Role of Positron Emission Tomography with 2-Deoxy-2-[fluorine-18]fluoro-D-glucose Integrated with Computed Tomography in the Evaluation of Hepatic Metabolic Activity due to Steatosis in Lymphoma Patients and its Impact on Deauville Score
DOI:
https://doi.org/10.3889/oamjms.2021.7048Keywords:
Steatosis, Lymphoma, Deauville score, Liver uptake, FDG Positron emission tomography/Computed tomographyAbstract
BACKGROUND: Liver uptake of 2-Deoxy-2-[fluorine-18]fluoro-D-glucose integrated (18F-FDG) is taken as the reference tissue in interpretation of Deauville score (DS), which is considered a response assessment.
AIM: This study was conducted to evaluate the prevalence of hepatic steatosis in patients with lymphoma and the impact of hepatic metabolic activity due to steatosis on 18F-FDG liver uptake and its effect on DS.
MATERIAL AND METHODS: This prospective study was conducted on 77 cases. Seventy-seven patients had baseline positron emission tomography/computed tomography (PET/CT), 69 patients had interim PET/CT, 31 patients had end of treatment (EOT) PET/CT, and 3 patients had follow-up (FU) PET/CT after EOT. The study included 49 female patients (63.6%) and 28 male patients (36.4%). The mean age = 39.5 + 13. Forty-one patients (53.2%) diagnosed as non-Hodgkin lymphoma [HL] while 36 patients (46.8%) diagnosed as HL. Steatosis was diagnosed on the unenhanced CT part of PET/CT examinations using a cutoff value of 42 Hounsfield units. Both maximum standardized uptake value (SUVmax) and SULmax were recorded on the liver and the tumor target lesion. DS was then computed.
RESULTS: Among 77 cases, prevalence of steatosis in baseline (10/77, 12.9%), interim (13/69, 18.8%), and EOT/FU (4/31, 12.9%), there was no significant difference in hepatic steatosis during their time course of their treatment. There was correlation between Liver SUVmax with body mass index (BMI) in each of interim and EOT PET/CT. Regarding SULmax, there was no correlation with BMI. There was no change in interpretation of DS using either SUVmax or SULmax.
CONCLUSION: Steatosis has no practical issue regarding liver metabolic activity (either SUVmax or SULmax) in interpretation of DS. Liver SUVmax is affected by body weight. Unlike, SULmax is not affected by body weight.Downloads
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Okada M, Sato N, Ishii K, Matsumura K, Hosono M, Murakami T. FDG PET/CT versus CT, MR imaging, and 67Ga scintigraphy in the posttherapy evaluation of malignant lymphoma. Radiographics. 2010;30(4):939-57. https://doi.org/10.1148/rg.304095150 PMid:20631361 DOI: https://doi.org/10.1148/rg.304095150
Merli F, Luminari S, Rossi G, Mammi C, Marcheselli L, Ferrari A, et al. Outcome of frail elderly patients with diffuse large B-cell lymphoma prospectively identified by Comprehensive Geriatric Assessment: results from a study of the Fondazione Italiana Linfomi. Leukemia Lymphoma. 2014;55(1):38-43. https://doi.org/10.3109/10428194.2013.788176 PMid:23517562 DOI: https://doi.org/10.3109/10428194.2013.788176
Juweid ME. FDG-PET/CT in Lymphoma, in Positron Emission Tomography. Berlin, Germany: Springer; 2011. p. 1-19. DOI: https://doi.org/10.1007/978-1-61779-062-1_1
Ben-Yakov G, Alao H, Haydek JP, Fryzek N, Cho MH, Hemmati M, et al. Development of hepatic steatosis after chemotherapy for non-hodgkin lymphoma. Hepatol Commun. 2019;3(2):220-6. https://doi.org/10.1002/hep4.1304 PMid:30766960 DOI: https://doi.org/10.1002/hep4.1304
Saadeh S, Younossi ZM, Remer EM, Gramlich T, Ong JP, Hurley M, et al. The utility of radiological imaging in nonalcoholic fatty liver disease. Gastroenterology. 2002;123(3):745-50. https://doi.org/10.1053/gast.2002.35354 PMid:12198701 DOI: https://doi.org/10.1053/gast.2002.35354
Boellaard R, Delgado-Bolton R, Oyen WJ, Giammarile F, Tatsch K, Eschner W, et al. FDG PET/CT: EANM procedure guidelines for tumour imaging: Version 2.0. Eur J Nucl Med Mol Imaging. 2015;42(2):328-54. https://doi.org/10.1007/s00259-014-2961-x PMid:25452219 DOI: https://doi.org/10.1007/s00259-014-2961-x
Salomon T, Nganoa C, Gac AC, Fruchart C, Damaj G, Aide N, et al. Assessment of alteration in liver 18 F–FDG uptake due to steatosis in lymphoma patients and its impact on the Deauville score. Eur J Nucl Med Mol Imaging. 2018;45(6):941-50. https://doi.org/10.1007/s00259-017-3914-y PMid:29279943 DOI: https://doi.org/10.1007/s00259-017-3914-y
Berthet L, Cochet A, Kanoun S, Berriolo-Riedinger A, Humbert O, Toubeau M, et al. In newly diagnosed diffuse large B-cell lymphoma,determination of bone marrow involvement with 18F-FDG PET/CT provides better diagnostic performance and prognostic stratification than does biopsy. J Nucl Med. 2013;54(8):1244-50. https://doi.org/10.2967/jnumed.112.114710 PMid:23674577 DOI: https://doi.org/10.2967/jnumed.112.114710
Lin CY, Lin WY, Lin CC, Shih CM, Jeng LB, Kao CH. The negative impact of fatty liver on maximum standarduptake value of liver on FDG PET. Clin Imaging. 2011;35(6):437-41. https://doi.org/10.1016/j.clinimag.2011.02.005 PMid:22040787 DOI: https://doi.org/10.1016/j.clinimag.2011.02.005
Lin CY, Ding HJ, Lin CC, Chen CC, Sun SS, Kao CH. Impact of age on FDG uptake in the liver on PET scan. Clin Imaging. 2010;34(5):348-50. https://doi.org/10.1016/j.clinimag.2009.11.003 PMid:20813297 DOI: https://doi.org/10.1016/j.clinimag.2009.11.003
Keramida G, Potts J, Bush J, Verma S, Dizdarevic S, Peters AM. Accumulation of 18F-FDG in the liver in hepatic steatosis. Am J Roentgenol. 2014;203(3):643-8. https://doi.org/10.2214/AJR.13.12147 PMid:25148170 DOI: https://doi.org/10.2214/AJR.13.12147
Sarikaya I, Albatineh AN, Sarikaya A. Revisiting weight-normalized SUV and lean-body-mass-normalized SUV in PET studies. J Nucl Med Technol. 2020;48(2):163-7. https://doi.org/10.2967/jnmt.119.233353 PMid:31604893 DOI: https://doi.org/10.2967/jnmt.119.233353
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Copyright (c) 2021 Marwa Adel, Ashraf Fawzy, Jehan Younes, Shiamaa ElRasad (Author)
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