Risk-adapted FDG-PET/CT-based follow-up in patients with diffuse large B-cell lymphoma after first-line therapy.

Area of Science:

• Oncology
• Nuclear Medicine
• Radiology

Background:

• Diffuse large B-cell lymphoma (DLBCL) is a common non-Hodgkin lymphoma.
• Effective follow-up strategies are crucial for detecting relapse after initial treatment.
• 2-[fluorine-18]fluoro-2-deoxy-D-glucose-positron emission tomography/computed tomography (FDG-PET/CT) is an imaging modality used in oncology.

Purpose of the Study:

• To evaluate the diagnostic impact of FDG-PET/CT in the follow-up of DLBCL patients post-first-line therapy.
• To assess the utility of FDG-PET/CT in identifying disease recurrence in patients in complete or unconfirmed complete remission.

Main Methods:

• Retrospective analysis of DLBCL patients undergoing FDG-PET/CT during follow-up.
• Mandatory confirmatory biopsy for suspected disease recurrence.
• Statistical analysis to identify risk factors for relapse.

Main Results:

• Twenty-three out of seventy-five (30%) patients experienced disease recurrence.
• FDG-PET/CT demonstrated a positive predictive value (PPV) of 0.85 for detecting recurrence.
• Patients over 60 years old and those with relapse symptoms had a significantly higher risk of recurrence.

Conclusions:

• FDG-PET/CT is a valuable tool for detecting recurrent DLBCL with high PPV.
• Routine use of FDG-PET/CT in follow-up is not recommended due to radiation burden and cost.
• Selective use in high-risk patients, including those <60 with relapse signs and all patients >60, is suggested.