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The prognostic value of mid- and post-treatment [18F]fluorodeoxyglucose (FDG) positron emission tomography (PET) in indolent follicular lymphoma

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Abstract

Background

[18F]fluorodeoxyglucose positron emission tomography (PET) is a useful staging investigation for follicular lymphoma (FL). Recent studies have shown that positive post-treatment PET is also a strong predictor of inferior overall survival.

Purpose

To evaluate the predictive value of mid- and post-treatment PET in FL patients with respect to progression-free survival (PFS) and overall survival (OS).

Methods

We included 57 patients with indolent FL (grade 1, 2, and 3a) who received induction chemotherapy. Mid- and post-treatment PET results were correlated with PFS and OS retrospectively and analysed using Kaplan–Meier survival analysis and Cox regression.

Results

Post-treatment PET was predictive of OS (mean OS 95.2 vs. 45.0 months for PET-negative vs. PET-positive, p < 0.001) and showed a trend towards significance for PFS (mean PFS 74.4 vs. 38.2 months for PET− vs. PET+, p = 0.083). 3-year PFS for post-treatment PET− and PET+ patients were 72 and 30 %, respectively. 3-year OS were 96 and 60 %, respectively. Mid-treatment PET was not predictive of PFS (mean PFS 78.5 vs. 51.0 months for PET− vs. PET+, p = 0.35) nor OS (mean OS 89.9 vs. 76.6 months for PET− vs. PET+, p = 0.92).

Conclusion

Post-treatment PET is predictive of OS in indolent FL. It identifies patients who might benefit from more intensive follow-up, enrolment in clinical trials or second-line therapy. Mid-treatment PET scan results did not appear to predict long-term treatment outcomes.

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Conflict of interest

The authors declare that there are no conflict of interests.

Ethical standard

Ethics approval was obtained from the Research and Ethics Office of the South Western Sydney Local Health District.

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Authors and Affiliations

  1. University of New South Wales, Sydney, Australia

    Zhou Lu, Michael Lin & Shanley Chong

  2. Department of Nuclear Medicine and PET, Liverpool Hospital, Ground Floor, New Clinical Building, Liverpool, NSW, 2170, Australia

    Michael Lin

  3. Department of Haematology, Liverpool Hospital, Liverpool, NSW, Australia

    Paul Downe & Silvia Ling

  4. The Centre for Research, Evidence Management and Surveillance, Liverpool Hospital, Liverpool, NSW, Australia

    Shanley Chong

Authors
  1. Zhou Lu
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  2. Michael Lin
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  3. Paul Downe
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  4. Shanley Chong
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  5. Silvia Ling
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Correspondence to Michael Lin.

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Lu, Z., Lin, M., Downe, P. et al. The prognostic value of mid- and post-treatment [18F]fluorodeoxyglucose (FDG) positron emission tomography (PET) in indolent follicular lymphoma. Ann Nucl Med 28, 805–811 (2014). https://doi.org/10.1007/s12149-014-0874-1

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  • DOI: https://doi.org/10.1007/s12149-014-0874-1

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