|
|
|
|
|
|
|
|
Lymphoma
Study Background:
32 year old female with histiologically-proven diffuse large B-cell Non-Hodgkin’s lymphoma of the left upper lung and mediastinum. No bone marrow involvement was found. The patient was treated with six courses of standard chemotherapy and the PET scan was obtained to determine treatment response. A baseline PET study, performed 4 ½ months previously, was used for comparison.
PET Imaging:
Fifty-five minutes after the injection of 640 MBq of 18F-FDG, images of the head, neck, and torso were obtained with a GE Advance tomograph (7 minutes emission, 3 minutes transmission data per bed position). Data were reconstructed using an OSEM algorithm and segmented attenuation correction. The PET study demonstrated markedly increased FDG uptake in the primary mediastinal mass with only minimal diminution in tumor size compared to baseline. Additionally, four foci of significantly increased tracer uptake were found in mediastinal and subcarinal lymph nodes not seen previously with PET.
Discussion:
Diffuse large B-cell lymphoma (DLCL) typically responds well to traditional chemotherapy with over 75% of all patients achieving complete response. Refractory lymphoma is usually attributable to advanced age (>60), bone marrow infiltration, increased serum lactate dehydrogenase, and/or an immunoblastic tumor subtype. Since prognosis for refractory DLCL lymphoma is poor (median survival 10 months), early identification of non-response is critical.
Reference:
Villela L, et al. Prognostic features and outcomes in patients with diffuse large B-cell lymphoma who do not achieve a complete response to first-line regimens.
Cancer 2001 Apr 15;91(8):1557-62.
Images courtesy of:
Lake Hospital Systems, Willoughby OH and
neo•pet, LLC, Oakwood OH
|
|
|
|
|
|
