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Ann Oncol. 2009 Mar;20(3):508-12. doi: 10.1093/annonc/mdn657. Epub 2009 Jan 12.

The majority of transformed lymphomas have high standardized uptake values (SUVs) on positron emission tomography (PET) scanning similar to diffuse large B-cell lymphoma (DLBCL).

Author information

1
Department of Medicine, Lymphoma Service, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA. noya@mskcc.org

Abstract

BACKGROUND:

We previously correlated non-Hodgkin's lymphoma (NHL) histology with (18)fluoro-2-deoxyglucose-positron emission tomography (FDG-PET) intensity: a standardized uptake value (SUV)>10 predicted aggressive lymphoma with >80% certainty and an SUV >13, with >90% certainty.

PATIENTS AND METHODS:

To evaluate SUV in transformed lymphoma, we identified all FDG-PET scans for NHL at Memorial Sloan-Kettering Cancer 1999-2007 with (i) biopsy-proven transformation, (ii) no therapy 60 days before PET scan and (iii) FDG-PET scans no more than 60 days before or 90 days after transformation.

RESULTS:

In 5 of 40 patients, the biopsy site was excised before PET; in two, only marrow was biopsied. In the remaining 33 patients, the SUV of the biopsy site ranged from 3 to 38, mean 14, median 12. Eighteen of 33 biopsies (55%) had an SUV>10 and 16 (48%)>13. The highest SUV in a transformed lymphoma PET scan (SUV(study-max)) ranged from 3.2 to 40, mean 15, median 12. Twenty-five of 40 patients (63%) presented with an SUV(study-max)>10 and 20 (50%)>13.

CONCLUSIONS:

Like de novo aggressive lymphomas, the majority of transformations have a high SUV(study-max) for a given pretreatment staging study, although many do not have very high values. Transformation should be suspected in indolent lymphoma with high SUVs on FDG-PET. Biopsies should be directed to the site of greatest FDG avidity.

PMID:
19139176
PMCID:
PMC4542578
DOI:
10.1093/annonc/mdn657
[Indexed for MEDLINE]
Free PMC Article

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