FDG PET/CT Predicts Stem Cell Transplant Response in Lymphoma

Lesions detected by FDG PET/CT can predict success of stem cell transplant in patients with aggressive lymphoma.

Imaging with FDG PET/CT among patients with aggressive lymphoma can help predict response to stem cell transplant, according to a study published in Radiology.

Researchers from Memorial Sloan-Kettering Cancer Center and Weill Cornell Medical College in New York, NY, performed a retrospective review study to determine the prognostic value of performing FDG PET/CT before allogeneic and autologous stem cell transplantation (SCT) in patients with aggressive lymphoma.

One-hundred-seventy-five patients with aggressive lymphoma who underwent allogeneic or autologous SCT between January 2005 and December 2010 participated in the study. The FDG PET/CT imaging of between mid-skull and upper thigh was performed within the three-month period before the transplantation; 73 patients underwent FDG PET/CT before [[{"type":"media","view_mode":"media_crop","fid":"44068","attributes":{"alt":"","class":"media-image media-image-right","id":"media_crop_90076324399","media_crop_h":"0","media_crop_image_style":"-1","media_crop_instance":"4904","media_crop_rotate":"0","media_crop_scale_h":"0","media_crop_scale_w":"0","media_crop_w":"0","media_crop_x":"0","media_crop_y":"0","style":"height: 120px; width: 160px; border-width: 0px; border-style: solid; margin: 1px; float: right;","title":" ","typeof":"foaf:Image"}}]]allogeneic SCT and 102 patients underwent FDG PET/CT before autologous SCT. The researchers evaluated the PET/CT images for lesions with FDG avidity greater than that of the background liver.

The results showed that before allogeneic SCT, 23 of 73 patients (32%) had FDG-avid lesions, and before autologous SCT, 11 of 102 patients (11%) had FDG-avid lesions.

Two-year progression-free survival:

 Patients without FDG-avid lesionsPatients with FDG-avid lesions
Allogeneic SCT68%35%
Autologous SCT72%18%

“Similar differences were seen in overall survival and disease-specific survival,” the authors wrote. “The risk for post-transplantation recurrence correlated with higher lesional maximum standardized uptake values: for PFS, P < .0001 to P = .01; for DSS, P < .0001 to P = .002; and for OS, P < .0001 to P = .015.”

The researchers concluded that  performing FDG PET/CT before SCT in patients with aggressive lymphoma has prognostic value and gives physicians a better indication of the likelihood of SCT success.