Abstract
BackgroundLymphoma incorporates histologically variable cancers derived from the immune system cells. The distinctive feature of lymphoma is the rapid increase in size and number of lymph nodes and/or secondary lymphoid tissues.The aim of the work is to evaluate the accuracy of PET/CT vs CECT in the assessment of response to therapy in lymphoma patients: both early and late therapeutic response assessment.This retrospective study was conducted on 80 patients with different types of lymphoma recruited and enrolled from a university hospital. All 80 patients underwent pre-treatment, during the course of chemotherapy and at the end of planned treatment contrast-enhanced СT (СEСT) and PET-СT. Interpretation of the СEСT and the fusion images PET/СT each was done separately and comparison of the results was achieved.ResultsPET/CT and contrast-enhanced computed tomography were concurrent in results in 55% of cases during treatment and 75% at the end of treatment with CT sensitivity of 61.1%, specificity of 92.2%, and accuracy of 76.2% during treatment in comparison to 100% sensitivity and specificity of PET/CT. Sensitivity of CT at end of treatment was 57.5%, specificity 86.7%, and accuracy 71.6% as compared to 100% sensitivity and specificity of PET/CT.ConclusionPET/СT using 2-deoxy-2-[18F] fluoro-d-glucose is considered one of the best oncologic imaging modalities at the time being with valuable applications in lymphoma. It is very efficient with least possible pitfalls and false results compared to either of its components alone and to side by side reading of separately acquired PET and СT. PET/CT can detect both anatomical information as well as metabolical information providing more data and thus giving more accurate results than CECT. It is becoming а standard modality for lymphoma providing а new vision to management and treatment plan.
Highlights
Lymphoma incorporates histologically variable cancers derived from the immune system cells
In first follow-up during the course of chemotherapy, out of the 80 cases, 18F-FDG positron emission tomography (PET)/computed tomography (CT) and Contrast-enhanced computed tomography (CECT) were concurrent in results in 44 out of the 80 cases (55%) and discordant in the other cases (45% n = 36) detailed as follows: CECT detected complete regression in 12 cases (15%), partial regression in 60 cases (75%), stationary course in 0 cases (0%), and progression in 8 cases (10%), while 18F-FDG PET/CT detected complete regression in 48 cases (60%), partial regression in 24 cases (30%), stationary course in 0 case (0%), and progression in 8 case (10%) (Tables 5 and 6)
In the follow-up study during treatment, our study revealed that the results of PET and CT were concordant in 44 patients [12 complete responses (CR), 24 partial responses (PR), and 8 progressive diseases (PD)]
Summary
Lymphoma incorporates histologically variable cancers derived from the immune system cells. The aim of the work is to evaluate the accuracy of PET/CT vs CECT in the assessment of response to therapy in lymphoma patients: both early and late therapeutic response assessment. PET/CT with [18F]FDG is considered one of the most widely used imaging techniques to evaluate both early and late treatment response during as well as after therapy in patients suffering from lymphomas [3]. PET/CT using (18F) FDG is considered one of the functional imaging techniques used to assess the glucose metabolism in vivo; its use has been widely increased in the evaluation of oncology patients being highly sensitive in assessment of malignancy as PET/CT can detect malignancy prior to morphological changes [4]
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