Lymphoma Case 02


Clinical History
55-year-old male patient with left flank pain presented to the emergency room, and was dismissed. The patient re-presented to his primary care physician one week later.

Imaging Findings
INITIAL NUCLEAR MEDICINE PET/CT
BLOOD GLUCOSE: 87 mg/dL
INITIAL PET/CT FINDINGS: There were multiple and extensive areas of soft tissue and bony metastases seen throughout the neck, chest, abdomen and pelvis.



FOLLOW-UP NUCLEAR MEDICINE PET/CT * (one month later)
BLOOD GLUCOSE: 89 mg/dL
FOLLOW-UP PET/CT FINDINGS: Compared to the previous examination there was near complete resolution of the previously noted areas of abnormal uptake of the radiopharmaceutical with only minimal uptake which persisted in the retroperitoneal and mesenteric mass. These findings suggested good response to therapy.

Discussion
There was near complete resolution of the previous areas of abnormal radiopharmaceutical uptake just one month after treatment started. Some evidence suggests that having no residual radiopharmaceutical uptake early in the course of treatment is a good prognostic indicator. In most cases, if patients had any remaining areas, even if there was a substantial reduction in the SUV value, there was a significantly higher rate of recurrence and shortened disease free interval.

Data courtesy of Dr. Todd Blodgett, University of Pittsburgh Medical Center, Pittsburgh, PA, USA

Reference: Spaepen K, Stroobants S, Verhoef G, Mortelmans L. Positron emission tomography with [(18)F]FDG for therapy response monitoring in lymphoma patients. Eur J Nucl Med Mol Imaging 2003;30 Suppl 1:S97-105.

* Any of the protocols presented herein are for informational purposes and are not meant to substitute for clinician judgment in how best to use any medical devices. It is the clinician that makes all diagnostic determinations based upon education, learning and experience.