Clinical characteristics of aggressive Non-Hodgkin lymphoma with emphasis on the role of positron emission tomography/computed tomography in assessment of treatment response: a retrospective study
Purpose: The purpose of this study was to evaluate the role of post-treatment Positron Emission Tomography/Computed Tomography (PET/CT) in aggressive non-Hodgkin’s lymphoma (NHL) with regard to the clinical and treatment characteristics and disease-free survival (DFS).
Methods: We retrospectively studied charts of 30 patients with aggressive NHL who had PET/CT only after completion of treatment.
Results: Thirty patients received CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) or Rituximab (R)-CHOP (22 and 8 patients respectively), followed by radiotherapy in 19/30 patients (63.3%). Following 3-4 cycles of chemotherapy, interim CT showed regressive, stationary and progressive disease in 18, 10, 2 (60%, 33.3%, 2%) patients respectively. PET/CT was performed 4-6 weeks after end of treatment. 22/30 (73.3%) patients had negative scan, of whom 13 (59.1%) patients remained in remission till the end of the study while 9 patients relapsed after a median DFS of 12 months. PET/CT was positive in 8/30 (26.7%) patients who had refractory disease. PET/ CT scan had sensitivity of 75%, specificity of 72.7%, negative predictive value (NPV) of 88.9%, and positive predictive value (PPV) of 50%.
Conclusion: PET/CT has an important role in end- of- therapy response evaluation in fluorodeoxyglucose (FDG)-avid aggressive NHL. It proves high sensitivity and specificity in detection of residual disease and provides an accurate indication of overall survival and disease-free survival. CT continues to have an important role in post-treatment response assessment whether as a single modality or in combination with PET scan.
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