Limited role for surveillance PET-CT scanning in patients with diffuse large B-cell lymphoma in complete metabolic remission following primary therapy

C. Y. Cheah; Michael S. Hofman; M. Dickinson; A. Wirth; D Westerman; S. J. Harrison; Kate Burbury; M. Wolf; Elchanan H Januszewicz; K. Herbert; H Miles Prince; D A A Carney; David S. Ritchie; R. J. Hicks; John F. Seymour

doi:10.1038/bjc.2013.338

Limited role for surveillance PET-CT scanning in patients with diffuse large B-cell lymphoma in complete metabolic remission following primary therapy

C. Y. Cheah, Michael S. Hofman, M. Dickinson, A. Wirth, D Westerman, S. J. Harrison, Kate Burbury, M. Wolf, Elchanan H Januszewicz, K. Herbert, H Miles Prince, D A A Carney, David S. Ritchie, R. J. Hicks, John F. Seymour

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Abstract

Background:The usefulness of positron emission tomography with computed tomography (PET-CT) in the surveillance of patients with diffuse large B-cell lymphoma (DLBCL) in complete metabolic remission after primary therapy is not well studied.Methods:We performed a retrospective review of our database between 2002 and 2009 for patients with de novo DLBCL who underwent surveillance PET-CT after achieving complete metabolic response (CMR) following primary therapy.Results:Four-hundred and fifty scans were performed in 116 patients, with a median follow-up of 53 (range 8-133) months from completion of therapy. Thirteen patients (11%) relapsed: seven were suspected clinically and six were subclinical (all within first 18 months). The positive predictive value in patients with international prognostic index (IPI) <3 was 56% compared with 80% in patients with IPI≥3. Including indeterminate scans, PET-CT retained high sensitivity 95% and specificity 97% for relapse.Conclusion:Positron emission tomography with computed tomography is not useful in patients for the majority of patients with diffuse large B-cell lymphoma in CMR after primary therapy, with the possible exception of patients with baseline IPI ≥3 in the 18 months following completion of primary therapy. This issue could be addressed by a prospective clinical trial.

Original language	English
Pages (from-to)	312-317
Number of pages	6
Journal	British Journal of Cancer
Volume	109
Issue number	2
DOIs	https://doi.org/10.1038/bjc.2013.338
Publication status	Published - 23 Jul 2013
Externally published	Yes

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10.1038/bjc.2013.338

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Cheah, C. Y., Hofman, M. S., Dickinson, M., Wirth, A., Westerman, D., Harrison, S. J., Burbury, K., Wolf, M., Januszewicz, E. H., Herbert, K., Miles Prince, H., Carney, D. A. A., Ritchie, D. S., Hicks, R. J., & Seymour, J. F. (2013). Limited role for surveillance PET-CT scanning in patients with diffuse large B-cell lymphoma in complete metabolic remission following primary therapy. British Journal of Cancer, 109(2), 312-317. https://doi.org/10.1038/bjc.2013.338

@article{5ee441b957e849029392e48e9416445f,

title = "Limited role for surveillance PET-CT scanning in patients with diffuse large B-cell lymphoma in complete metabolic remission following primary therapy",

abstract = "Background:The usefulness of positron emission tomography with computed tomography (PET-CT) in the surveillance of patients with diffuse large B-cell lymphoma (DLBCL) in complete metabolic remission after primary therapy is not well studied.Methods:We performed a retrospective review of our database between 2002 and 2009 for patients with de novo DLBCL who underwent surveillance PET-CT after achieving complete metabolic response (CMR) following primary therapy.Results:Four-hundred and fifty scans were performed in 116 patients, with a median follow-up of 53 (range 8-133) months from completion of therapy. Thirteen patients (11%) relapsed: seven were suspected clinically and six were subclinical (all within first 18 months). The positive predictive value in patients with international prognostic index (IPI) <3 was 56% compared with 80% in patients with IPI≥3. Including indeterminate scans, PET-CT retained high sensitivity 95% and specificity 97% for relapse.Conclusion:Positron emission tomography with computed tomography is not useful in patients for the majority of patients with diffuse large B-cell lymphoma in CMR after primary therapy, with the possible exception of patients with baseline IPI ≥3 in the 18 months following completion of primary therapy. This issue could be addressed by a prospective clinical trial.",

keywords = "diffuse large B-cell lymphoma, follow-up, non-Hodgkin lymphoma, PET-CT, surveillance imaging, surveillance PET",

author = "Cheah, {C. Y.} and Hofman, {Michael S.} and M. Dickinson and A. Wirth and D Westerman and Harrison, {S. J.} and Kate Burbury and M. Wolf and Januszewicz, {Elchanan H} and K. Herbert and {Miles Prince}, H and Carney, {D A A} and Ritchie, {David S.} and Hicks, {R. J.} and Seymour, {John F.}",

year = "2013",

month = jul,

day = "23",

doi = "10.1038/bjc.2013.338",

language = "English",

volume = "109",

pages = "312--317",

journal = "British Journal of Cancer",

issn = "0007-0920",

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number = "2",

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Cheah, CY, Hofman, MS, Dickinson, M, Wirth, A, Westerman, D, Harrison, SJ, Burbury, K, Wolf, M, Januszewicz, EH, Herbert, K, Miles Prince, H, Carney, DAA, Ritchie, DS, Hicks, RJ & Seymour, JF 2013, 'Limited role for surveillance PET-CT scanning in patients with diffuse large B-cell lymphoma in complete metabolic remission following primary therapy', British Journal of Cancer, vol. 109, no. 2, pp. 312-317. https://doi.org/10.1038/bjc.2013.338

TY - JOUR

T1 - Limited role for surveillance PET-CT scanning in patients with diffuse large B-cell lymphoma in complete metabolic remission following primary therapy

AU - Cheah, C. Y.

AU - Hofman, Michael S.

AU - Dickinson, M.

AU - Wirth, A.

AU - Westerman, D

AU - Harrison, S. J.

AU - Burbury, Kate

AU - Wolf, M.

AU - Januszewicz, Elchanan H

AU - Herbert, K.

AU - Miles Prince, H

AU - Carney, D A A

AU - Ritchie, David S.

AU - Hicks, R. J.

AU - Seymour, John F.

PY - 2013/7/23

Y1 - 2013/7/23

N2 - Background:The usefulness of positron emission tomography with computed tomography (PET-CT) in the surveillance of patients with diffuse large B-cell lymphoma (DLBCL) in complete metabolic remission after primary therapy is not well studied.Methods:We performed a retrospective review of our database between 2002 and 2009 for patients with de novo DLBCL who underwent surveillance PET-CT after achieving complete metabolic response (CMR) following primary therapy.Results:Four-hundred and fifty scans were performed in 116 patients, with a median follow-up of 53 (range 8-133) months from completion of therapy. Thirteen patients (11%) relapsed: seven were suspected clinically and six were subclinical (all within first 18 months). The positive predictive value in patients with international prognostic index (IPI) <3 was 56% compared with 80% in patients with IPI≥3. Including indeterminate scans, PET-CT retained high sensitivity 95% and specificity 97% for relapse.Conclusion:Positron emission tomography with computed tomography is not useful in patients for the majority of patients with diffuse large B-cell lymphoma in CMR after primary therapy, with the possible exception of patients with baseline IPI ≥3 in the 18 months following completion of primary therapy. This issue could be addressed by a prospective clinical trial.

AB - Background:The usefulness of positron emission tomography with computed tomography (PET-CT) in the surveillance of patients with diffuse large B-cell lymphoma (DLBCL) in complete metabolic remission after primary therapy is not well studied.Methods:We performed a retrospective review of our database between 2002 and 2009 for patients with de novo DLBCL who underwent surveillance PET-CT after achieving complete metabolic response (CMR) following primary therapy.Results:Four-hundred and fifty scans were performed in 116 patients, with a median follow-up of 53 (range 8-133) months from completion of therapy. Thirteen patients (11%) relapsed: seven were suspected clinically and six were subclinical (all within first 18 months). The positive predictive value in patients with international prognostic index (IPI) <3 was 56% compared with 80% in patients with IPI≥3. Including indeterminate scans, PET-CT retained high sensitivity 95% and specificity 97% for relapse.Conclusion:Positron emission tomography with computed tomography is not useful in patients for the majority of patients with diffuse large B-cell lymphoma in CMR after primary therapy, with the possible exception of patients with baseline IPI ≥3 in the 18 months following completion of primary therapy. This issue could be addressed by a prospective clinical trial.

KW - diffuse large B-cell lymphoma

KW - follow-up

KW - non-Hodgkin lymphoma

KW - PET-CT

KW - surveillance imaging

KW - surveillance PET

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U2 - 10.1038/bjc.2013.338

DO - 10.1038/bjc.2013.338

M3 - Article

C2 - 23807169

AN - SCOPUS:84881115822

SN - 0007-0920

VL - 109

SP - 312

EP - 317

JO - British Journal of Cancer

JF - British Journal of Cancer

IS - 2

ER -

Limited role for surveillance PET-CT scanning in patients with diffuse large B-cell lymphoma in complete metabolic remission following primary therapy

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