment of Hodgkin and non-Hodgkin lymphoma: the Lugano classification. J Clin Oncol. 2014; 32(27): 3059-3068.
- 20Yi JH, Kim SJ, Choi JY, Ko YH, Kim BT, Kim WS. 18F-FDG uptake and its clinical relevance in primary gastric lymphoma. Hematol Oncol. 2010; 28(2): 57-61.
- 21Enomoto K, Hamada K, Inohara H, et al. Mucosa-associated lymphoid tissue lymphoma studied with FDG-PET: a comparison with CT and endoscopic findings. Ann Nucl Med. 2008; 22(4): 261-267.
- 22Chong EA, Torigian DA, Mato AR, Downs LH, Schuster SJ. Marginal zone lymphoma involving subcutaneous fat: appearance by FDG-PET/CT, MRI, and contrast-enhanced CT imaging. Clin Nucl Med. 2008; 33(10): 692-693.
- 23Perry C, Herishanu Y, Metzer U, et al. Diagnostic accuracy of PET/CT in patients with extranodal marginal zone MALT lymphoma. Eur J Haematol. 2007; 79(3): 205-209.
- 24Liu JD, Tai CJ, Chang CC, Lin YH, Hsu CH. FDG-PET in a patient with gastric MALT lymphoma. Acta Oncol. 2006; 45(6): 750-752.
- 25Hoffmann M, Wohrer S, Becherer A, et al. 18F-Fluoro-deoxy-glucose positron emission tomography in lymphoma of mucosa-associated lymphoid tissue: histology makes the difference. Ann Oncol. 2006; 17(12): 1761-1765.
- 26Ambrosini V, Rubello D, Castellucci P, et al. Diagnostic role of 18F-FDG PET in gastric MALT lymphoma. Nucl Med Rev Cent East Eur. 2006; 9(1): 37-40.
- 27Alinari L, Castellucci P, Elstrom R, et al. 18F-FDG PET in mucosa-associated lymphoid tissue (MALT) lymphoma. Leuk Lymphoma. 2006; 47(10): 2096-2101.
- 28Beal KP, Yeung HW, Yahalom J. FDG-PET scanning for detection and staging of extranodal marginal zone lymphomas of the MALT type: a report of 42 cases. Ann Oncol. 2005; 16(3): 473-480.
- 29Hoffmann M, Kletter K, Becherer A, Jager U, Chott A, Raderer M. 18F-fluorodeoxyglucose positron emission tomography (18F-FDG-PET) for staging and follow-up of marginal zone B-cell lymphoma. Oncology. 2003; 64(4): 336-340.
- 30Hoffmann M, Kletter K, Diemling M, et al. Positron emission tomography with fluorine-18-2-fluoro-2-deoxy-D-glucose (F18-FDG) does not visualize extranodal B-cell lymphoma of the mucosa-associated lymphoid tissue (MALT)-type. Ann Oncol. 1999; 10(10): 1185-1189.
- 31Carrillo-Cruz E, Marin-Oyaga VA, de la Cruz Vicente F, et al. Role of 18F-FDG-PET/CT in the management of marginal zone B cell lymphoma. Hematol Oncol. 2015; 33(4): 151-158.
- 32Schoder H, Noy A, Gonen M, et al. Intensity of 18fluorodeoxyglucose uptake in positron emission tomography distinguishes between indolent and aggressive non-Hodgkin's lymphoma. J Clin Oncol. 2005; 23(21): 4643-4651.
- 33Watanabe R, Tomita N, Takeuchi K, et al. SUVmax in FDG-PET at the biopsy site correlates with the proliferation potential of tumor cells in non-Hodgkin lymphoma. Leuk Lymphoma. 2010; 51(2): 279-283.