Article Figures & Data
Figures
- Figure 1.
A and B, coronal sections of FLT-PET in a patient with aggressive lymphoma (patient 1). Intense focal FLT uptake in lymphoma manifestations of the axilla, the neck, the mediastinum, and the right groin. Arrows, lesions detected additionally to conventional staging procedures. C and D, corresponding sections of FDG-PET.
- Figure 2.
Mean SUV of FLT (FLT-SUV) in malignant lymphoma and reference segments in normal organs (21 patients) compared with respective uptake of the glucose analogue FDG (FDG-SUV).
- Figure 3.
Significantly higher FLT uptake was observed in aggressive compared with indolent lymphoma. A, FLT-PET (maximum intensity projection) of patient 2 with indolent lymphoma. Low FLT uptake in an enlarged spleen and in paraaortic, iliac, and inguinal bulky lesions (arrow). Physiologic intense FLT uptake in proliferating bone marrow and mild FLT uptake in the liver due to glucoronization of FLT. B, transaxial section of the inguinal region, low FLT uptake in lymphoma (arrow). C, anti-Ki-67 immunostaining (MIB-1) indicates low proliferation fraction of <5%. D, FLT-PET (maximum intensity projection) of patient 14 with aggressive lymphoma. Intense uptake of FLT in cervical, axillary, mediastinal, paraaortic, iliac, and inguinal lymph nodes (arrows). E, transaxial section of inguinal region shows intense FLT uptake in lymphoma (arrow). F, anti-Ki-67 immunostaining (MIB-1) indicates high proliferation fraction (immunoreactivity in 95% of nuclei).
- Figure 4.
A, intense FLT uptake in soft tissue manifestations of aggressive lymphoma and retromandibular lymph nodes (patient 22). Corresponding sections of CT (B), FDG-PET (C), and FDG-PET/CT image fusion (D) at 3-week follow-up show similar location sites of lymphoma. E, periventricular FLT uptake indicated cerebral lymphoma manifestation, which was confirmed by CT (F), FDG-PET (G), and FDG-PET/CT (H) at follow-up.
- Figure 5.
A, scattergram of mean FLT-SUV values in biopsied lesions obtained from indolent (11 patients) and aggressive lymphoma (21 patients). Patient 7 with initial diagnosis of indolent lymphoma and high FLT uptake (SUV = 4.5) was reclassified as high-grade lymphoma 3 weeks after PET imaging. Excluding that patient, a cutoff value of SUV = 3 discriminates between indolent and aggressive lymphoma. B, mean FDG-SUV values in biopsied lesions from indolent (8 patients) and aggressive lymphoma (11 patients). An overlap of FDG-SUV (1.4-5.8) was observed in indolent and aggressive lymphoma.
- Figure 6.
A, linear regression analysis shows a significant correlation between FLT uptake in biopsied lesions (mean FLT-SUV) and proliferative activity (Ki-67 index, MIB-1-positive nuclei per total number of nuclei). B, linear regression analysis of mean FDG-SUV and proliferative activity (Ki-67 index) was not statistically significant.
Tables
- Table 1.
Clinical characteristics, histopathology, and PET-findings in indolent and aggressive lymphoma
A. Correlation of histopathology, FLT/FDG uptake, and proliferation in indolent lymphoma Patient no. Histology Age Clinical stage Lesions FLT-PET Lesions routine staging Mean FLT-SUV Mean FDG-SUV Max FLT-SUV Max FDG-SUV Ki-67 index * 2 Follicular lymphoma grade I 60 IV A 79 79 2.1 6.3 3.6 10.2 4 5 Extramedullary plasmacytoma 67 I A 3 3 1.3 2.1 1.8 2.8 n/a 6 Lymphoplasmocytic lymphoma 44 IV A 8 3 2.1 1.4 3.7 1.8 n/a 7 Follicular lymphoma grade I 57 IV B Rel. 53 57 4.5 3.9 8.1 6.1 n/a 9 Follicular lymphoma grade II 70 IV A 5 5 2.9 n/a 4.6 n/a 50 15 Follicular lymphoma NOS 38 IV B Rel. 51 52 2.6 4.5 4.2 6.5 n/a 17 Follicular lymphoma grade I 53 III A 14 14 1.5 3.2 2.7 5.1 1 21 Follicular lymphoma grade I 48 II A E Rel. 3 2 2.7 3.1 4.2 3.9 5 25 Follicular lymphoma grade I 37 III B 29 15 2.8 n/a 5.1 n/a n/a 28 Follicular lymphoma grade I 53 II A 3 3 1.9 n/a 3.2 n/a 20 31 Extranodal marginal zone lymphoma (MALT type) 58 I E 1 1 1.2 3.2 1.3 3.9 1 B. Correlation of histopathology, FLT/FDG uptake, and proliferation in aggressive lymphoma 1 Diffuse large B-cell lymphoma 70 IV 33 13 5.5 3.1 10.3 4.7 80 3 Diffuse large B-cell lymphoma (anaplastic variant) 44 IV 1 1 4.1 6.6 5.6 10.5 80 8 Diffuse large B-cell lymphoma 64 IV B 6 6 4.8 3.6 5.3 5.5 80 10 Diffuse large B-cell lymphoma (mediastinum) 49 III B Rel. 3 2 4.7 n/a 6.6 n/a 85 11 Diffuse large B-cell lymphoma 43 IV B Rel. 5 5 3.2 3.1 5.6 4.0 n/a 12 Diffuse large B-cell lymphoma (anaplastic variant) 39 IV B 2 2 9.2 n/a 12.3 n/a n/a 13 Diffuse large B-cell lymphoma 53 III A Rel. 2 2 5.3 n/a 8.7 n/a 80 14 Diffuse large B-cell lymphoma 61 III E Rel. 33 25 5.8 n/a 10.4 n/a 95 16 Diffuse large B-cell lymphoma 56 IV B 11 3 5.7 2.0 9.7 3.2 48 18 Diffuse large B-cell lymphoma 46 I A E 1 1 4.4 5.2 5.9 7.8 n/a 19 Diffuse large B-cell lymphoma (centroblastic variant) 39 IV A E 4 3 8.5 15.9 17.0 21.2 n/a 20 Diffuse large B-cell lymphoma 35 IV B 3 5 3.7 13.2 5.2 22.5 n/a 22 Diffuse large B-cell lymphoma 66 II E B Rel. 59 54 4.8 8.5 8.7 13.8 100 23 Diffuse large B-cell lymphoma (anaplastic variant) 38 III B 17 10 5.8 6.2 9.5 8.3 90 24 Diffuse large B-cell lymphoma (T-cell rich variant) 58 IV B 6 6 6.4 n/a 10.9 n/a n/a 26 Diffuse large B-cell lymphoma (anaplastic variant) 38 I A 7 3 8.3 n/a 14.3 n/a 90 29 Diffuse large B-cell lymphoma 56 I E Rel. 1 1 3.5 n/a 3.7 n/a n/a 30 Diffuse large B-cell lymphoma (T-cell rich variant) 64 IV A E 9 8 3.4 n/a 3.7 n/a 80 32 Diffuse large B-cell lymphoma (anaplastic variant) 82 IV A 15 12 8.8 n/a 9.4 n/a 90 33 Diffuse large B-cell lymphoma (anaplastic variant) 50 I B 4 4 8.0 n/a 9.1 n/a 80 34 Diffuse large B-cell lymphoma (NOS) 63 IV E 12 12 5.2 2.1 6.0 2.4 n/a -
Abbreviations: Max, maximum; Rel., relapse.
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↵* Number of Ki-67-labeled nuclei per total number of nuclei.
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Volume 66, Issue 22
