Value of Pretherapeutic 18F-FDG PET/CT in the Diagnosis, Staging and Prognosis Evaluation of Adult Burkitt's Lymphoma

Abstract

To investigate the value of pretherapeutic 18F-FDG PET/CT in the focus detection, staging and prognosis evaluation of adult Burkitt's lymphoma(BL). The clinical data and detection results of 18F-FDG PET/CT scan of 18 patients with BL before the treatment from December 2008 to February 2015 were analyzed retrospectively. The lesions distribution were observed, the maximal standard uptake value(SUVmax) of 18F-FDG by lesions and the maximal diameter of lymph nodes were measured. One-way analysis of variance was used to analyze the SUVmax, and the Spearman correlation was used to analyze the relationship between SUVmax and the maximum diameter of lymph nodes. The prognostic factors were analyzed by using Kaplan-Meier survival analysis. 18F-FDG PET/CT showed 100% positive detection rate for 18 adults with BL, lymph nodal lesions were found in all the patients, and the most common area was lymphonodi coeliaci (9/18, 50%), 8 cases showed extranodal soft tissue involvement, 6 cases showed gastrointestinal tract, bone marrow involvement was detected in 7 cases, out of which the mutiple-focal involvement was found in 4 cases. The median SUVmax of lymph nodes, extranodal soft tissue and bone marrow was 11.7 (range of 3.4 to 28.5), 9.85 (range of 6.7 to 21.9) and 11.8(range of 5.6 to 23.8), respectively, there were no significant differences among these 3 types of lesions (F=1.013, P=0.369). And the median SUVmax of all lesions was 16.5 (range of 8.8 to 28.5). The clinical staging of 2 patients (2/8, 11.1%) was changed by 18F-FDG PET/CT imaging. The univariate analysis revealed that only the IPI (international prognostic index) could be the prognostic factor (χ2=6.602, P=0.010), but the prognosis was not different between the patients below and above the median SUVmax of all lesions and lymph node (all P>0.05). BL in adult is an intensely 18F-FDG-avid tumor, the 18F-FDG PET/CT is an effective imaging tool for the detection and staging of this disease. In our study, the prognostic value of pretherapeutic 18F-FDG PET/CT still is unclear, that is not recommended for the prognosis of the adult BL patients.