PURPOSE: The use of 18F-fluoro-deoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) in primary gastric lymphoma (PGL) is challenging due to physiologic FDG activity in the stomach and variability in the degree of uptake in various histologic subtypes. This study assesses FDG avidity and PET/CT patterns in newly diagnosed PGL. METHODS: Sixty-two PET/CT studies of newly diagnosed PGL were reviewed (24 low-grade mucosa-associated lymphoid tissue [MALT], 38 aggressive non-Hodgkin's lymphoma [AGNHL]). FDG avidity, patterns (focal/diffuse), and intensity (visually vs. the liver and SUVmax) were assessed and compared to 27 controls. Gastric CT abnormalities and extragastric sites were recorded. RESULTS: Gastric FDG uptake was found in 55/62 (89%) PGL (71% MALT vs. 100% AGNHL, p < 0.001) and 63% controls. A diffuse pattern was found in 60% PGL (76% MALT vs. 53% AGNHL, p = NS) and 47% controls. FDG uptake higher than liver was found in 82% PGL (58% MALT vs. 97% AGNHL, p < 0.05) and 63% controls. SUVmax in FDG-avid PGLs was 15.3 +/- 11.7 (5.4 +/- 2.9 MALT vs. 19.7 +/- 11.5 AGNHL, p < 0.001) and 4.6 +/- 1.4 in controls. CT abnormalities were found in 79% PGL (thickening, n = 49; ulcerations, n = 22). Extra-gastric FDG-avid sites were seen in none of MALT, but 61% of AGNHL (nodal, n = 18; nodal and extranodal, n = 5). CONCLUSIONS: FDG avidity was present in 89% of PGLs, including all patients with AGNHL but only 71% of MALT. FDG uptake can be differentiated, in particular in AGNHL-PGL, from physiologic tracer activity by intensity but not by pattern. Extragastric foci on PET and structural CT abnormalities are additional parameters that can improve PET/CT assessment of PGL. Defining FDG avidity and PET/CT patterns in AGNHL and a subgroup of MALT-PGL before treatment may be important for further monitoring therapy response.
PURPOSE: The use of 18F-fluoro-deoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) in primary gastric lymphoma (PGL) is challenging due to physiologic FDG activity in the stomach and variability in the degree of uptake in various histologic subtypes. This study assesses FDG avidity and PET/CT patterns in newly diagnosed PGL. METHODS: Sixty-two PET/CT studies of newly diagnosed PGL were reviewed (24 low-grade mucosa-associated lymphoid tissue [MALT], 38 aggressive non-Hodgkin's lymphoma [AGNHL]). FDG avidity, patterns (focal/diffuse), and intensity (visually vs. the liver and SUVmax) were assessed and compared to 27 controls. Gastric CT abnormalities and extragastric sites were recorded. RESULTS: Gastric FDG uptake was found in 55/62 (89%) PGL (71% MALT vs. 100% AGNHL, p < 0.001) and 63% controls. A diffuse pattern was found in 60% PGL (76% MALT vs. 53% AGNHL, p = NS) and 47% controls. FDG uptake higher than liver was found in 82% PGL (58% MALT vs. 97% AGNHL, p < 0.05) and 63% controls. SUVmax in FDG-avid PGLs was 15.3 +/- 11.7 (5.4 +/- 2.9 MALT vs. 19.7 +/- 11.5 AGNHL, p < 0.001) and 4.6 +/- 1.4 in controls. CT abnormalities were found in 79% PGL (thickening, n = 49; ulcerations, n = 22). Extra-gastric FDG-avid sites were seen in none of MALT, but 61% of AGNHL (nodal, n = 18; nodal and extranodal, n = 5). CONCLUSIONS:FDG avidity was present in 89% of PGLs, including all patients with AGNHL but only 71% of MALT. FDG uptake can be differentiated, in particular in AGNHL-PGL, from physiologic tracer activity by intensity but not by pattern. Extragastric foci on PET and structural CT abnormalities are additional parameters that can improve PET/CT assessment of PGL. Defining FDG avidity and PET/CT patterns in AGNHL and a subgroup of MALT-PGL before treatment may be important for further monitoring therapy response.
Authors: L Salvagno; M Sorarù; M Busetto; C Puccetti; C Sava; L Endrizzi; M Giusto; S Aversa; V Chiarion Sileni; R Polico; A Bianco; M Rupolo; D Nitti; C Doglioni; M Lise Journal: Tumori Date: 1999 Mar-Apr Impact factor: 2.098
Authors: Sith Phongkitkarun; Vithya Varavithya; Toshiki Kazama; Silvana C Faria; Martha V Mar; Donald A Podoloff; Homer A Macapinlac Journal: World J Gastroenterol Date: 2005-12-14 Impact factor: 5.742
Authors: Heiko Schöder; Ariela Noy; Mithat Gönen; Lijun Weng; David Green; Yusuf E Erdi; Steven M Larson; Henry W D Yeung Journal: J Clin Oncol Date: 2005-04-18 Impact factor: 44.544
Authors: F d'Amore; H Brincker; K Grønbaek; K Thorling; M Pedersen; M K Jensen; E Andersen; N T Pedersen; L S Mortensen Journal: J Clin Oncol Date: 1994-08 Impact factor: 44.544
Authors: Martha Hoffmann; Kurt Kletter; Alexander Becherer; Ulrich Jäger; Andreas Chott; Markus Raderer Journal: Oncology Date: 2003 Impact factor: 2.935