18F-FDG uptake and its clinical relevance in primary gastric lymphoma

Hematol Oncol. 2010 Jun;28(2):57-61. doi: 10.1002/hon.905.

Abstract

We studied the clinical relevance of (18)F-fluorodeoxyglucose ((18)F-FDG) uptake in patients with primary gastric lymphoma underwent positron emission tomography (PET)/ computed tomography (CT) scan. Forty-two patients with primary gastric lymphoma were analysed: 32 diffuse large B-cell lymphomas (DLBCL) and 10 extranodal marginal zone B-cell lymphomas of mucosa-associated lymphoid tissue (MALT lymphomas). The PET/CT scans were compared with clinical and pathologic features, and the results of CT and endoscopy. Nine patients were up-staged based on the results of their PET/CT scan compared to CT (seven DLBCLs, two MALT lymphomas) while six patients were down-staged by the PET/CT scan. The standard uptake value (SUV) was used as an indicator of a lesion with a high metabolic rate. The high SUVmax group, defined as an SUVmax >or= median value, was significantly associated with an advanced Lugano stage (p < 0.001). Three patients with DLBCL, who showed an initially high SUVmax, died of disease progression. Among 24 patients for whom follow-up PET/CT scan with endoscopy was performed, 11 patients with ulcerative or mucosal lesions showed residual (18)F-FDG uptake. All of these gastric lesions were grossly and pathologically benign lesions without evidence of lymphoma cells. In conclusion, PET/CT scan can be used in staging patients with primary gastric lymphoma; however, the residual (18)F-FDG uptake observed during follow-up should be interpreted cautiously and should be combined with endoscopy and multiple biopsies of the stomach.

MeSH terms

  • Adult
  • Aged
  • Biopsy
  • Diagnosis, Differential
  • Female
  • Fluorine Radioisotopes* / pharmacokinetics
  • Fluorodeoxyglucose F18* / pharmacokinetics
  • Gastric Mucosa / diagnostic imaging
  • Gastric Mucosa / pathology
  • Gastroscopy
  • Humans
  • Lymphoma, B-Cell, Marginal Zone / diagnostic imaging*
  • Lymphoma, B-Cell, Marginal Zone / metabolism
  • Lymphoma, B-Cell, Marginal Zone / pathology
  • Lymphoma, Large B-Cell, Diffuse / diagnostic imaging*
  • Lymphoma, Large B-Cell, Diffuse / metabolism
  • Lymphoma, Large B-Cell, Diffuse / pathology
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / diagnostic imaging
  • Neoplasm Staging
  • Positron-Emission Tomography*
  • Prognosis
  • Radiopharmaceuticals* / pharmacokinetics
  • Stomach Neoplasms / diagnostic imaging*
  • Stomach Neoplasms / metabolism
  • Stomach Neoplasms / pathology
  • Stomach Ulcer / diagnostic imaging
  • Tomography, X-Ray Computed
  • Young Adult

Substances

  • Fluorine Radioisotopes
  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18