Skip to main content
SpringerLink
Log in

Comparison of fluorine-18 fluorodeoxyglucose positron emission tomography with gallium-67 scintigraphy in the initial clinical staging of diffuse large B-cell lymphoma

  • Original Article
  • Published:
International Journal of Hematology Aims and scope Submit manuscript

Abstract

Fluorine-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) has been recommended as a complementary tool for the staging of various malignancies, including malignant lymphoma. PET findings often shift patients to higher stages and may affect treatment outcomes. In this study, we retrospectively compared staging and treatment outcomes of newly diagnosed diffuse large B-cell lymphoma (DLBCL) assessed by PET (n = 153) or gallium-67 scintigraphy (Ga) (n = 95). In total, Ga upstaged two (2.1%) of 95 patients, whereas PET upstaged 13 (8.5%) of 153 patients. Bone/bone marrow (15 vs. 4%, P = 0.01) and muscle lesion (5 vs. 0%, P = 0.03) were identified more frequently in the PET group than in the Ga group. The estimated 3-year overall and progression-free survival rates did not differ significantly in the two groups at any stage. However, patients with stage III disease tended to have better progression-free survival in the PET group than in the Ga group [92.3 (95% CI 56.6–98.9%) vs. 58.3% (95% CI 27.0–80.1%), P = 0.086]. These results suggest that PET has a greater potential in detecting musculoskeletal lesions of DLBCL as extranodal lesions than Ga, and may contribute to the optimal staging.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Kostakoglu L, Leonard JP, Kuji I, Coleman M, Vallabhajosula S, Goldsmith SJ. Comparison of fluorine-18 fluorodeoxyglucose positron emission tomography and Ga-67 scintigraphy in evaluation of lymphoma. Cancer. 2002;94:879–88.

    Article  PubMed  Google Scholar 

  2. Bednaruk-Młyński E, Pieńkowska J, Skórzak A, Małkowski B, Kulikowski W, Subocz E, et al. Comparison of positron emission tomography/computed tomography with classical contrast-enhanced computed tomography in the initial staging of Hodgkin lymphoma. Leuk Lymphoma. 2015;56:377–82.

    Article  PubMed  Google Scholar 

  3. Wirth A, Seymour JF, Hicks RJ, Ware R, Fisher R, Prince M, et al. Fluorine-18 fluorodeoxyglucose positron emission tomography, gallium-67 scintigraphy, and conventional staging for Hodgkin’s disease and non-Hodgkin’s lymphoma. Am J Med. 2002;112:262–8.

    Article  PubMed  Google Scholar 

  4. Chee KG, Nguyen DV, Brown M, Gandara DR, Wun T, Lara PN Jr. Positron emission tomography and improved survival in patients with lung cancer: the Will Rogers phenomenon revisited. Arch Intern Med. 2008;168:1541–9.

    Article  PubMed  Google Scholar 

  5. Feinstein AR, Sosin DM, Wells CK. The Will Rogers phenomenon. Stage migration and new diagnostic techniques as a source of misleading statistics for survival in cancer. N Engl J Med. 1985;312:1604–8.

    Article  CAS  PubMed  Google Scholar 

  6. Risum S, Høgdall C, Loft A, Berthelsen AK, Høgdall E, Nedergaard L, et al. Does the use of diagnostic PET/CT cause stage migration in patients with primary advanced ovarian cancer? Gynecol Oncol. 2010;116:395–8.

    Article  CAS  PubMed  Google Scholar 

  7. VanderWalde NA, Salloum RG, Liu TL, Hornbrook MC, O’Keeffe Rosetti MC, Ritzwoller DP, et al. Positron emission tomography and stage migration in head and neck cancer. JAMA Otolaryngol Head Neck Surg. 2014;140:654–61.

    Article  PubMed  Google Scholar 

  8. Baba S, Abe K, Isoda T, Maruoka Y, Sasaki M, Honda H. Impact of FDG-PET/CT in the management of lymphoma. Ann Nucl Med. 2011;25:701–16.

    Article  PubMed  Google Scholar 

  9. Cheson BD. Role of functional imaging in the management of lymphoma. J Clin Oncol. 2011;29:1844–54.

    Article  PubMed  Google Scholar 

  10. Gallamini A, Borra A. Role of PET in lymphoma. Curr Treat Options Oncol. 2014;15:248–61.

    Article  PubMed  Google Scholar 

  11. Kostakoglu L, Cheson BD. Current role of FDG PET/CT in lymphoma. Eur J Nucl Med Mol Imaging. 2014;41:1004–27.

    Article  PubMed  Google Scholar 

  12. Pelosi E, Pregno P, Penna D, Deandreis D, Chiappella A, Limerutti G, et al. Role of whole-body [18F] fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) and conventional techniques in the staging of patients with Hodgkin and aggressive non Hodgkin lymphoma. Radiol Med. 2008;113:578–90.

    Article  CAS  PubMed  Google Scholar 

  13. Kanda Y. Investigation of the freely available easy-to-use software ‘EZR’ for medical statistics. Bone Marrow Transplant. 2013;48:452–8.

    Article  CAS  PubMed  Google Scholar 

  14. Carr R, Barrington SF, Madan B, O’Doherty MJ, Saunders CA, van der Walt J, et al. Detection of lymphoma in bone marrow by whole-body positron emission tomography. Blood. 1998;91:3340–6.

    CAS  PubMed  Google Scholar 

  15. Shimizu T, Hatanaka K, Kaneko H, Shimada T, Imada K. Primary uterine diffuse large B-cell lymphoma (DLBCL) in a patient with prolonged insertion of intrauterine device (IUD). Int J Hematol. 2017;106:138–40.

    Article  PubMed  Google Scholar 

  16. Kanaya M, Endo T, Hashimoto D, Endo S, Takemura R, Okada K. Diffuse large B-cell lymphoma with a bulky mass in the cranial vault. Int J Hematol. 2017;106:147–8.

    Article  PubMed  Google Scholar 

  17. Ishibashi N, Hata M, Mochizuki T, Ogawa K, Sugiura H, Takekawa Y, et al. Radiation therapy for primary breast lymphoma in male gynecomastia: a rare case report and review of the literature. Int J Hematol. 2016;104:519–24.

    Article  CAS  PubMed  Google Scholar 

  18. Leighl NB. Positron emission tomography use and stage migration in lung cancer: a false sense of accomplishment? J Clin Oncol. 2012;30:2710–1.

    Article  PubMed  Google Scholar 

  19. Morgensztern D, Goodgame B, Baggstrom MQ, Gao F, Govindan R. The effect of FDG-PET on the stage distribution of non-small cell lung cancer. J Thorac Oncol. 2008;3:135–9.

    Article  PubMed  Google Scholar 

  20. Chen YK, Yeh CL, Tsui CC, Liang JA, Chen JH, Kao CH. F-18 FDG PET for evaluation of bone marrow involvement in non-Hodgkin lymphoma: a meta-analysis. Clin Nucl Med. 2011;36:553–9.

    Article  CAS  PubMed  Google Scholar 

  21. Hong J, Lee Y, Park Y, Kim SG, Hwang KH, Park SH, et al. Role of FDG-PET/CT in detecting lymphomatous bone marrow involvement in patients with newly diagnosed diffuse large B-cell lymphoma. Ann Hematol. 2012;91:687–95.

    Article  CAS  PubMed  Google Scholar 

  22. Muslimani AA, Farag HL, Francis S, Spiro TP, Chaudhry AA, Chan VC, et al. The utility of 18-F-fluorodeoxyglucose positron emission tomography in evaluation of bone marrow involvement by non-Hodgkin lymphoma. Am J Clin Oncol. 2008;31:409–12.

    Article  PubMed  Google Scholar 

  23. Paes FM, Kalkanis DG, Sideras PA, Serafini AN. FDG PET/CT of extranodal involvement in non-Hodgkin lymphoma and Hodgkin disease. Radiographics. 2010;30:269–91.

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

The authors are indebted to Yuri Niizuma and Kaori Yanai for their skillful data management, and to Satomi Yamanaka for her excellent care of the patients and their families.

Author information

Authors and Affiliations

  1. Division of Hematology, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan

    Masatoshi Sakurai, Takaaki Toyama, Taku Kikuchi, Jun Kato, Takayuki Shimizu, Yuya Koda, Daiki Karigane, Yusuke Yamane, Ryohei Abe, Rie Yamazaki, Tomonori Nakazato, Shinichiro Okamoto & Takehiko Mori

  2. Department of Radiology, Keio University School of Medicine, Tokyo, Japan

    Tadaki Nakahara & Masahiro Jinzaki

Authors
  1. Masatoshi Sakurai
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Takaaki Toyama
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Taku Kikuchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jun Kato
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Takayuki Shimizu
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Yuya Koda
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Daiki Karigane
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Yusuke Yamane
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Ryohei Abe
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Rie Yamazaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Tomonori Nakazato
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Tadaki Nakahara
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Masahiro Jinzaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Shinichiro Okamoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  15. Takehiko Mori
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Takehiko Mori.

Ethics declarations

Conflict of interest

The authors declare no conflict of interest.

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sakurai, M., Toyama, T., Kikuchi, T. et al. Comparison of fluorine-18 fluorodeoxyglucose positron emission tomography with gallium-67 scintigraphy in the initial clinical staging of diffuse large B-cell lymphoma. Int J Hematol 107, 194–200 (2018). https://doi.org/10.1007/s12185-017-2337-7

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12185-017-2337-7

Keywords

Search

Navigation