Oops, you're using an old version of your browser so some of the features on this page may not be displaying properly.

MINIMAL Requirements: Google Chrome 24+Mozilla Firefox 20+Internet Explorer 11Opera 15–18Apple Safari 7SeaMonkey 2.15-2.23

Role of FDG-PET/CT and gastrointestinal endoscopy in the staging of diffuse large B-cell lymphoma (DLBCL)

Date

21 Dec 2015

Session

Haematological malignancies

Presenters

Tadahiro Honda

Citation

Annals of Oncology (2015) 26 (suppl_9): 85-92. 10.1093/annonc/mdv526

Authors

T. Honda1, D. Maruyama2, H. Kurihara3, A.M. Maeshima4, S. Yuda1, K. Toyoda1, N. Yamauchi1, S. Makita1, S. Fukuhara1, W. Munakata1, Y. Kobayashi1, H. Taniguchi4, Y. Saito5, K. Tobinai1

Author affiliations

  • 1 Department Of Hematology, National Cancer Center Hospital, 104-0045 - Tokyo/JP
  • 2 Department Of Hematology, National Cancer Center Hospital, Tokyo/JP
  • 3 Department Of Diagnostic Radiology, National Cancer Center Hospital, Tokyo/JP
  • 4 Department Of Pathology And Clinical Laboratoy, National Cancer Center Hospital, Tokyo/JP
  • 5 Endoscopy Division, National Cancer Center Hospital, Tokyo/JP
More

Aim/Background

The Lugano Classification incorporating FDG-PET/CT in the staging and response assessment of lymphomas was published (JCO 2014). However, the concordance between the clinical stage assessed by FDG-PET/CT and that assessed by the conventional evaluation remains elusive.

Methods

Patients (pts) who were initially histopathologically diagnosed as having DLBCL at our institution from 2010 to 2012 were included. The clinical stage using only FDG-PET/CT was compared to that by the conventional evaluation based on CT, esophageogastroduodenal endoscopy (EGD) and bone marrow (BM) aspiration and/or biopsy.

Results

A total of 98 pts were identified as subjects of this retrospective analysis with a median age of 64 years (range; 30-91). 11 pts (11%) resulted in upstaging through conventional evaluation plus FDG-PET/CT; 3 from stage I to IV, 6 from II to IV, 1 from II to III, and 1 from III to IV (Table 1). 3 pts (3%) resulted in downstaging; 1 from stage II to I, and 2 from IV to III. Bone or BM lesions were more frequently detected by FDG-PET/CT. BM examination detected 6 pts (6%) with BM lesions, while FDG-PET/CT detected 10 pts (10%). However, 2 pts (2%) of BM lesions went undetected by FDG-PET/CT. Compared with EGD, FDG-PET/CT seems to be less accurate in detecting gastric lesions. 19 pts (19%) had gastric lesions detected by the EGD but only 4 of them were positive by FDG-PET/CT. On the other hand, 3 pts had FDG-PET/CT positive colon lesions, which turned out to be adenocarcinoma with colonoscopic biopsy.

Conventional Staging
I II III IV Total
FDG-PET/CT I 27 1 0 0 28
II 0 34 0 0 34
III 0 1 2 2 5
IV 3 6 1 21 31
Total 30 42 3 23 98

Conclusions

Our data suggests that FDG-PET/CT cannot completely take the place of conventional staging evaluation for DLBCL mainly because of low sensitivity of gastrointestinal lesions, although FDG-PET/CT is useful in the staging of DLBCL. Therefore, we still recommend EGD as one of the routine staging procedures of DLBCL, and also recommend colonoscopy when FDG-PET/CT positive.

Clinical trial identification

Disclosure

All authors have declared no conflicts of interest.

Resources from the same session

This site uses cookies. Some of these cookies are essential, while others help us improve your experience by providing insights into how the site is being used.

For more detailed information on the cookies we use, please check our Privacy Policy.

Customise settings