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The value of PET-CT scan in determining remission status in lymphoma patients involving the head & neck region
Wan Fariza Wan Jamaludin1, Fara Rahidah Husin2, Aini Ab. Aziz3, Mohd Razif Mohd Yunus,4, Mawaddah Azman5, Kong, Min Han6, Noraidah Masir7, Ghoddoosi, Mahdieh8, Seery Zaliza Azura Zaider9, Normi Mustapha10, Nor Asiah Muhamad11, S Fadilah Abdul Wahid12.
In lymphoma, Positron Emission Tomography-Computerized Tomography (PET-CT) provides greater prognostic information than conventional imaging. However, false positivity occurred particularly in the head & neck due to predilection for infection and inflammation. We investigated the association between positive scans in the head & neck at the end of therapy with histology, and its diagnostic and prognostic values. 488 PET-CT were retrospectively assessed in 2012-2016 (40 months). Positive uptakes in the head & neck (five-point scale ≥4) were biopsied. Prevalence of positive scans was 10.9% (53/488). Two positive scans were histologically lymphomatous with mean maximum standardized uptake value (SUVmax) of 9.0±2.69. False positivity (96.2%) was histologically attributed to reactive lymphoid hyperplasia (SUVmax 9.0±3.88). Positive and negative predictive values, sensitivity and specificity were 3.8%, 100%, 100% and 89.5%, respectively. False positivity was associated with age, gender, extra-nodal involvement, Eastern Cooperative Oncology Group score (ECOG), positivity only in the head & neck and its pattern of positivity. No significant predictors were identified. Hodgkin Disease (HD) was more likely to have positivity only in the head & neck compared to Non-Hodgkin Lymphoma (NHL) (p=0.019). 106 patients with negative scans remained negative during study period, hence regarded as true negatives. Positive scans in the head & neck at post therapy yielded high false positivity and should not be routinely performed. HD has higher likelihood of scan positivity only in the head & neck than NHL. The value of PET-CT to detect true lymphomatous relapse in selected high-risk patients remained to be confirmed in future trials.
Affiliation:
- Universiti Kebangsaan Malaysia Medical Centre, Malaysia
- Universiti Kebangsaan Malaysia Medical Centre, Malaysia
- Universiti Kebangsaan Malaysia Medical Centre, Malaysia
- Universiti Kebangsaan Malaysia Medical Centre, Malaysia
- Universiti Kebangsaan Malaysia Medical Centre, Malaysia
- Universiti Kebangsaan Malaysia Medical Centre, Malaysia
- Universiti Kebangsaan Malaysia Medical Centre, Malaysia
- Universiti Kebangsaan Malaysia Medical Centre, Malaysia
- Universiti Kebangsaan Malaysia Medical Centre, Malaysia
- Universiti Kebangsaan Malaysia Medical Centre, Malaysia
- Ministry of Health, Malaysia
- Universiti Kebangsaan Malaysia Medical Centre, Malaysia
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Indexed by |
MyJurnal (2021) |
H-Index
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6 |
Immediacy Index
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0.000 |
Rank |
0 |
Indexed by |
Web of Science (SCIE - Science Citation Index Expanded) |
Impact Factor
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JCR (1.009) |
Rank |
Q4 (Multidisciplinary Sciences) |
Additional Information |
JCI (0.15) |
Indexed by |
Scopus 2020 |
Impact Factor
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CiteScore (1.4) |
Rank |
Q2 (Multidisciplinary) |
Additional Information |
SJR (0.251) |
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