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Implantation and Monitoring by PET/CT of an Orthotopic Model of Human Pleural Mesothelioma in Athymic Mice

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Can We Predict Bleomycin Toxicity with PET-CT?

Seda Beyhan Sagmen¹, Sevda Comert², Esra Turan Erkek³

¹Pulmonary Medicine, University of Health Sciences Kartal Dr. Lutfi Kirdar Training and Research Hospital, Kartal, Turkey, sedabeyhansagmen@gmail.com.

Acta Haematologica

|August 28, 2019

Summary

Fluorodeoxyglucose positron-emission tomography (FDG-PET/CT) can predict bleomycin toxicity (BT) in Hodgkin's lymphoma patients before symptoms appear. Elevated lung FDG uptake after chemotherapy indicates a higher risk of developing this serious side effect.

Keywords:

Bleomycin Positron-emission tomography Toxicity

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Gene Regulation and Targeted Therapy in Gastric Cancer Peritoneal Metastasis: Radiological Findings from Dual Energy CT and PET/CT

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Published on: January 22, 2018

Area of Science:

Oncology
Radiology
Pulmonology

Background:

Bleomycin is a vital antitumor antibiotic for treating malignancies like Hodgkin's lymphoma (HL).
A significant limitation of bleomycin therapy is the risk of potentially fatal interstitial pulmonary fibrosis.
Early identification of patients at risk for bleomycin toxicity (BT) is crucial for timely intervention.

Purpose of the Study:

To evaluate the efficacy of fluorodeoxyglucose positron-emission tomography/computed tomography (FDG-PET/CT) in predicting BT.
To assess if FDG-PET/CT can identify asymptomatic patients at risk for BT early in their treatment course.
To correlate lung parenchymal FDG uptake with the development of BT following ABVD chemotherapy.

Main Methods:

Retrospective analysis of FDG-PET/CT scans from Hodgkin's lymphoma patients treated with ABVD chemotherapy.
Measurement of maximum standardized uptake value (SUVmax) in the lung parenchyma at diagnosis and after 4 cycles of chemotherapy.
Statistical comparison of lung parenchymal SUVmax values between patients who developed BT and those who did not.

Main Results:

Five out of thirty (16.7%) HL patients developed BT, diagnosed after 5 or 6 chemotherapy cycles.
In patients who developed BT, FDG uptake in the lungs increased after 4 chemotherapy cycles, predicting toxicity before clinical or radiological signs.
Post-chemotherapy lung SUVmax was significantly higher in patients with BT (3.24 ± 0.76) compared to those without (1.84 ± 0.52) (p < 0.001).

Conclusions:

FDG-PET/CT is a valuable tool for the early prediction of bleomycin toxicity in HL patients.
Increased lung FDG uptake detected by FDG-PET/CT after chemotherapy can identify patients at high risk for developing BT.
Early detection of BT using FDG-PET/CT is essential for clinical management and improving patient outcomes.