Abstract for presentation at 38th Annual Scientific Meeting of the Australian and New Zealand Society of Nuclear Medicine 2008

Evaluation of the Impact of FDG PET and Gallium on the Clinical Management of Patients with Low Grade non-Hodgkin's Lymphoma: A Prospective, Multi-centre Study

  • Prof Andrew Scott, Centre for P.E.T., and Ludwig Institute for Cancer Research, Austin Hospital, Melbourne, Australia
  • Dr Dishan Gunawardana, Centre for P.E.T., Ludwig Institute for Cancer Research, Austin Hospital, Melbourne, Australia
  • Dr Joseph Wong, Southern X-ray Clinics, The Wesley Hospital, Brisbane, Australia
  • Prof Rodney Hicks, P.E.T. Centre, Peter MacCallum Cancer Centre, Melbourne, Australia
  • Prof Ian Kirkwood, Department of Nuclear Medicine and P.E.T., Royal Adelaide Hospital, Adelaide, Australia
  • Dr Ivan Ho Shon, Department of Nuclear Medicine & P.E.T., Liverpool Hospital, Sydney, Australia
  • Ms Jayne Ramshaw, ANZAPNM, Australia
  • Dr Peter Robbins, WA P.E.T./Cyclotron Service, Sir Charles Gardiner Hospital, Perth, Australia

    • Objectives. The aims of this study were to assess the impact of 18F-fluorodeoxyglucose (FDG) PET on disease staging, and management, of patients (pts) with previously untreated clinically localised low grade non-Hodgkin's lymphoma (LGNHL), and to compare the relative impact of FDG PET and Gallium on staging and management in these pts.
    Methods. Pts with biopsy proven LGNHL (Stage I-III) underwent FDG PET scans. All pts underwent comprehensive staging investigations including contrast CT scans and bone marrow aspirate. Pre-PET management plans were documented blinded to PET results and management plan changes due to PET scan findings, and clinical follow-up to 12 months, were recorded.
    Results. There were 74 pts (37M:37F, median age 58 yrs). PET detected an additional 105 sites of disease (87 lymph node, 18 extra-nodal) in 37 (50%) pts. PET resulted in management change in 25 (33.8%) pts (95% CI 23.0% - 44.6%). A high and medium management impact was seen in 20 (27.0%) and 5 (6.8%) pts respectively. Compared with PET, Gallium scans (n=16) detected fewer additional lesions, and had less impact on management plans. Pts with additional lesions detected by PET compared with standard imaging had a significantly inferior disease free survival (p<.0035), and a lower complete response rate (47.2% vs 62.2%).
    Conclusions. This study clearly demonstrates that PET changes management plans and provides important prognostic information in pts with untreated LGNHL.

    Conference Organiser - ICMS Pty Ltd