Features of Imaging of Different Types of Hodgkin’s Lymphoma Using Combined Positron Emission and Computed Tomography

AS Subbotin1, NG Afanas’eva2

1 Chelyabinsk District Clinical Oncological Dispensary, 42 Blyukhera str., Chelyabinsk, Russian Federation, 454087

2 South Ural State Medical University, 64 Vorovskogo str., Chelyabinsk, Russian Federation, 454092

For correspondence: Aleksei Sergeevich Subbotin, 42 Blyukhera str., Chelyabinsk, Russian Federation, 454087; e-mail: acsubbotin@yandex.ru

For citation: Subbotin AS, Afanas’eva NG. Features of Imaging of Different Types of Hodgkin’s Lymphoma Using Combined Positron Emission and Computed Tomography. Clinical oncohematology. 2017;10(1):61–4(In Russ).

DOI: 10.21320/2500-2139-2017-10-1-61-64


ABSTRACT

Background & Aims. At present, PET-CT has an important clinical significance in Hodgkin’s lymphoma (HL) and is used both for initial tumor staging and restaging and for the evaluation of treatment efficacy. Published data indicate the possible lack of radiotracer accumulation in the tumor tissue in HL before primary treatment. A low metabolic activity of the tumor tissue prior to treatment makes it difficult to assess the treatment dynamics during the anti-tumor therapy. The aim of this work is to determine the incidence of the low metabolic activity of tumor tissue in HL.

Methods. Findings of 131 18F-fluorodeoxyglucose (FDG) whole body PET-CT scans of patients with histologically verified HL (over the period from 2011 to 2015) were studied retrospectively. Patterns of FDG accumulation in different histological types of HL, as well as the levels of metabolic activity in patients with tumor-related toxicity symptoms (B-symptoms) were studied.

Results. The low metabolic activity was detected in 4 % of patients with de novo HL. The highest levels of metabolic activity were detected in nodular sclerosis and the lowest ones in nodular lymphocyte-predominant HL. Higher levels of radiotracer metabolic activity were observed in patients with general symptoms.

Conclusion. In general, a high metabolic activity of the neoplasm is typical for HL. Primary staging before the treatment should be performed for a more accurate evaluation of dynamics of HL treatment outcomes, because in a number of cases a baseline low FDG accumulation in the neoplasm may imitate the absence of a viable tumor tissue in the affected lymph nodes at assessment of treatment results.

Keywords: Hodgkin’s lymphoma, histological types, PET-CT, 18F-fluorodeoxyglucose.

Received: August 25, 2016

Accepted: December 19, 2016

Read in PDF (RUS)pdficon


REFERENCES

  1. Ильин Н.В., Виноградова Ю.Н. Отдаленные последствия лучевой и комбинированной терапии больных лимфомой Ходжкина. Клиническая онкогематология. 2008;1(2):131–5.
    [Ilyin NV, Vinogradova YuN. Late side effects after radio- and combined therapy in patients with Hodgkin’s lymphoma. Klinicheskaya onkogematologiya. 2008;1(2):131–5. (In Russ)]
  2. Курпешев О.К., Павлов В.В., Шкляев С.С. Эффективность локальной гипертермии при химиотерапевтическом и/или лучевом лечении рецидивов лимфомы Ходжкина. Сибирский онкологический журнал. 2013;4(58):28–30.
    [Kupreshev OK, Pavlov VV, Shklyaev SS. Efficacy of local hyperthermia in chemotherapy and/or radiation therapy for recurrences of Hodgkin’s lymphoma. Sibirskii onkologicheskii zhurnal. 2013;4(58):28–30. (In Russ)]
  3. Гранов А.М., Ильин Н.В. (ред.) Лимфомы. СПб.: РНЦРХТ, 2010. С. 222–40.
    [Granov AM, Il’in NV, eds. Limphomy. (Lymphomas.) Saint Petersburg: RNCRHT Publ.; 2010. pp. 222–40. (In Russ)]
  4. Biggi A, Gallamini A, Chauvie S, et al. International validation study for interim PET in ABVD-treated, advanced-stage Hodgkin lymphoma: interpretation criteria and concordance rate among reviewers. J Nucl Med. 2013;54(5):683–90. doi: 10.2967/jnumed.112.110890.
  5. Barrington SF, Mikhaeel NG, Kostakoglu L, et al. Role of imaging in the staging and response assessment of lymphoma: consensus of the International Conference on Malignant Lymphomas Imaging Working Group. J Clin Oncol. 2014;32(27):3048–58. doi: 10.1200/jco.2013.53.5229.
  6. Cheson BD, Fisher RI, Barrington SF, et al. Recommendations for initial evaluation, staging, and response assessment of Hodgkin and non-Hodgkin lymphoma: the Lugano classification. J Clin Oncol. 2014;32(27):3059–68. doi: 10.1200/jco.2013.54.8800.
  7. Труфанов Г.Е., Рязанов В.В., Дергунова Н.И. и др. Совмещенная позитронно-эмиссионная и компьютерная томография (ПЭТ-КТ) в онкологии. СПб.: ЭЛБИ-СПб, 2005. 124 c.
    [Trufanov GE, Ryazanov VV, Dergunova NI, et al. Sovmeschennaya pozitronno-emissionnaya i kompyuternaya tomographiya (PET-KT) v onkologii. (Combined positron emission and computed tomography (PET-CT) in oncology.) Saint-Petersburg: ELBI-SPb.; 2005. 124 p. (In Russ)]
  8. Weiler-Sagie M, Bushelev O, Epelbaum R, et al. 18F-FDG Avidity in Lymphoma Readdressed: A Study of 766 Patients. J Nucl Med. 2010;51(1):25–30. doi: 10.2967/jnumed.109.067892.
  9. Tsukamoto N, Kojima M, Hasegawa M, et al. The usefulness of 18F-fluorodeoxyglucose positron emission tomography (18F-FDG-PET) and a comparison of 18F-FDG-PET with 67gallium scintigraphy in the evaluation of lymphoma: relation to histologic subtypes based on the World Health Organization classification. Cancer. 2007;110(3):652–9. doi: 10.1002/cncr.22807.
  10. Elstrom R, Guan L, Baker G, et al. Utility of FDG-PET scanning in lymphoma by WHO classification. Blood. 2003;101(10):3875–6. doi: 10.1182/blood-2002-09-2778.