F.A. Bayembaev ¹, R.I. Rakhimzhanova ¹, T.B. Dautov ², A.B. Saduakasova ³, A.Zh. Temirbekov ³

1. «Astana Medical University» NAO, Astana, the Republic of Kazakhstan;
2. «University Medical Center» Corporate Fund, Astana, the Republic of Kazakhstan;
3. «Hospital of the Medical Center of the Office of the President of the Republic of Kazakhstan» RSE on REM, Astana, the Republic of Kazakhstan

DOI: https://www.doi.org/10.52532/2663-4864-2023-1-67-62-67

UDC: 616-006.441-073.756.8:621.039.85

Year: 2023 issure: 67 number: 1 pages: 62-67

Download PDF:

ABSTRACT

Relevance: Positron emission tomography combined with computed tomography (PET/CT) is a young and promising technique for lymphoproliferative diseases’ primary detection, staging, and evaluation of the treatment results. However, at this stage of nuclear medicine development, some shortcomings in PET/CT diagnostics of lymphomas using 18Fluorodeoxyglucose (F18-FDG) affect its reliability to a certain extent.
The study aimed to evaluate the physical and technical weaknesses of F18-FDG PET/CT in diagnosing lymphomas and review the analytical methods that affect opinion accuracy.
Methods: The articles on the use of F18-FDG PET/CT in diagnosing lymphomas, its reliability, and methods for optimizing were searched in the PUBMED database for 2012-2022.
Results: One of the main shortcomings of F18-FDG PET/CT in diagnosing lymphomas is the Deauville 5-point scale, which does not fully meet clinical requirements. This scale has some disadvantages, including low inter-reader agreement and an unreliable reference organ for F18-FDG accumulation. Mathematical algorithms for correction to the patient’s weight also require optimization.
Conclusion: Some of the existing deficiencies can be improved at the software level and through educating staff about the importance of changing the SUV calculation method. However, other deficiencies, such as classifications that do not meet clinical requirements, require more efforts at the level of international experts and much more in-depth study of this issue to avoid such shortcomings of new staging methods. However, even considering all the shortcomings described, at the moment, PET/CT with F18-FDG is one of the most reliable modalities available, both for the initial detection and for evaluating the therapy effectiveness in patients with lymphomas.
Keywords: Positron emission tomography (PET/CT), lymphoma, Deauville, SUV, 18F-fluoro-2-deoxy-D-glucose” (F18-FDG), tumor staging.

References:
1. Azmi N.H.M., Suppiah S., Liong C.W., Noor N.M., Said S.M., Hanafi M.H., Kaewput C., Saad F.F.A., Vinjamuri S. Reliability of standardized uptake value normalized to lean body mass using the liver as a reference organ, in contrast-enhanced 18F-FDG PET/CT imaging // Radiat. Phys. Chem. – 2018. – Vol. 147. – P. 35-39. https://doi.org/10.1016/j.radphyschem.2018.01.019
2. Barrington S.F., Kluge R. FDG PET for therapy monitoring in Hodgkin and non-Hodgkin lymphomas // Eur. J. Nucl. Med. Mol. Imaging. – 2017. – Vol. 44(Suppl 1). – P. 97-110. https://doi.org/10.1007/s00259-017-3690-8
3. Cheson B.D., Fisher R.I., Barrington S.F., Cavalli F., Schwartz L.H., Zucca E., Lister T.A. Recommendations for initial evaluation, staging, and response assessment of Hodgkin and non-Hodgkin lymphoma: the Lugano classification // J. Clin. Oncol. – 2014. – Vol. 32(27). – P. 3059-3067.
4. Barrington S.F., Mikhaeel N.G., Kostakoglu L., Meignan M., Hutchings M., Müeller S.P., Schwartz L.H., Zucca E., Fisher R.I., Trotman J., Hoekstra O.S., Hicks R.J., O’Doherty M.J., Hustinx R., Biggi A., Cheson B.D. 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. – Vol. 32(27). – P. 3048-3058. https://doi.org/10.1200/jco.2013.53.5229
5. Ceriani L., Suriano S., Ruberto T., Zucca E., Giovanella L. 18F-FDG uptake changes in liver and mediastinum during chemotherapy in patients with diffuse large B-cell lymphoma // Clin. Nucl. Med. – 2012. – Vol. 37(10). – P. 949-952. https://doi.org/10.1097/rlu.0b013e318263831d
6. Chiaravalloti A., Danieli R., Abbatiello P., di Pietro B., Travascio L., Cantonetti M., Guazzaroni M., Orlacchio A., Simonetti G., Schillaci. Factors affecting intrapatient liver and mediastinal blood pool 18F-FDG standardized uptake value changes during ABVD chemotherapy in Hodgkin’s lymphoma // Eur. J. Nucl. Med. Mol. Imaging. – 2014. – Vol. 41(6). – P. 1123-1132. https://doi.org/10.1007/s00259-014-2703-0
7. Decazes P., Tivier D., Rouquette A., Talbot J.N., Kerrou K.A. Method to Improve the Semiquantification of 18F-FDG Uptake: Reliability of the Estimated Lean Body Mass Using the Conventional, Low-Dose CT from PET/CT // J. Nucl. Med. – 2016. – Vol. 57(5). – P. 753-758. https://doi.org/10.2967/jnumed.115.164913
8. Ceriani L., Barrington S., Biggi A., Malkowski B., Metser U., Versari A., Martelli M., Davies A., Johnson P. W., Zucca E., Chauvie S. Training improves the interobserver agreement of the expert positron emission tomography review panel in primary mediastinal B-cell lymphoma: interim analysis in the ongoing International Extranodal Lymphoma Study Group-37 study // Hematol. Oncol. – 2017. – Vol. 35(4). – P. 548-553. https://doi.org/10.1002/hon.2339
9. Chan T., Hospital Q.M., Lam P.F., Kong H. Computerized Method for Automatic Evaluation of Lean Body Mass from PET/CT: Comparison with Predictive Equations // J. Nucl. Med. – 2012. – Vol. 53(1). – P. 130-137. https://doi.org/10.2967/jnumed.111.089292
10. Eugene T., Corradini N., Carlier T., Dupas B., Leux C., Bodet-Milin C. 18F-FDG-PET/CT in initial staging and assessment of early response to chemotherapy of pediatric rhabdomyosarcomas // Nucl. Med. Comm. – 2012. – Vol. 33(10). – P. 1089-1095. https://doi.org/10.1097/MNM.0B013E328356741F
11. Groheux D., Delord M., Rubell D., Colletti P.M., Nguyen M.L., Hindié E. Variation of liver SUV on (18)FDG-PET/CT studies in women with breast cancer // Clin. Nucl. Med. – 2013. – Vol. 38(6). – P. 422-425. https://doi.org/10.1097/rlu.0b013e3182872f0e
12. Groheux D., Espié M., Giacchetti S., Hindié E. Performance of FDG PET/CT in the clinical management of breast cancer // Radiology. – 2013. – Vol. 266(2). P. 388-405. https://doi.org/10.1148/radiol.12110853
13. Halsne T., Müller E.G., Spiten A.E., Sherwani A.G., Mikalsen L.T.G., Revheim M.E., Stokke C. The Effect of New Formulas for Lean Body Mass on Lean-Body-Mass-Normalized SUV in Oncologic 18 F-FDG PET/CT // J. Nucl. Med. Technol. – 2018. – Vol. 46(3). – P. 253-259. https://doi.org/10.2967/jnmt.117.204586
14. Isik E.G., Kuyumcu S., Kebudi R., Sanli Y., Karakas Z., Cakir F.B., Unal S. N. Prediction of outcome in pediatric Hodgkin lymphoma based on interpretation of 18 FDG-PET/CT according to ΔSUV max, Deauville 5-point scale and IHP criteria // Ann. Nucl. Med. – 2017. – Vol. 31(9). – P. 660-668. https://doi.org/10.1007/s12149-017-1196-x
15. Johnson S.A., Kumar A., Matasar M.J., Schöder H., Rademaker J. Imaging for Staging and Response Assessment in Lymphoma // Radiology. – 2015. – Vol. 276(2). – P. 323-338. https://doi.org/10.1148/radiol.2015142088
16. Kim C.G., Kim W.H., Kim M.H., Kim D.W. Direct Determination of Lean Body Mass by CT in F-18 FDG PET/CT Studies: Comparison with Estimates Using Predictive Equations // Nucl. Med. Mol. Imaging. – 2013. – Vol.47(2). – P. 98-103. https://doi.org/10.1007/s13139-013-0207-7
17. Kluge R., Chavdarova L., Hoffmann M., Kobe C., Malkowski B., Montravers F., Kurch L., Georgi T., Dietlein M., Wallace W.H., Karlen J., Fernández-Teijeiro A., Cepelova M., Wilson L., Bergstraesser E., Sabri O., Mauz-Körholz C., Körholz D., Hasenclever D. Inter-Reader Reliability of Early FDG-PET/CT Response Assessment Using the Deauville Scale after 2 Cycles of Intensive Chemotherapy (OEPA) in Hodgkin’s Lymphoma // PloS One. – 2016. – Vol. 11(3). – Art. ID: e0149072. https://doi.org/10.1371/journal.pone.0149072
18. Kostakoglu L., Cheson B.D. Current role of FDG PET/CT in lymphoma // Eur. J. Nucl. Med. Mol. Imaging. – 2014. – Vol. 41(5). – P. 1004-1027. https://doi.org/10.1007/s00259-013-2686-2
19. Ku C.R., Lee N., Hong J.W., Kwon I.G., Hyung W.J., Noh S.H., Lee E.J., Yun M., Cho A. Intestinal Glycolysis Visualized by FDG PET/CT Correlates With Glucose Decrement After Gastrectomy // Diabetes. – 2017. – Vol. 66(2). – P. 385-391. https://doi.org/10.2337/db16-1000
20. Peacock J.G., Christensen C.T., Banks K.P. RESISTing the Need to Quantify: Putting Qualitative FDG-PET/CT Tumor Response Assessment Criteria into Daily Practice // Am. J. Neuroradiol. – 2019. – Vol. 40(12). – P. 1978. https://doi.org/10.3174/ajnr.a6294
21. Sawan P., Rebeiz K., Schoder H., Batlevi C., Moskowitz A., Ulaner G.A., Dunphy M., Mannelli L. Specialized second-opinion radiology review of PET/CT examinations for patients with diffuse large B-cell lymphoma impacts patient care and management // Medicine. – 2017. – Vol. 96(51). – P. e9411. https://doi.org/10.1097/md.0000000000009411
22. Sheikhbahaei S., Mena E., Pattanayak P., Taghipour M., Solnes L.B., Subramaniam R.M. Molecular Imaging and Precision Medicine: PET/Computed Tomography and Therapy Response Assessment in Oncology // PET Clinics. – 2017. – Vol. 12(1). – P. 105-118. https://doi.org/10.1016/j.cpet.2016.08.002
23. Suppiah S., Saad F.F.A., Azmi N.H.M., Nordin A.J. Mapping 18F-Fluorodeoxyglucose Metabolism Using PET/CT for the Assessment of Treatment Response in Non-Small Cell Lung Cancer Patients Undergoing Epidermal Growth Factor Receptor Inhibitor Treatment: A Single-Centre Experience // Malays. J. Med. Health Sci. – 2017. – P. 9-15. https://pesquisa.bvsalud.org/portal/resource/pt/wpr-625464
24. Tahari A.K., Chien D., Azadi J.R., Wahl R.L. Optimum lean body formulation for correction of standardized uptake value in PET imaging // J. Nucl. Med. – 2014. – Vol. 55(9). – P. 1481-1484. https://doi.org/10.2967/jnumed.113.136986
25. Tiseo M., Ippolito, M., Scarlattei M., Spadaro P., Cosentino S., Latteri F., Ruffini L., Bartolotti M., Bortesi B., Fumarola C., Caffarra C., Cavazzoni A., Alfieri R.R., Petronini P.G., Bordonaro R., Bruzzi P., Ardizzoni A., Soto Parra H.J. Predictive and prognostic value of early response assessment using 18FDG-PET in advanced non-small cell lung cancer patients treated with erlotinib // Cancer Chemother. Pharmacol. – 2014. – Vol. 73(2). – P. 299-307. https://doi.org/10.1007/s00280-013-2356-x
26. Boktor R.R., Walker G., Stacey R., Gledhill S., Pitman A.G. Reference range for intrapatient variability in blood-pool and liver SUV for 18F-FDG PET // J. Nucl. Med. – 2013. – Vol. 54(5). – P. 677-682. https://doi.org/10.2967/jnumed.112.108530
27. Burggraaff C.N., Cornelisse A.C., Hoekstra O.S., Lugtenburg P.J., de Keizer B., Arens A.I.J., Celik F., Huijbregts J.E., de Vet H.C.W., Zijlstra J.M. Interobserver Agreement of Interim and End-of-Treatment 18 F-FDG PET/CT in Diffuse Large B-Cell Lymphoma: Impact on Clinical Practice and Trials // J. Nucl. Med. – 2018. – Vol. 59(12). – P. 1831-1836. https://doi.org/10.2967/jnumed.118.210807