Abstract
6584 Purpose: FDG PET is recommended for the initial evaluation and staging of patients with non-Hodgkin's lymphoma (NHL). We investigated whether the intensity of tumor FDG uptake in NHL is significantly different between indolent and aggressive histology. Materials and Methods: We studied a retrospective cohort of lymphoma patients with NHL, attended at a single tertiary care center from April 2003 to November 2006 and who had not received treatment. We reviewed the initial, re-staging and/or relapse PET studies of 50 patients with diagnosis of NHL. Mean age 42 (15 to 72) years, 27 female and 23 male. We recorded the highest standardized uptake value (SUV), correlations were made with histopathology. We analyzed SUVs considering the various histologies and grades. Two sample comparisons were performed using the Wilcoxon test. Results: The histopathological diagnoses were: diffuse large B-cell lymphomas (26 patients), anaplastic large cell lymphoma (7 patients), Follicular lymphoma (14 patients), and other types (3 patients, 1 MALT, 1 Burkitt and 1 small cell Burkitt-like). FDG uptake was lower in indolent (15 patients) than aggressive lymphoma (35 patients) (SUV, mean 6.2, SD  ± 1.7, mean rank 15.47, sum of ranks 232 vs 12.9  ± 7.4, mean rank 29.8, sum of ranks 1,043; P=.001). Despite overlap between indolent and aggressive disease in the low SUV range (indolent 3.7 to 9.3; aggressive 3.2 to 24.9) all cases of indolent lymphoma had an SUV ≤ 9.3. Conclusion: FDG uptake is significantly lower in indolent than in aggressive lymphoma. Patients with NHL and SUV > 10 have a high likelihood for aggressive disease. As with other retrospective studies, this information should be confirmed prospectively, but this data allows formulating new hypothesis about correlations between the SUV, the molecular subtypes and the clinical behaviour of the lymphomas No significant financial relationships to disclose.
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