Use of FDG-PET/CT for systemic assessment of suspected primary central nervous system lymphoma: a LOC study
| Autor: | M. Bertaux, Caroline Houillier, Sébastien Bergeret, Khê Hoang-Xuan, Veronique Edeline, Valérie Touitou, Sylvain Choquet, Nathalie Cassoux, Alain Giron, Aurélie Kas, Marie-Odile Habert, Carole Soussain, Karima Mokhtari |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male Cancer Research medicine.medical_specialty Neurology Lymphoma Sensitivity and Specificity Central Nervous System Neoplasms 03 medical and health sciences 0302 clinical medicine Bone Marrow Fluorodeoxyglucose F18 hemic and lymphatic diseases Positron Emission Tomography Computed Tomography Biopsy Medicine Humans Aged Retrospective Studies Aged 80 and over medicine.diagnostic_test business.industry Primary central nervous system lymphoma Middle Aged medicine.disease Image Enhancement Occult medicine.anatomical_structure Oncology 030220 oncology & carcinogenesis Concomitant Female Neurology (clinical) Radiology Bone marrow business 030217 neurology & neurosurgery Rare disease |
| Zdroj: | Journal of neuro-oncology. 148(2) |
| ISSN: | 1573-7373 |
| Popis: | Primary Central Nervous System Lymphoma (PCNSL) is a rare disease with different therapeutic implications than systemic lymphoma. In this study, we evaluated whole-body 18FDG-PET/CT for pre-chemotherapy imaging of suspected PCNSL. One hundred and thirty consecutive immunocompetent patients were retrospectively included. The results of initial 18FDG-PET/CT, contrast-enhanced CT (CeCT) and bone marrow biopsy (BMB) when available were compared to a gold standard based on pathological diagnosis or follow-up. CNS lesion pathology showed large B-cell lymphoma in 95% of patients, including 11 patients with primary vitro-retinal lymphoma. Ten patients (8%) where ultimately diagnosed with systemic lymphoma involvement, including five pathologically confirmed cases, all of which were detected by 18FDG-PET/CT. 18FDG-PET/CT showed incidental systemic findings unrelated to lymphoma in 14% of patients. An SUVmax threshold of nine enabled good discrimination between systemic lymphoma and other lesions (sensitivity 92% and specificity 89%). CeCT and BMB performed in 108 and 77 patients respectively revealed systemic lesions in only three patients. 18FDG-PET/CT detected concomitant occult systemic involvement in a non-negligible proportion of suspected PCNSL cases (8%). In this setting its sensitivity is higher than that of CeCT. All of our patients ultimately diagnosed with concomitant systemic involvement had positive 18FDG-PET/CT. We believe it constitutes a safe one-stop shop evaluation for the systemic pre-treatment imaging of suspected PCNSL. |
| Databáze: | OpenAIRE |
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