Role of Fluorine 18 Fluorodeoxy-Glucose (FDG) Positron Emission Tomography (PET)/ Computed Tomography (CT) in evaluation of lymphoma patients

Abstract

Background: Malignant lymphoma is considered the most common hematological malignancy. Lymphoma is divided into Hodgkin’s disease and non-Hodgkin’s lymphoma. Non-Hodgkin’s lymphoma forms most cases with more affinity to involve extra-nodal sites. The objective of the study was to highlight the role of 18F-FDG Positron Emission Tomography (PET)/ Computed tomography (CT) in evaluation & follow up cases of Lymphoma.

Methods: This prospective study was performed from January-2021 to May-2022 for staging and therapeutic assessment of lymphoma. Biopsy results were the gold standard, which compared with CT and PET/CT results.

Results: Out of 48 cases in our study came for initial staging, assessment of treatment and follow up. PET/CT showed the same results as CT in 28 cases with no changes, while 20 cases showed discordant results with CT, mostly showing changes in FDG uptake of previously noted lesions in follow up patients, which was statistically significant. PET-CT detected additional extra nodal involvement than CT in 15 cases: 6 cases splenic infiltration, 3 bone marrow and musculoskeletal lesions, 2 hepatic, 1 gastric, 1 nasal, 1 CNS and 1 breast lesion.

Conclusions: The present findings revealed the significance of 18F-FDG PET/CT as a potential method in lymphoma initial staging. PET/CT had remarkable indications in evaluation of treatment feedback as
compared to conventional CT. PET/CT is highly specific and permits definite localization of remanent masses and detects active tumor within residual mass. PET/CT was also helpful in detection of early relapsing lymphomas in both HD and NHL.